Vilanterol Trifenatate + Fluticasone Furoate + Umeclidinium Bromide: Brands, Price & Uses in Bangladesh

Vilanterol Trifenatate + Fluticasone Furoate + Umeclidinium Bromide is a fixed-dose combination inhaler containing a long-acting beta2-agonist (LABA), an inhaled corticosteroid (ICS), and a long-acting muscarinic antagonist (LAMA), indicated for the following FDA-approved uses:

Established / FDA-approved indications

• Chronic Obstructive Pulmonary Disease (COPD): long-term, once-daily maintenance treatment of airflow obstruction in patients with COPD, including chronic bronchitis and/or emphysema, and to reduce exacerbations in patients with a history of exacerbations despite appropriate maintenance therapy.
• Asthma: maintenance treatment of asthma in patients aged 18 years and older whose disease is not adequately controlled on an inhaled corticosteroid combined with a long-acting beta2-agonist, or whose disease severity warrants initiation of triple maintenance therapy.

Not indicated for

• Relief of acute bronchospasm or as a rescue inhaler.
• Primary treatment of status asthmaticus or acute, life-threatening episodes of COPD or asthma requiring intensive measures.
• Use in asthma or COPD patients under 18 years of age (safety and efficacy not established).

Vilanterol Trifenatate + Fluticasone Furoate + Umeclidinium Bromide must always be used together with a separate short-acting bronchodilator ("reliever") for sudden symptoms, as it is not a rescue medicine.

Route and technique

Vilanterol Trifenatate + Fluticasone Furoate + Umeclidinium Bromide is for oral inhalation only, using the supplied multi-dose dry powder inhaler. One inhalation delivers the full labeled dose. Do not use with a spacer device. After inhaling, the patient should rinse the mouth with water and spit it out without swallowing, to reduce the risk of oral candidiasis.

Dosing by indication

Missed dose

If a dose is missed, the next dose should be taken at the usual scheduled time; do not double the dose.

Renal and hepatic impairment

No dosage adjustment is required for renal impairment. No dosage adjustment is required for mild-to-moderate hepatic impairment; use with caution in moderate-to-severe hepatic impairment (see Precautions).

Reported adverse effects of Vilanterol Trifenatate + Fluticasone Furoate + Umeclidinium Bromide include:

Common

• Nasopharyngitis / upper respiratory tract infection
• Headache
• Oral or oropharyngeal candidiasis (oral thrush)
• Cough, dysphonia (hoarseness)
• Back pain, arthralgia
• Pharyngitis, sinusitis, bronchitis, influenza
• Diarrhea, constipation
• Urinary tract infection

Less common but notable

• Pneumonia — a well-recognized risk with inhaled corticosteroid use in COPD patients; report new or worsening fever, chills, increased sputum/cough, or worsening breathlessness promptly.
• Cardiovascular effects from the LABA component — palpitations, tachycardia, and rarely arrhythmias or ECG changes.
• Anticholinergic effects from the LAMA component — dry mouth, urinary retention, blurred vision.
• Hyperglycemia, hypokalemia (usually transient).

Rare / postmarketing

• Hypersensitivity reactions including anaphylaxis, angioedema, rash, urticaria.
• Blurred vision, eye pain, glaucoma, raised intraocular pressure.
• Tremor, anxiety, muscle spasms.