What is the difference between Breo and albuterol?
- Breo Ellipta (fluticasone furoate and vilanterol inhalation powder) and albuterol sulfate are both used to treat asthma and chronic obstructive pulmonary disease (COPD).
- Breo Ellipta is a combination of fluticasone, a glucocorticoid, and vilanterol, a bronchodilator of the beta-2 agonist type. Albuterol is a bronchodilator.
- Brand names of albuterol include ProAir HFA, Proventil HFA, ProAir RespiClick, and Ventolin HFA.
- Side effects of Breo Ellipta and albuterol that are similar include headache, cold symptoms, and bronchospasms (wheezing).
- Side effects of Breo Ellipta that are different from albuterol include upper respiratory tract infections and oral candidiasis or thrush (a fungal infection).
- Side effects of albuterol that are different from Breo Ellipta include migraine headaches, nausea, stomach upset, flu-like symptoms, ear infections, bronchitis, cough, allergic reactions (rash, hives, itching), nervousness, tremor, increased sputum and shortness of breath.
What are Breo and albuterol?
Breo Ellipta (fluticasone furoate and vilanterol inhalation powder) is used for treating chronic obstructive pulmonary disease (COPD). Fluticasone is a steroid of the glucocorticoid class. Glucocorticoids have potent anti-inflammatory actions. Vilanterol is a bronchodilator of the beta-2 agonist type. Beta-2 agonists are medications that stimulate beta-2 receptors on the smooth muscle cells that surround the airways, causing these muscle cells to relax and thereby opening the airways. Breo Ellipta opens the airways and increases air supply to the lungs of COPD patients.
Albuterol sulfate dilates the airways of the lung and is used for treating asthma and other conditions of the lung. Albuterol sulfate dilates bronchial airways by relaxing the muscles that surround the airways. Albuterol also can be helpful in patients with emphysema and chronic bronchitis when symptoms are partially related to spasm of the airways' muscles.
What are the side effects of Breo and albuterol?
The most common side effects of Breo Ellipta are:
- upper respiratory tract infections,
- cold symptoms, and
- oral candidiasis or thrush (a fungal infection).
Breo Ellipta also may cause bronchospasms (wheezing). Bronchospasm should be treated with a rescue inhaler.
High doses of inhaled fluticasone may decrease formation and increase breakdown of bone thereby weakening bones and promoting fractures. Higher doses of fluticasone also may cause suppression of the body's ability to make its own natural glucocorticoid in the adrenal gland. People with suppression of their own adrenal glands (which can be diagnosed by a doctor) would need increased amounts of glucocorticoids, probably by the oral or intravenous route, during periods of high physical stress when glucocorticoids are particularly important.
Allergic reactions, including swelling of face, throat and tongue, rash, hives, and breathing problems may occur. Use of long acting drugs like vilanterol may increase the risk of asthma-related death. Breo Ellipta should not be used for treatment of asthma.
Other important side effects of Vilanterol include:
Common side effects include:
- Migraine headaches
- Non-migraine headaches
- stomach upset
- flu-like symptoms
- cold symptoms
- ear infections (otitis media)
Other side effects include:
- allergic reactions (rash, hives, itching)
- increased sputum
- shortness of breath
Possible serious side effects include:
- bronchospasm (worsening of asthma)
- serious allergic reactions (anaphylaxis)
- worsening of diabetes
- low potassium
- abnormal heart rhythm (palpitations)
- fast heart rate
- elevated blood pressure
- chest pain
What is the dosage for Breo vs. albuterol?
- The recommended dose is one inhalation once daily by mouth. Following administration, the mouth should be rinsed thoroughly with water without swallowing to reduce risk of fungal infections.
- A jet nebulizer connected to an air compressor equipped with a mouthpiece or face mask is used to administer albuterol sulphate solution.
- The recommended starting dose for patients 2 to 12 years of age is 0.63, 1.25, or 2.5 mg given by nebulization 3 or 4 times daily, as needed. More frequent administration is not recommended.
- Children 6 to 12 years of age with more severe asthma may achieve a better initial response with the 1.25 or 2.5 mg dose.
- The entire contents of one vial should be placed in the nebulizer and the flow rate should be adjusted to deliver albuterol sulphate over 5 to 15 minutes.
What drugs interact with Breo and albuterol?
- Ritonavir (Norvir), atazanavir (Reyataz), clarithromycin (Biaxin), indinavir (Crixivan), itraconazole (Sporanox), ketoconazole, nelfinavir (Viracept), and telithromycin (Ketek) may increase levels of fluticasone and vilanterol in the body by reducing the breakdown of fluticasone and vilanterol by liver enzymes. This may increase side effects of Breo Ellipta.
- Beta blockers (for example, atenolol [Tenormin]) can block the effects of vilanterol and cause bronchospam in patients with COPD.
- Combining or using Breo Ellipta within two weeks of stopping monoamine oxidase inhibitors (for example, phenelzine), tricyclic antidepressants (for example, amitriptyline [Endep, Elavil]), or other drugs that affect heart rate and rhythm, may increase risk of heart-related side effects.
- Tricyclic antidepressants, for example, amitriptyline (Elavil, Endep), and monoamine oxidase inhibitors (MAOIs), for example, tranylcypromine, should not be combined with albuterol sulfate because of their additive effects on the vascular system (increased blood pressure, heart rate, etc.). A period of two weeks should elapse between treatment with albuterol sulphate and tricyclic antidepressants or monoamine oxidase inhibitors.
- Use of albuterol sulphate with other stimulant medications is discouraged because of their combined effects on heart rate, blood pressure, and the potential for causing chest pain in patients with underlying coronary heart disease.
- Beta-blockers, for example, propranolol (Inderal, Inderal LA), block the effect of albuterol sulphate and may induce bronchospasm in asthmatics.
- Albuterol sulphate may cause hypokalemia (low potassium). Therefore, combining albuterol sulphate with loop diuretics, for example, furosemide (Lasix) may increase the likelihood of hypokalemia.
Are Breo and albuterol safe to take while pregnant or breastfeeding?
- It is not known if fluticasone or vilanterol are secreted in breast milk. Other medications in the same class as fluticasone or vilanterol are secreted into breast milk.
- Albuterol sulphate inhalation solution is used for treating children.
- There are no adequate studies of albuterol sulphate use during pregnancy. Some reports indicate that albuterol sulphate may cause congenital defects when used during pregnancy.
- It's not known whether albuterol sulphate is excreted in breast milk.