Breo: the Superhero Inhaler?

There are so many new inhalers on the market these days, making it difficult to keep track of them all. Some people with COPD may try a few of these inhalers before finding the right regimen that stabilizes their symptoms.

In this series, we will go over the less-commonly known inhalers available, with the first being Breo Ellipta.

What is Breo?

Breo is a dry-powder inhaler that is a combination of two ingredients:¹

1. Fluticasone, an inhaled corticosteroid
2. Vilanterol, a bronchodilator

Vilanterol is specifically in a class of drugs known as LABAs (Long-Acting Beta2-Adrenergic Agonists). This is a fancy classification for a drug that helps dilate your airways.

Overall, Breo has been shown to help reduce the risk of COPD exacerbations by 20%.²

Breo Dosing

Breo is supplied in two different doses. Note that the dose of the vilanterol is the same in both – it is just the steroid component that differs:

• Breo 100
• Breo 200

What is interesting is that Breo 200 is not officially used for people with COPD. This is because it has been found that the higher steroid component in Breo 200 does not provide additional value and may even worsen outcomes. For example, some studies have shown that Breo 200 increases the risk of pneumonia and oral thrush compared to the 100.¹

Warnings

Before starting Breo, there are some alerts to be aware of:

• Breo is not a rescue inhaler. If you are struggling to breathe or wheezing, Breo will not relieve this. This is why it is highly recommended that you continue to have a rescue inhaler, such as Ventolin, on hand for such instances.
• People who have severe allergies to the milk protein lactose should not take this medication.
• You should never take more than prescribed. High doses can cause heart problems such as palpitations and arrhythmias.

Side effects

Like any drug, Breo has side effects. However, if your doctor is recommending this drug, that means that the expected benefits will likely outweigh the side effects. Some potential side effects that you may experience are:¹

• Oral thrush, which is a fungal infection of the mouth. This side effect is due to the steroid component of the drug and can be prevented by rinsing your mouth with water right after using the medication.
• Prolonged use may reduce bone density. This is again directly related to the steroid component of the drug. Your doctor will assess your risk of osteoporosis,  a condition in which the bone becomes weak and may be predisposed to fractures. If you have many of the risk factors, your doctor may decide not to start Breo.
• A rise in blood sugar may happen for some people; this is more of a concern for people with diabetes who are not controlled on their diabetes medication.

How to take Breo

Breo is a once-daily medication. There are 30 doses in one inhaler, as marked on the front of the inhaler. When you are ready to take your first dose, slide down the cover until you hear a click.¹ Once you hear the click, you are ready to inhale your first dose. For a full demonstration, don't hesitate to ask your pharmacist!

Do you take Breo to manage your COPD? What has been your experience so far?

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