When You Can't Get Breo Ellipta, You Still Have Options

If you've been prescribed Breo Ellipta (fluticasone furoate/vilanterol) for asthma or COPD and your pharmacy can't fill it — whether due to stock issues, insurance restrictions, or cost — it's natural to feel worried. After all, consistent use of your maintenance inhaler is critical for controlling your symptoms and preventing flare-ups.

The good news is that several effective alternatives exist in the same drug class. In this article, we'll explain how Breo Ellipta works and walk you through the most common alternatives your doctor might consider.

What Is Breo Ellipta and How Does It Work?

Breo Ellipta is a combination inhaler containing two active ingredients:

• Fluticasone furoate — an inhaled corticosteroid (ICS) that reduces inflammation and swelling in your airways
• Vilanterol — a long-acting beta-agonist (LABA) that relaxes the muscles around your airways for up to 24 hours

Together, these ingredients address both the underlying inflammation and the airway tightness that cause breathing difficulties in asthma and COPD. Breo Ellipta's key advantage is its once-daily dosing, which makes it convenient and can improve medication adherence.

It comes as a dry powder inhaler in two strengths: 100/25 mcg (for asthma and COPD) and 200/25 mcg (for asthma only). For a full overview of the medication, see our guide: What Is Breo Ellipta? Uses, Dosage, and What You Need to Know.

Alternatives to Breo Ellipta

All of the alternatives below are ICS/LABA combination inhalers — meaning they work through the same basic mechanism as Breo Ellipta. However, they differ in specific ingredients, dosing frequency, inhaler device type, cost, and availability.

Important: Never switch medications on your own. Always talk to your doctor or prescriber before making any changes to your inhaler therapy.

1. Wixela Inhub (Generic Fluticasone Propionate/Salmeterol)

Wixela Inhub is an authorized generic version of Advair Diskus — and it's one of the most affordable ICS/LABA options available today.

• Active ingredients: Fluticasone propionate + salmeterol
• Dosing: One inhalation twice daily (morning and evening)
• Device: Dry powder inhaler (Inhub device)
• Approved for: Asthma (age 4+) and COPD
• Cost: Typically $50-$150 per month with insurance or discount card, compared to $350-$450 for Breo Ellipta
• Availability: Widely stocked at most pharmacies

Wixela Inhub is often the first alternative insurers suggest through step therapy programs. The main difference from Breo Ellipta is that it requires twice-daily dosing instead of once daily.

2. Advair Diskus / Advair HFA (Fluticasone Propionate/Salmeterol)

Advair is one of the most well-known respiratory medications in the world and was the predecessor to Breo Ellipta.

• Active ingredients: Fluticasone propionate + salmeterol
• Dosing: One inhalation twice daily
• Device: Diskus (dry powder) or HFA (metered-dose inhaler)
• Approved for: Asthma (age 4+) and COPD
• Cost: Brand Advair can be expensive, but generic versions (like Wixela Inhub) are much more affordable
• Availability: Very widely available

If you've used Breo Ellipta, you'll find the Diskus device somewhat familiar, though not identical to the Ellipta inhaler.

3. Symbicort (Budesonide/Formoterol)

Symbicort is another popular ICS/LABA combination that uses a metered-dose inhaler (MDI) rather than a dry powder device.

• Active ingredients: Budesonide + formoterol
• Dosing: Two inhalations twice daily
• Device: Metered-dose inhaler (MDI) — uses a propellant to deliver medication
• Approved for: Asthma (age 6+) and COPD
• Cost: Generic budesonide/formoterol has become available, reducing costs significantly
• Availability: Widely available at most pharmacies

Symbicort may be a good option if you prefer or do better with an MDI device rather than a dry powder inhaler. Formoterol also has a faster onset of action than vilanterol or salmeterol, which some patients appreciate.

4. Trelegy Ellipta (Fluticasone Furoate/Umeclidinium/Vilanterol)

If you have COPD and need more than what a two-drug inhaler provides, Trelegy Ellipta adds a third medication — an anticholinergic (LAMA) — to the same ingredients found in Breo Ellipta.

• Active ingredients: Fluticasone furoate + umeclidinium + vilanterol
• Dosing: One inhalation once daily
• Device: Ellipta dry powder inhaler (same device as Breo)
• Approved for: COPD (not asthma)
• Cost: $400-$550 per month without insurance — more expensive than Breo Ellipta
• Availability: Available at most pharmacies but may require prior authorization

Trelegy Ellipta is a step up in therapy, not a direct substitute. Your doctor might recommend it if your COPD isn't well-controlled on a two-drug combination.

How to Choose the Right Alternative

The best alternative for you depends on several factors:

• Your diagnosis — Asthma and COPD have different treatment guidelines
• Your insurance formulary — What does your plan cover at the lowest tier?
• Device preference — Do you prefer dry powder inhalers or MDIs?
• Dosing convenience — Once daily vs. twice daily
• Cost — Check your copay for each option, and explore savings programs

Your doctor and pharmacist are your best resources for choosing an alternative that fits your needs and budget.

Final Thoughts

Not being able to fill your Breo Ellipta prescription is frustrating, but it doesn't mean you have to go without effective treatment. Alternatives like Wixela Inhub, Advair, and Symbicort are proven ICS/LABA combinations that have helped millions of patients manage asthma and COPD.

If you'd like to try finding Breo Ellipta in stock before switching, use Medfinder to check real-time availability at pharmacies near you. And for more on how Breo Ellipta works, check out How Does Breo Ellipta Work? Mechanism of Action Explained.