Breo Ellipta is a once-daily inhaler prescribed for the long-term maintenance treatment of two chronic lung conditions: COPD (chronic obstructive pulmonary disease) and asthma in patients aged 5 and older. It combines two active ingredients, an inhaled corticosteroid that reduces airway inflammation and a long-acting bronchodilator that relaxes the muscles around the airways, making it easier to breathe over time.
Breo Ellipta is not a rescue inhaler. It will not relieve sudden breathing problems, and you should always keep a separate rescue inhaler on hand for acute symptoms.
How the Two Ingredients Work Together
Each dose of Breo Ellipta delivers two medications at once. The first is an inhaled corticosteroid (fluticasone furoate) that calms inflammation in the airways. It works by suppressing the immune cells and chemical signals that drive swelling, mucus production, and airway narrowing. Over days to weeks of consistent use, this reduces the chronic inflammation that makes breathing difficult.
The second ingredient is a long-acting bronchodilator (vilanterol). It triggers receptors on the smooth muscle lining your airways, causing those muscles to relax and the airways to widen. The effect lasts roughly 24 hours, which is why you only need one inhalation per day. Together, the anti-inflammatory and bronchodilator components address different parts of the problem: one quiets the underlying inflammation, while the other physically opens the airways.
COPD vs. Asthma: Which Strength Is Used
Breo Ellipta comes in two strengths, and which one you use depends on the condition being treated. For COPD, only the lower strength (100/25) is indicated. One inhalation once daily is both the starting and maximum dose.
For asthma, your doctor may start you on either the 100/25 or 200/25 strength, depending on how well controlled your symptoms are. The higher strength (200/25) is the maximum dose for asthma. In both cases, the goal is to find the lowest effective dose that keeps symptoms under control. Breo Ellipta has been approved for asthma in children as young as 5, though safety data for children under 5 has not been established.
What Breo Ellipta Does Not Do
Because both ingredients take time to work, Breo Ellipta is strictly a maintenance medication. It is designed for daily use to prevent symptoms and reduce flare-ups, not to stop an attack that’s already happening. If you experience sudden shortness of breath or wheezing, you need a fast-acting rescue inhaler. Taking extra doses of Breo Ellipta during an acute episode will not help and is not recommended.
How to Use the Ellipta Inhaler
The Ellipta device is simpler than many older inhalers. You do not need to shake it or coordinate pressing a canister while breathing in. Here’s how it works:
- Check the dose counter. If it reads zero, the inhaler is empty and needs to be replaced.
- Open the cover. Hold the inhaler upright and slide the cover down until you hear a click. This loads a single dose automatically.
- Breathe out fully, away from the device. Never exhale into the mouthpiece.
- Inhale the dose. Tilt your head back slightly, place the mouthpiece between your teeth, seal your lips around it, and take a steady, deep breath in.
- Close the cover by sliding it back up over the mouthpiece.
- Rinse your mouth with water and spit it out. This step helps prevent irritation and fungal infections in the mouth and throat.
Use it at the same time every day. Store the inhaler in a cool, dry place. If you’re unsure whether you’re using the device correctly, a pharmacist can walk you through the technique in person.
Common Side Effects
The most frequently reported side effects include headache, upper respiratory tract infection (essentially cold-like symptoms), and throat irritation. Rinsing your mouth after each dose helps reduce the risk of oral thrush, a yeast infection that can develop when inhaled corticosteroids settle in the mouth and throat.
One concern that has received significant attention is pneumonia risk in people with COPD. Inhaled corticosteroids as a class are associated with a higher rate of pneumonia in COPD patients, and the risk tends to increase with more severe airflow limitation. A large clinical trial called SUMMIT looked at this specifically in COPD patients with moderate airflow limitation and found that pneumonia rates were similar across groups receiving the combination inhaler, the corticosteroid alone, and placebo (roughly 4 to 5 events per 100 patient-years of treatment). Factors that raised pneumonia risk included more severe airway obstruction, a history of previous flare-ups, and a BMI below 25. In patients with moderate COPD, the added pneumonia risk from the corticosteroid component was not clearly evident.
Why Daily Use Matters
Maintenance inhalers only work when used consistently. Skipping doses or stopping because you feel better can allow inflammation to build back up and increase the chance of a flare-up. Many people notice improved breathing within the first few days, but the full anti-inflammatory benefit develops over weeks of regular use. If your symptoms don’t improve or get worse, that’s worth discussing with your prescriber, as it may mean the dose or treatment plan needs adjusting rather than that the medication isn’t right for you.