Arnuity Ellipta is a prescription inhaler used to prevent asthma symptoms. It contains fluticasone furoate, a corticosteroid that reduces inflammation in the airways, and it’s taken as one puff once a day. Unlike rescue inhalers that treat symptoms in the moment, Arnuity Ellipta is a maintenance medication designed for daily use to keep asthma under control over time.
How Arnuity Ellipta Works
Asthma involves chronic inflammation in the airways. Even when you feel fine, the lining of your airways can be swollen and reactive, making them more likely to tighten up in response to triggers like allergens, cold air, or exercise. Arnuity Ellipta delivers a corticosteroid directly to the lungs, where it calms this underlying inflammation.
Corticosteroids work by acting on the immune cells responsible for the inflammatory response, including the cells that release histamine and other chemicals that cause swelling and mucus production. By dialing down this activity day after day, the medication makes your airways less reactive and reduces the frequency and severity of asthma flare-ups. This fits squarely with current international asthma guidelines, which recommend that all adults and adolescents with asthma use an inhaled corticosteroid rather than relying on a rescue inhaler alone.
One thing to understand clearly: Arnuity Ellipta does not provide quick relief during an asthma attack. You still need a separate rescue inhaler for sudden symptoms. Arnuity Ellipta is the daily background treatment that makes those emergencies less likely.
Available Strengths and Dosing
Arnuity Ellipta comes in three strengths: 50, 100, and 200 micrograms of fluticasone furoate per dose. Your prescribed strength depends on how severe your asthma is and how well it’s currently controlled. The dosing schedule is the same across all strengths: one inhalation, once a day, at the same time each day. You should never take more than one puff in a 24-hour period.
The once-daily dosing is a practical advantage. Older fluticasone inhalers, like Flovent HFA, typically require twice-daily use. Arnuity Ellipta uses a dry powder formulation rather than the pressurized aerosol spray found in metered-dose inhalers, which some people find easier to coordinate with their breathing.
How to Use the Ellipta Inhaler
The Ellipta device is relatively straightforward. Hold the inhaler upright without shaking it, then slide the cover down until you hear a click. That click means a dose is loaded and ready. Before inhaling, breathe out fully, but do so away from the device. Never breathe into the mouthpiece.
Place the curved mouthpiece between your teeth, close your lips tightly around it, and breathe in deeply through your mouth. Be careful not to block the small air vents on the sides of the mouthpiece. After inhaling, remove the device, hold your breath for up to five seconds, then breathe out slowly. Close the cover by sliding it back up over the mouthpiece.
The inhaler has a built-in dose counter so you always know how many doses remain. When the counter reads zero, the inhaler is empty and needs to be replaced. After each use, rinse your mouth with water and spit it out. This step is important for preventing side effects in your mouth and throat.
What Clinical Trials Showed
In clinical trials submitted to the FDA, patients using Arnuity Ellipta showed significant improvements in lung function compared to placebo over 12 weeks. Researchers measured peak expiratory flow (how forcefully a person can breathe out), and all tested doses produced meaningful gains. Patients also showed increases in a standard lung function test called FEV1, which measures how much air you can push out in one second. These improvements appeared within the first week and were sustained through the study period.
Common Side Effects
Because the medication is a corticosteroid delivered to the mouth and throat, the most well-known side effect is oral thrush, a yeast infection that can develop in the mouth. This is why rinsing your mouth after each dose matters. Other common side effects of inhaled corticosteroids in this class include headache, sore throat, and upper respiratory infections like colds.
Long-term use at higher doses can occasionally lead to more systemic effects. In rare cases, particularly at doses above what’s recommended or over prolonged periods, the medication can suppress the body’s natural production of cortisol, a hormone your adrenal glands make. This is uncommon at standard inhaled doses but is something to be aware of. If you’re switching to Arnuity Ellipta from an oral corticosteroid like prednisone, the transition needs to happen gradually so your adrenal glands have time to resume normal function.
Drug Interactions to Know About
Fluticasone furoate is broken down in the body by a specific liver enzyme. Certain medications block that enzyme, which causes more of the corticosteroid to accumulate in your bloodstream. This raises the risk of side effects that you’d normally only see with oral steroids.
The most notable culprits are strong antifungal medications like ketoconazole and itraconazole, along with certain HIV medications like ritonavir and lopinavir. Some antibiotics, including clarithromycin, also fall into this category. In studies, taking ketoconazole alongside fluticasone furoate increased the body’s exposure to the steroid by 36% and reduced natural cortisol levels by 27%. If you take any of these medications, your prescriber needs to weigh the risks carefully.
How It Compares to Older Fluticasone Inhalers
If you’ve used Flovent HFA in the past, the main differences are frequency and delivery method. Flovent HFA is a pressurized aerosol that typically requires two puffs twice daily. Arnuity Ellipta is a dry powder inhaler that requires just one puff once daily. The active ingredients are also slightly different: Arnuity uses fluticasone furoate, while Flovent uses fluticasone propionate. Both are corticosteroids, but fluticasone furoate binds more strongly to the receptor involved in reducing inflammation, which is part of why the once-daily dosing is effective.
The dry powder format also eliminates the need to coordinate pressing a canister and breathing in at the same time, a step that trips up many people using traditional metered-dose inhalers. With the Ellipta, you simply open the cover, breathe in, and close it.