Understanding Trelegy Ellipta Side Effects

Trelegy Ellipta is a triple-combination inhaler used to treat COPD and asthma. Like all medications, it can cause side effects. The good news is that most people tolerate Trelegy well, and many side effects are mild and manageable. However, knowing what to watch for — and when to seek medical attention — is important for staying safe on this medication.

Trelegy contains three active ingredients — fluticasone furoate (an inhaled corticosteroid), umeclidinium (a long-acting muscarinic antagonist), and vilanterol (a long-acting beta2-agonist). Each component can contribute its own side effects, which is why the side effect profile is broader than single-ingredient inhalers.

Common Side Effects of Trelegy Ellipta

These side effects occur in a notable percentage of patients and are usually mild:

• Upper respiratory tract infection — The most commonly reported side effect. Symptoms include sore throat, runny nose, and congestion. This is partly because inhaled corticosteroids can suppress local immune defenses in the airways.
• Headache — Usually mild and responds to over-the-counter pain relievers.
• Back pain — Reported by some patients; typically not severe.
• Oral candidiasis (thrush) — A fungal infection in the mouth caused by the corticosteroid component. White patches on the tongue, inner cheeks, or throat are telltale signs. Rinsing your mouth with water after each use significantly reduces this risk.
• Dysphonia (hoarse voice) — The corticosteroid can irritate vocal cords. Rinsing after use helps here too.
• Cough — Some patients experience coughing after inhalation. This is usually temporary.
• Urinary tract infection — More common in older patients.
• Sinusitis — Sinus inflammation and congestion.
• Diarrhea — Usually mild and self-limiting.

How to Manage Common Side Effects

Many common side effects can be minimized with simple steps:

Preventing Thrush and Hoarseness

After every use of Trelegy Ellipta, rinse your mouth thoroughly with water and spit it out — do not swallow. This removes residual corticosteroid from your mouth and throat, dramatically reducing the risk of oral candidiasis and voice changes. This single habit is the most important thing you can do to prevent common side effects.

Managing Upper Respiratory Infections

If you develop frequent upper respiratory infections while on Trelegy, talk to your doctor. While some increase in infections is expected with inhaled corticosteroids, frequent or severe infections may warrant a treatment review. Practice good hand hygiene and avoid close contact with sick individuals.

Dealing With Headaches

Over-the-counter pain relievers like acetaminophen or ibuprofen usually help. If headaches are persistent or severe, let your doctor know — they may be unrelated to Trelegy.

Serious Side Effects: When to Call Your Doctor

While uncommon, Trelegy Ellipta can cause serious side effects that require medical attention:

Pneumonia

Inhaled corticosteroids increase the risk of pneumonia, particularly in patients with COPD. Symptoms include fever, chills, increased mucus production, chest pain, and worsening breathing. Contact your doctor promptly if you develop these symptoms. Elderly patients are at higher risk.

Paradoxical Bronchospasm

In rare cases, Trelegy can cause sudden worsening of breathing immediately after use. This is a medical emergency. Stop using Trelegy, use your rescue inhaler, and seek emergency medical care if this occurs.

Cardiovascular Effects

The vilanterol component (a LABA) can increase heart rate and affect blood pressure. Report any of the following to your doctor:

• Rapid or irregular heartbeat
• Chest pain or tightness
• Significant blood pressure changes
• Tremor or nervousness

Eye Problems

Long-term use of inhaled corticosteroids may increase the risk of glaucoma and cataracts. Report any changes in vision, eye pain, or halos around lights to your doctor. Regular eye exams are recommended for long-term Trelegy users.

Bone Density Loss

Prolonged use of inhaled corticosteroids can contribute to decreased bone mineral density, increasing fracture risk. Your doctor may recommend bone density monitoring and calcium/vitamin D supplementation, especially if you have other risk factors for osteoporosis.

Adrenal Suppression

High doses of inhaled corticosteroids over time can suppress your adrenal glands. Symptoms include fatigue, weakness, nausea, and low blood pressure. Do not stop Trelegy abruptly — your doctor should taper the dose gradually if discontinuation is needed.

Hypokalemia and Hyperglycemia

The LABA component can lower potassium levels and raise blood sugar. Patients with diabetes or those taking diuretics should be monitored. Report symptoms like muscle cramps, weakness, or increased thirst.

Serious Allergic Reactions

Though rare, anaphylaxis and severe allergic reactions can occur. Seek emergency medical attention for:

• Swelling of the face, lips, tongue, or throat
• Severe rash or hives
• Difficulty breathing or swallowing
• Dizziness or fainting

Important Safety Warning: Asthma Patients

Trelegy Ellipta carries a boxed warning (the FDA's most serious warning) for asthma patients. Long-acting beta2-adrenergic agonists (LABAs) like vilanterol increase the risk of asthma-related death. Trelegy should only be used for asthma in patients who are not adequately controlled on other asthma-control medications, or whose disease severity warrants both an ICS and LABA. This warning does not apply to COPD patients.

Drug Interactions That May Increase Side Effects

Certain medications can increase the risk or severity of Trelegy side effects. For a complete guide, see our article on Trelegy drug interactions. Key interactions include:

• Strong CYP3A4 inhibitors (ketoconazole, ritonavir, clarithromycin) — increase corticosteroid and LABA levels, raising side effect risk
• Beta-blockers — can block the bronchodilatory effects of vilanterol
• Non-potassium-sparing diuretics — may worsen hypokalemia

When to Seek Emergency Care

Go to the emergency room or call 911 if you experience:

• Sudden worsening of breathing after using Trelegy (paradoxical bronchospasm)
• Signs of a severe allergic reaction (swelling, hives, difficulty breathing)
• Chest pain or severe irregular heartbeat
• Signs of pneumonia with high fever and severe breathing difficulty

Talking to Your Doctor About Side Effects

Don't stop taking Trelegy Ellipta without talking to your doctor first — even if you're experiencing side effects. Suddenly stopping can worsen your COPD or asthma. Your doctor may adjust your treatment plan, switch you to an alternative medication, or help manage the side effect.

Keep a log of any side effects you experience, including when they started and how severe they are. This helps your doctor make informed decisions about your care.

If you're looking for Trelegy Ellipta, MedFinder can help you find pharmacies with it in stock near you.