Trelegy Ellipta Drug Interactions

Clinically significant drug interactions mediated by fluticasone furoate, umeclidinium or vilanterol at clinical doses are considered unlikely due to the low plasma concentrations achieved after inhaled dosing.
Interaction with beta-blockers: Beta-adrenergic blockers may weaken or antagonise the effect of beta₂-adrenergic agonists, such as vilanterol. If beta-blockers are required, cardioselective beta-blockers should be considered; however, caution should be exercised during concurrent use of both non-selective and selective beta-blockers.
Interaction with CYP3A4 inhibitors: Fluticasone furoate and vilanterol, both components of Fluticasone furoate + Umeclidinium + Vilanterol (Trelegy Ellipta), are rapidly cleared by extensive first-pass metabolism mediated by the enzyme CYP3A4.
Care is advised when co-administering with strong CYP3A4 inhibitors (e.g. ketoconazole, ritonavir) as there is potential for an increased systemic exposure to both fluticasone furoate and vilanterol, which could lead to an increase in the potential for adverse reactions (see Pharmacology: Pharmacokinetics under Actions).
Other long acting antimuscarinics and long acting beta₂-adrenergic agonists: Co-administration of Fluticasone furoate + Umeclidinium + Vilanterol (Trelegy Ellipta) with other long-acting muscarinic antagonists or long-acting beta₂-adrenergic agonists has not been studied and is not recommended as it may potentiate the adverse reactions (see Adverse Reactions and Overdosage).