What’s the difference between Breo Ellipta 100/25 and 200/25?
Breo Ellipta combines two medicines in one inhaler: an inhaled corticosteroid (fluticasone furoate) plus a long-acting beta2-agonist (vilanterol).
- Breo Ellipta 100/25 contains fluticasone furoate 100 mcg and vilanterol 25 mcg.
- Breo Ellipta 200/25 contains fluticasone furoate 200 mcg and vilanterol 25 mcg.
So the key change is the inhaled steroid dose: the 200/25 strength has double the fluticasone compared with 100/25, while the vilanterol dose is the same. This typically means 200/25 provides a stronger anti-inflammatory dose for people whose asthma or COPD symptoms are not adequately controlled on a lower steroid dose.
Which one is used for asthma vs COPD?
Breo Ellipta is used for both asthma and COPD, but the starting strength depends on your diagnosis and how well your symptoms are controlled.
- Asthma: Clinicians often start with a lower strength when possible and step up if control is inadequate. If symptoms persist, a higher steroid dose (like moving from 100/25 to 200/25) may be considered.
- COPD: Higher inhaled steroid doses may be used when symptom control or exacerbations require it, but the decision balances benefits against steroid side effects.
Your prescriber chooses the strength based on your history of flare-ups, current symptom level, and risk factors.
Is 200/25 stronger, and does that mean it works better?
Yes, 200/25 is a higher-dose inhaled steroid. Because vilanterol is the same in both (25 mcg), any difference in effect between the two strengths mainly comes from the extra fluticasone.
In practice, moving from 100/25 to 200/25 is generally considered when the lower steroid dose hasn’t kept symptoms or exacerbations under control. It does not guarantee better control for everyone, and some people may not need the higher dose.
Does 200/25 increase side effects compared with 100/25?
Because 200/25 has more inhaled corticosteroid, it can increase the chance of steroid-related effects compared with 100/25. Common steroid-related concerns with inhaled corticosteroids include:
- Oral thrush (yeast infection in the mouth)
- Hoarseness or throat irritation
You can reduce mouth/throat effects by rinsing your mouth or gargling after each dose (per typical inhaler instructions). If you notice persistent hoarseness, white patches in the mouth, or worsening throat symptoms, you should contact your clinician.
How do patients usually take Breo (and does the strength change the dosing schedule)?
For both strengths, Breo Ellipta is usually taken once daily (the “daily” schedule is tied to the vilanterol component’s long-acting bronchodilator effect). The inhaler strength changes the mcg of fluticasone, not the “once daily” approach.
If you’re switching between 100/25 and 200/25, follow your exact prescription for the correct strength and dose schedule.
What might prompt a switch from 100/25 to 200/25?
Common reasons include:
- Ongoing asthma symptoms despite correct use
- COPD symptoms that are not controlled
- Recent exacerbations or flare-ups
- A need for tighter inflammation control
Before switching, clinicians also check whether the inhaler technique is correct and whether adherence is consistent, since many “treatment failures” come from technique or missed doses.
What should you ask your clinician when choosing between them?
- What goal are we trying to improve (symptoms, nighttime waking, rescue inhaler use, or preventing flare-ups)?
- Why choose 200/25 now versus staying on 100/25?
- What side effects should I watch for, and how should I prevent thrush?
- If symptoms improve, should I step back down to 100/25?
If you tell me whether you’re using Breo for asthma or COPD (and whether this is a dose increase or a switch you’re considering), I can help you interpret what 100/25 vs 200/25 likely means for your situation.