Breo 100/25?

Breo 100/25
Combination inhaler – fluticasone furoate 100 µg + vilanterol 25 µg per actuation.

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1. What it is & how it works

Component	Class	Typical Dose	Primary Action	Key Point
Fluticasone furoate	Inhaled corticosteroid (ICS)	100 µg (one actuation)	Reduces airway inflammation and hyper‑responsiveness	Long‑acting (half‑life ≈ 12 h)
Vilanterol	Long‑acting β₂‑agonist (LABA)	25 µg (one actuation)	Causes bronchodilation by stimulating β₂‑adrenergic receptors	Long‑acting (duration ≈ 24 h)

The combination provides both anti‑inflammatory (ICS) and bronchodilatory (LABA) effects, making it a maintenance therapy for chronic obstructive pulmonary disease (COPD) and, in some regions, for asthma in adults.

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2. Indications

• COPD (Chronic Obstructive Pulmonary Disease) – Adults 18 + years for maintenance treatment to reduce exacerbations and improve lung function.
• Asthma (in some markets) – Adults and adolescents (≥ 12 yrs) when a single‑inhaler approach is preferred.

Not indicated for:

• Acute bronchospasm or asthma attacks – use a short‑acting β₂‑agonist (SABA) instead.
• Patients who have not been on an inhaled corticosteroid in the past 4 weeks (risk of adrenal suppression).

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3. Typical dosage & administration

Condition	Dose	Frequency	Instructions
COPD	1 actuation (100 µg + 25 µg)	Twice daily (every 12 h)	Use at the same times each day. If you miss a dose, take it as soon as possible but do not double the next dose.

How to use

1. Shake the inhaler 3–4 times.
2. Remove the cap and attach the spacer (if you use one).
3. Breathe out fully, place your mouth over the mouthpiece, and inhale slowly and deeply while pressing the dose button.
4. Hold breath for 10 s, then exhale slowly.
5. Rinse your mouth with water and spit out (reduces oral thrush risk).

Tip: If you’re using a spacer, ensure the mouthpiece fits snugly into the spacer to prevent drug loss.

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4. Common side effects

System	Possible Effect	Notes
Oral/respiratory	Oral candidiasis (thrush), dysphonia (hoarseness)	Rinse mouth after each actuation.
Cardiovascular	Palpitations, tachycardia	Rare with LABA; more common with higher doses.
Endocrine	Mild adrenal suppression (rare)	Usually only with large daily doses or prolonged use.
Musculoskeletal	Muscle cramps	Uncommon.

What to monitor: If you develop persistent hoarseness, throat irritation, or signs of infection (e.g., fever, swollen lymph nodes), contact your clinician.

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5. Contraindications & cautions

• Contraindications

  • Known hypersensitivity to fluticasone, vilanterol, or any excipients.
  • Uncontrolled narrow‑angle glaucoma (rare).

• Cautions

  • COPD with concurrent heart disease: LABAs may cause palpitations or arrhythmias.
  • Pregnancy & lactation: Limited data; use only if benefits outweigh risks.
  • Impaired renal or hepatic function: No dose adjustment needed, but monitor for systemic side effects.

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6. Drug interactions

Interaction	Reason	What to do
Strong CYP3A inhibitors (e.g., ketoconazole, clarithromycin)	May increase systemic absorption of fluticasone	Use with caution; consider alternative therapy.
Strong CYP3A inducers (e.g., rifampin, carbamazepine)	May reduce fluticasone levels	Monitor efficacy; dose adjustment usually not needed for LABA.
Other LABAs or β₂‑agonists	Additive bronchodilator effect → risk of tachycardia	Use with caution; monitor heart rate.
Systemic corticosteroids	Potential adrenal suppression	May need to taper systemic steroids more gradually.

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7. Patient counseling points

1. Proper inhaler technique – Demonstrate and confirm correct use.
2. Rinse mouth after each inhalation to reduce thrush.
3. Do not use for rescue – This inhaler is for maintenance only. For sudden symptoms, use a SABA.
4. Regular follow‑up – Check lung function (spirometry) every 3–6 months.
5. Report side effects – Especially hoarseness, throat irritation, chest pain, or palpitations.
6. Keep a diary – Note times of use and any symptoms; helps your clinician assess control.

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8. Storage

• Keep the inhaler at room temperature (15–30 °C).
• Protect from moisture and extreme heat.
• Do not expose to direct sunlight.
• Keep out of reach of children.

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9. Quick reference – “What to remember”

Question	Answer
What’s the active drug?	Fluticasone furoate 100 µg + vilanterol 25 µg per actuation.
How often?	Twice daily (every 12 h).
Can I use it if I have an asthma flare?	No – use a rescue inhaler (SABA).
Side effects?	Oral thrush, hoarseness, tachycardia (rare).
Should I rinse my mouth?	Yes, after each dose.
What to do if I miss a dose?	Take it as soon as possible; don’t double the next dose.

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Bottom line

Breo 100/25 is a dual‑action inhaler that helps keep airways open and inflammation under control in people with COPD (and in some adults with asthma). Proper technique, consistent twice‑daily use, and routine follow‑up are key to getting the most benefit while minimizing risks. If you have any concerns—whether about side effects, interactions, or how it fits into your overall treatment plan—talk with your pharmacist or prescribing clinician.