Trelegy Ellipta 92 micrograms/55 micrograms/22 micrograms is a dry powder inhaler. Every inhalation provides a delivered dose (the dose leaving the mouthpiece) of 92 micrograms fluticasone furoate, 65 micrograms umeclidinium bromide equivalent to 55 micrograms umeclidinium and 22 micrograms vilanterol. This equates to a pre-dispensed dose of 100 micrograms fluticasone furoate, 74.2 micrograms umeclidinium bromide equivalent to 62.5 micrograms umeclidinium and 25 micrograms vilanterol.
Mechanism of action
Fluticasone furoate/umeclidinium/vilanterol is a combination of inhaled synthetic corticosteroid, long-acting muscarinic receptor antagonist and a long-acting beta2-adrenergic agonist.
Fluticasone furoate is a corticosteroid with potent anti-inflammatory activity. The mechanism through which fluticasone furoate affects COPD symptoms is unknown. Corticosteroids have been shown to have a wide range of actions on multiple cell types. For example;
- Mediators involved in inflammation.
Umeclidinium is a long-acting muscarinic receptor antagonist. Umeclidinium delivers its bronchodilatory activity through the process of competitively inhibiting the binding of acetylcholine with muscarinic receptors on airway smooth muscle.
Vilanterol is a selective long-acting, beta2-adrenergic receptor agonist. The pharmacologic effects of beta2-adrenergic agonists, including vilanterol, are at least in part attributable to stimulation of intracellular adenylate cyclase, the enzyme that catalyses the conversion of adenosine triphosphate (ATP) to cyclic-3′,5′-adenosine monophosphate (cyclic AMP). Increased cyclic AMP levels cause relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from cells, especially from mast cells.