Fluticasone Furoate

Arnuity Ellipta 

Arnuity Ellipta is an FDA-approved inhalation powder containing fluticasone furoate, used to manage and prevent asthma symptoms. Available in dosages of 50 mcg, 100 mcg, and 200 mcg, it’s designed for daily use to reduce airway inflammation and improve breathing. Suitable for adults, adolescents, and children over five, depending on the dosage. Common side effects include headaches and respiratory infections. It is important to rinse the mouth post-use to prevent oral thrush. Store Arnuity Ellipta at room temperature and use it within 6 weeks of opening. Consult a healthcare provider for potential interactions, especially if allergic to milk proteins or taking specific medications.

Product Overview

Arnuity Ellipta is a maintenance inhalation therapy containing fluticasone furoate, a corticosteroid that helps manage and prevent asthma symptoms. Approved by the FDA, Arnuity Ellipta is designed to decrease inflammation and irritation in the lungs and airways, thus improving breathing in individuals with asthma. Regular use of this medication can prevent the recurrences and severity of asthma attacks, but it is not meant for the immediate relief of acute symptoms.

Available in strengths of 50 mcg, 100 mcg, and 200 mcg per actuation, Arnuity Ellipta is formulated as a powder for inhalation. It should be administered once daily, preferably in the morning. The inhaler is suited for adults and adolescents aged 12 and older, and children aged 5 to 11, depending on the strength. The medication works by inhibiting certain cells and chemicals in the immune system that contribute to inflammation and asthma symptoms.

Potential side effects include headaches, respiratory infections, and bronchitis. Severe side effects may include allergic reactions, eye problems, and worsening tuberculosis or infections. Patients are suggested to rinse their mouths after use to prevent oral thrush, a common side effect. If a missed dose, it should be skipped, and the next dose should be taken regularly. An overdose is not typically life-threatening, but monitoring is recommended. Arnuity Ellipta should be stored at a normal or room temperature, away from moisture and direct sunlight, and used within 6 weeks of opening. It is important to discuss all potential drug interactions and contraindications with a healthcare provider, particularly for those with severe milk protein allergies or those taking strong CYP3A4 inhibitors.

Uses of Arnuity Ellipta 

• Treats Asthma

How to Use an Arnuity Ellipta?

Dosage

Form: powder for inhalation

Strength:

• 100 mcg/actuation
• 200 mcg/actuation

Recommended Dosage for Different Patients

Adults and Adolescents (12 years and older)

• The typical starting dose is 100 mcg inhaled once daily.
• Some patients may start at or be adjusted to a higher dose of 200 mcg once daily based on their asthma control and previous asthma therapy.

Children (5 to 11 years old)

• The recommended dose is 50 mcg inhaled once daily.

[Note: Remember these recommendations may vary depending on person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Take It?

• Take Arnuity Ellipta once a day, preferably in the morning.
• Use it at least one hour before or two to three hours after food.
• Slide the cover down to reveal the mouthpiece (you should hear a click).
• Each time you slide the cover down, a dose is loaded. You’ll lose the dose if you open and close the cover without inhaling the medicine.
• While holding the inhaler at a distance from your mouth, breathe out fully.
• Put the mouthpiece between your lips and close your lips gently around it. Your lips should fit over the curved shape of the inhaler mouthpiece.
• Avoid blocking the mouthpiece with your teeth or tongue.
• Take one long, steady, deep breath in your mouth (do not inhale through your nose).
• Remove the inhaler from your mouth and hold the inhaled breath for 3 to 4 seconds.
• Breathe out slowly and gently.
• Slide the cover-up over the mouthpiece.
• If your doctor has prescribed more than one dose, wait 30 seconds and repeat the steps.
• You may not taste, feel, or smell the dry powder when using your inhaler, but you’ll get the full dose of medication.

[Note: Your doctor will decide the correct amount for you based on your health condition, following guidelines and studies on the drug. They’ll adjust the dosage as needed over time.]

How Does Arnuity Ellipta Work?

Arnuity Ellipta comprises the active ingredient fluticasone furoate, a corticosteroid that helps manage asthma by reducing inflammation within the airways. When inhaled, it works directly in the lungs to inhibit the release of substances that trigger allergic and inflammatory responses. This action decreases swelling, irritation, and mucus production in the airways, improving breathing and fewer asthma symptoms. Arnuity Ellipta is designed for regular use to provide consistent, long-term asthma control and is not intended for immediate relief of acute symptoms. Regular administration helps maintain stable drug levels in the lungs, enhancing overall asthma management.

Important Safety Information

Side Effects

Common Side Effects

• Headache
• Upper respiratory tract infection or inflammation
• Throat irritation
• Oral candidiasis (white patches in the mouth and throat)
• Nausea and vomiting

Serious Side Effects

• Fungal infection in mouth or throat (thrush).
• Weak immune system and
• increased chance of getting infections (immunosuppression).

[Note: Remember, this list may not include all possible side effects of this medication. Always consult with your healthcare expert for medical advice about drug side effects.]

Warnings

• Milk Allergy: This medication may contain lactose, which could trigger a reaction in individuals with severe milk allergies. Contact emergency services or your healthcare provider immediately if you experience a severe rash, itching, swelling, or difficulty breathing.
• Fungal Infections of the Mouth and Throat: Arnuity Ellipta can lead to a fungal infection known as thrush in the mouth or throat. To prevent this, rinse your mouth, gargle with water, and spit it out after each use. Inform your healthcare provider if you observe white patches inside your mouth or throat or have difficulty swallowing.
• Vision Changes: Long-term use of Arnuity Ellipta can increase eye pressure, exacerbate glaucoma, and contribute to the development of cataracts. If you notice any changes in vision, such as blurry vision or eye discomfort, consult your healthcare provider promptly.
• Sudden-Onset Breathing Problems: Although rare, some individuals may experience breathing difficulties immediately after using Arnuity Ellipta (fluticasone). In such cases, your healthcare provider will administer a fast-acting rescue inhaler, like albuterol, and may advise discontinuing Arnuity Ellipta. Discuss alternative asthma treatments with your healthcare provider.

Precautions

• Arnuity Ellipta should not be used if you are allergic to fluticasone or milk proteins. It is not intended for the immediate relief of an asthma attack.
• Before using Arnuity Ellipta, inform your doctor if you have a history of:
  • Any infection (bacterial, viral, or fungal);
  • Glaucoma or cataracts;
  • Parasitic infections (such as giardia, malaria, leishmaniasis);
  • Tuberculosis;
  • Herpes infection of the eyes;
  • Liver disease;
  • Low bone mineral density;
  • A weakened immune system.
• Long-term steroid use may lead to osteoporosis, particularly if you smoke, lack physical activity, or have insufficient vitamin D or calcium intake, or a family history of osteoporosis. Discuss your risks with your doctor.
• Consult your doctor if you are pregnant. The effects of fluticasone on an unborn baby are unknown, but untreated asthma can result in complications such as low birth weight of the baby or premature birth.
• Breastfeeding while using fluticasone inhalation may not be safe. Discuss the risks with your doctor.
• Arnuity Ellipta is not recommended for children under 5 years old.

Contraindications

Allergy to Fluticasone or Milk Proteins

• Do not use Arnuity Ellipta if you have a known allergy to fluticasone or any milk proteins, as the formulation may contain lactose, which can include these proteins.

Status Asthmaticus or Acute Bronchospasm

• Arnuity Ellipta is not designed to relieve acute bronchospasm or during an episode of status asthmaticus. It should not be used as a rescue inhaler for sudden breathing problems.

Children Under the Age of 5

• Arnuity Ellipta is not approved for use in children younger than 5 years old because of the lack of data on safety and efficacy in this age group.

Missed Dose

If you miss a dose of Arnuity Ellipta, skip it and take the next dose at your regularly scheduled time. Avoid taking an extra dose of this medication to compensate for the missed dose. You should not use more than one inhalation per day.

[Note: If you have missed a dose of this medication and are not sure when to take another dose, immediately consult your doctor or pharmacist.]

Overdose

An overdose of fluticasone is unlikely to cause life-threatening symptoms. However, prolonged use of inhaled steroids can lead to several side effects, including glaucoma, cataracts, thinning skin, and changes in body fat distribution, such as increased fat in your face, neck, back, and waist. Other potential side effects include increased acne or facial hair, menstrual irregularities, impotence, or a decreased sex drive.

[Note: If you consumed more than the suggested dose, seek medical help immediately or call the Poison Help line at 1-800-222-1222.]

Storage

• Store Arnuity Ellipta in a cool and dry place at room temperature, ideally anywhere between 68°F and 77°F.
• Keep it away from heat and direct sunlight.
• Keep the inhaler unopened until ready to use.
• Dispose of Arnuity Ellipta safely 6 weeks after opening or when the counter reads “zero,” whichever comes first.

[Note: Discuss with your healthcare expert about the proper disposal of unused or expired medication and any questions you may have regarding the storage of the medicine.]

Arnuity Ellipta Interactions

• Strong CYP3A4 Inhibitors: Medications that inhibit CYP3A4 enzymes can increase the levels of fluticasone in the blood, potentially leading to more side effects. Examples include ketoconazole, itraconazole, and ritonavir.
• Other Corticosteroids: Using Arnuity Ellipta with other corticosteroids (either systemic or topical) can increase the risk of systemic corticosteroid side effects.
• Ritonavir and Other HIV Protease Inhibitors: These can substantially increase the concentration of fluticasone in the blood, increasing the risk of systemic corticosteroid effects.
• Certain Antibiotics: Some antibiotics, like clarithromycin, can also inhibit CYP3A4, leading to higher systemic levels of fluticasone.
• Antifungal Agents: Antifungal medications such as ketoconazole can increase plasma fluticasone levels, enhancing its effects and side effects.

[Note: This is not a complete list, and there could be other drugs that can interact with Arnuity Ellipta. Make sure to inform your respective doctor about any prescription, over-the-counter medicines, or herbal products you’re taking.]

Arnuity Ellipta Alternatives

• Flovent HFA (fluticasone propionate)
• Asmanex Twisthaler (mometasone furoate)
• Qvar RediHaler (beclomethasone dipropionate)
• Pulmicort Flexhaler (budesonide)
• Alvesco (ciclesonide)
• Symbicort (budesonide/formoterol fumarate dihydrate)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

Can I use Arnuity Ellipta and albuterol together?

Yes, you can use Arnuity Ellipta in conjunction with an albuterol inhaler, but they should not be used frequently at the same time. Albuterol is normally used as a rescue inhaler for quick relief. Regular reliance on albuterol while using Arnuity Ellipta may indicate poorly controlled asthma, which can increase the risk of cardiovascular side effects. If you notice an increased need for your albuterol inhaler, it is important to consult your healthcare provider.

Does Arnuity Ellipta weaken the immune system because it contains a steroid?

Yes, Arnuity Ellipta contains fluticasone, a steroid type that can weaken the immune system. However, because the steroid is inhaled, its effects are generally localized to the mouth and respiratory tract, limiting broader systemic side effects. Nonetheless, long-term use of high doses of inhaled steroids may result in side effects similar to those seen with oral steroids. It’s important to discuss with your healthcare provider whether Arnuity Ellipta is appropriate for your health needs.

How fast does Arnuity Ellipta start to work?

Arnuity Ellipta is designed for long-term asthma management and is not intended for immediate relief like a rescue inhaler such as albuterol. It functions by gradually reducing inflammation and swelling in the airways. It may take up to two weeks to experience the full benefits of the medication.

Why is it necessary to rinse my mouth after using Arnuity Ellipta?

Rinsing your mouth after using Arnuity Ellipta (fluticasone), which is an inhaled steroid, is important because it helps prevent oral thrush (oral candidiasis). Oral thrush is a fungal infection that can occur in the mouth due to the medication deposited in your oral cavity. Rinsing with water after each use helps remove any residual medication, reducing the risk of this infection.

Can you abruptly discontinue Arnuity Ellipta?

It is not recommended to abruptly stop taking Arnuity Ellipta unless instructed by your healthcare provider. Similar to other steroid-containing inhalers, Arnuity Ellipta should be tapered off gradually to prevent adverse effects like dizziness, headaches, and upset stomach.

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