Relvar Ellipta - patient leaflet, side effects, dosage

1. What Relvar Ellipta is and what it is used for

Relvar Ellipta contains two active substances: fluticasone furoate and vilanterol. Two different strengths of Relvar Ellipta are available: fluticasone furoate 92 micrograms/vi­lanterol 22 micrograms and fluticasone furoate 184 microgram­s/vilanterol 22 micrograms.

The 92/22 micrograms strength is used for the regular treatment of chronic obstructive pulmonary disease (COPD ) in adults, and asthma in adults and adolescents 12 years and over.

The 184/22 micrograms strength is used to treat asthma in adults and adolescents aged 12 years and older. The 184/22 micrograms strength is not approved for the treatment of COPD.

Relvar Ellipta should be used every day and not only when you have breathing problems or other symptoms of COPD and asthma. It should not be used to relieve a sudden attack of breathlessness or wheezing. If you get this sort of attack you must use a quick-acting inhaler (such as salbutamol). If you do not have a quick-acting inhaler contact your doctor.

Fluticasone furoate belongs to a group of medicines called corticosteroids, often simply called steroids. Corticosteroids reduce inflammation. They reduce the swelling and irritation in the small air passages in the lungs and so gradually ease breathing problems. Corticosteroids also help to prevent attacks of asthma and aggravation of COPD.

Vilanterol belongs to a group of medicines called long acting bronchodilators. It relaxes the muscles of the small air passages in the lungs. This helps to open the airways and makes it easier for air to get in and out of the lungs. When it is taken regularly, it helps the small air passages to remain open.

When you take these two active substances together regularly, they will help to control your breathing difficulties more than either medicine alone.

Asthma is a serious, long term lung disease where the muscles surrounding the smaller airways become tight (bronchoconstric­tion ) and swollen and irritated (inflammation ). Symptoms come and go and include shortness of breath, wheezing, chest tightness and cough. Relvar Ellipta has been shown to reduce flare-ups and symptoms of asthma.

Chronic obstructive pulmonary disease (COPD) is a serious, long term lung disease where the airways become inflamed and thickened. Symptoms include shortness of breath, cough, chest discomfort and coughing up mucus. Relvar Ellipta has been shown to reduce flare-ups of COPD symptoms.

2. What you need to know before you use Relvar Ellipta

Do not use Relvar Ellipta

• – if you are allergic to fluticasone furoate, vilanterol or any other ingredients of this medicine (listed in

section 6).

• - if you think the above applies to you, don’t use Relvar Ellipta until you have checked with your

doctor.

Warnings and precautions

Talk to your doctor before you use Relvar Ellipta:

• – if you have liver disease , as you may be more likely to have side effects. If you have moderate or

severe liver disease, your doctor will limit your dose to the lower strength of Relvar Ellipta (92/22 micrograms once daily).

• – if you have heart problems or high blood pressure.

• – if you have tuberculosis (TB) of the lung, or any long standing or untreated infections.

• – if you have ever been told you have diabetes or high blood sugar.

• – if you have thyroid gland problems.

• – if you have low potassium in your blood.

• – if you experience blurred vision or other visual disturbances.

Check with your doctor before you use this medicine if you think any of these applies to you.

While you’re using Relvar Ellipta

• – Contact your doctor if you experience blurred vision or other visual disturbances.

• – Contact your doctor if you experience increased thirst, frequent urination or unexplained tiredness

(signs of high blood sugar).

Immediate breathing difficulties

If your breathing or wheezing gets worse straight after using Relvar Ellipta, stop using it and get medical help immediately.

Infection of the lung

If you are using this medicine for COPD you may be at an increased risk of developing an infection of the lungs known as pneumonia. See section 4 for information on symptoms to look out for while you are using this medicine. Tell your doctor as soon as possible if you develop any of these symptoms.

Children and adolescents

Do not give this medicine to children under the age of 12 years for the treatment of asthma, or in children and adolescents of any age for the treatment of COPD.

Other medicines and Relvar Ellipta

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. If you are not sure what your medicine contains talk to your doctor or pharmacist.

Some medicines may affect how this medicine works, or make it more likely that you will have side effects.

These include:

• – beta-blockers, such as metoprolol, used to treat high blood pressure or a heart condition.

• – ketoconazole, to treat fungal infections.

• – ritonavir or cobicistat, to treat HIV infections.

• - long-acting beta2-adrenergic agonists, such as salmeterol

Tell your doctor or pharmacist if you are taking any of these medicines. Your doctor may wish to monitor you carefully if you are taking any of these medicines as they may increase the side effects of Relvar Ellipta.

Pregnancy and breast-feeding

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine. Don’t use this medicine if you are pregnant unless your doctor tells you that you can.

It is not known whether the ingredients of this medicine can pass into breast milk. If you are breastfeeding, you must check with your doctor before you use Relvar Ellipta. Don’t use this medicine if you are breast-feeding unless your doctor tells you that you can.

If you are breast-feeding, check with your doctor before you use Relvar Ellipta.

Driving and using machines

This medicine is unlikely to affect your ability to drive or use machines.

Relvar Ellipta contains lactose

If you have been told by your doctor that you have an intolerance to some sugars, or to milk protein, contact your doctor before using this medicine.

3. How to use Relvar Ellipta

Always use this medicine exactly as your doctor has told you to. Check with your doctor, nurse or pharmacist if you are not sure.

How much to use

Asthma

The recommended dose to treat asthma is one inhalation (92 micrograms of fluticasone furoate and

22 micrograms of vilanterol) once daily at the same time each day.

If you have severe asthma, your doctor may decide that you should use one inhalation of the higher strength inhaler (184 micrograms fluticasone furoate and 22 micrograms of vilanterol). This dose is also used once daily at the same time each day.

COPD

The recommended dose to treat COPD is one inhalation (92 micrograms of fluticasone furoate and

22 micrograms of vilanterol) once daily at the same time each day.

The higher strength of Relvar Ellipta (184 micrograms fluticasone furoate and 22 micrograms of vilanterol) is not suitable for the treatment of COPD.

Relvar Ellipta is for inhalation use.

Use Relvar Ellipta at the same time each day as it is effective over 24 hours

It is very important that you use this medicine every day, as instructed by your doctor. This will help to keep you free of symptoms throughout the day and night.

Relvar Ellipta should not be used to relieve a sudden attack of breathlessness or wheezing. If you get this sort of attack you must use a quick-acting inhaler (such as salbutamol).

If you feel you are getting breathless or wheezy more often than normal, or if you are using your quickacting inhaler more than usual, see your doctor.

How to use Relvar Ellipta

See ‘Step-by-step instructions’ after section 6 of this leaflet for full information.

Relvar Ellipta is for inhalation use. You do not need to prepare Relvar Ellipta in any special way, not even the first time you use it.

If your symptoms do not improve

If your symptoms (breathlessness, wheezing, cough) do not improve or get worse, or if you are using your quick-acting inhaler more often:

contact your doctor as soon as possible.

If you use more Relvar Ellipta than you should

If you accidentally use more Relvar Ellipta than your doctor has instructed, talk to your doctor or pharmacist.

You may notice that your heart is beating faster than usual, you feel shaky or have a headache.

If you have used more than instructed for a long period of time, it is particularly important that you ask your doctor or pharmacist for advice. This is because larger doses of Relvar Ellipta may reduce the amount of steroid hormones produced naturally by your body.

If you forget to use Relvar Ellipta

Do not inhale a double dose to make up for a forgotten dose. Just take your next dose at the usual time.

If you become wheezy or breathless, or develop any other symptoms of an asthma attack, use your quick-acting inhaler (e.g. salbutamol), then seek medical advice.

Do not stop using Relvar Ellipta without advice

Use this medicine for as long as your doctor recommends. It will only be effective as long as you are using it. Do not stop unless your doctor advises you to, even if you feel better.

If you have further questions on the use of this medicine, ask your doctor, pharmacist or nurse.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Allergic reactions

Allergic reactions are rare (may affect up to 1 in 1,000 people).

If you have any of the following symptoms after taking Relvar Ellipta stop taking this medicine and tell your doctor immediately.

• skin rash (hives) or redness
• swelling, sometimes of the face or mouth (angioedema)
• becoming very wheezy, coughing or having difficulty in breathing
• suddenly feeling weak or light headed (which may lead to collapse or loss of consciousness)

Immediate breathing difficulties

Immediate breathing difficulties after using Relvar Ellipta are rare.

If your breathing or wheezing gets worse straight after using this medicine, stop using it and get medical help immediately.

Pneumonia (infection of the lung) (common side effect, may affect up to 1 in 10 people)

Tell your doctor if you have any of the following while taking Relvar Ellipta – they could be symptoms of a lung infection:

• fever or chills
• increased mucus production, change in mucus colour
• increased cough or increased breathing difficulties

Other side effects include:

Very common side effects

These may affect more than 1 in 10 people:

• headache
• common cold

Common side effects

These may affect up to 1 in 10 people:

• sore, raised patches in the mouth or throat caused by a fungal infection (candidiasis). Rinsing your mouth out with water immediately after using Relvar Ellipta may help stop this side effect developing.
• inflammation of the lungs (bronchitis)
• infection of the nose sinuses or throat
• flu (influenza)
• pain and irritation in the back of the mouth and throat
• inflammation of the sinuses
• itchy, runny or blocked nose
• cough
• voice disorders
• weakening of the bones, leading to fractures
• stomach pain
• back pain
• high temperature (fever)
• joint pain
• muscle spasms

Uncommon side effects

This may affect up to 1 in 100 people:

• irregular heartbeat
• blurred vision
• increase in blood sugar (hyperglycaemia)

Rare side effects

These may affect up to 1 in 1,000 people:

• heart beating faster (tachycardia)
• awareness of heart beat (palpitations)
• tremor
• anxiety

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V. By reporting side effects you can help provide more information on the safety of this medicine.

5. How to store Relvar Ellipta

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the pack after EXP. The expiry date refers to the last day of that month.

Do not store above 25°C.

Keep the inhaler inside the sealed tray to protect from moisture and only remove immediately before first use. Once the tray is opened, the inhaler can be used for up to 6 weeks, starting from the date of opening the tray. Write the date the inhaler should be thrown away on the label in the space provided. The date should be added as soon as the inhaler has been removed from the tray.

If stored in a refrigerator, allow the inhaler to return to room temperature for at least an hour before use.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What Relvar Ellipta contains

• – The active substances are fluticasone furoate and vilanterol.

• – For the 92/22mcg dose: each single inhalation provides a delivered dose (the dose leaving the mouthpiece) of 92 micrograms of fluticasone furoate and 22 micrograms of vilanterol (as trifenatate).

• – For the 184/22 dose: each single inhalation provides a delivered dose (the dose leaving the mouthpiece) of 184 micrograms of fluticasone furoate and 22 micrograms of vilanterol (as trifenatate).

• – The other ingredients are lactose monohydrate (See section 2) and magnesium stearate.

What Relvar Ellipta looks like and contents of the pack

Relvar Ellipta is an inhalation powder, pre-dispensed.

The Ellipta inhaler is a light grey inhaler with a yellow mouthpiece cover and a dose counter. It is packaged in a foil laminate tray with a peelable foil lid. The tray contains a desiccant sachet, to reduce moisture in the packaging. Once you have opened the lid of the tray, throw the desiccant away – do not eat or inhale it. The inhaler does not need to be stored in the foil laminate tray once it has been opened.

The inhaler contains two aluminium foil laminate strips of 14 or 30 doses. Multipacks contain 3 × 30 dose inhalers.

Marketing Authorisation Holder:

GlaxoSmithKline (Ireland) Limited

12 Riverwalk

Citywest Business Campus

Dublin 24

Ireland

Manufacturer:

Glaxo Wellcome Production

Zone Industrielle No.2,

23 Rue Lavoisier,

27000 Evreux,

France

For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:

Belgie/Belgiqu­e/Belgien GlaxoSmithKline Pharmaceuticals s.a./n.v. Tél/Tel: + 32 (0) 10 85 52 00	Lietuva UAB “BERLIN-CHEMIE MENARINI BALTIC” Tel: +370 52 691 947
Efc^rapufl “Eep.iHH-XeMH/Ä. MeHapuHu Etarapua” EOOfl Tea.: +359 2 454 0950	Luxembourg/Lu­xemburg GlaxoSmithKline Pharmaceuticals s.a./n.v. Belgique/Belgien Tel/Tel: + 32 (0) 10 85 52 00
Česká republika GlaxoSmithKline s.r.o. Tel: + 420 222 001 111	Magyarorszag Berlin-Chemie/A. Menarini Kft Tel.: +36 23501301
Danmark GlaxoSmithKline Pharma A/S Tlf: + 45 36 35 91 00	Malta GlaxoSmithKline (Ireland) Limited Tel: +356 80065004
Deutschland GlaxoSmithKline GmbH & Co. KG Tel.: + 49 (0)89 36044 8701	Nederland GlaxoSmithKline BV Tel: + 31 (0) 33 2081100
Eesti OÜ Berlin-Chemie Menarini Eesti Tel: +372 667 5001	Norge GlaxoSmithKline AS Tlf: + 47 22 70 20 00
EZZáSa Menarini Hellas A.E. Tql: +30 210 83161 11–13	Österreich GlaxoSmithKline Pharma GmbH Tel: + 43 (0)1 97075 0

España GlaxoSmithKline, S.A. Tel: + 34 900 202 700	Polska GSK Services Sp. z o.o. Tel.: + 48 (0)22 576 9000
France Laboratoire GlaxoSmithKline Tél.: + 33 (0)1 39 17 84 44	Portugal GlaxoSmithKline – Produtos Farmacéuticos, Lda. Tel: + 351 21 412 95 00
Hrvatska Berlin-Chemie Menarini Hrvatska d.o.o. Tel: +385 1 4821 361	Romania GlaxoSmithKline (Ireland) Limited Tel: +40 800672524
Ireland GlaxoSmithKline (Ireland) Limited Tel: + 353 (0)1 4955000	Slovenija Berlin-Chemie / A. Menarini Distribution Ljubljana d.o.o. Tel: +386 01 300 2160
Ísland Vistor hf. Sími: + 354 535 7000	Slovenská republika Berlin-Chemie / A. Menarini Distribution Slovakia s.r.o. Tel: +421 2 544 30 730
Italia GlaxoSmithKline S.p.A. Tel: + 39 (0)45 7741111	Suomi/Finland GlaxoSmithKline Oy Puh/Tel: + 358 (0)10 30 30 30
Kúnpog GlaxoSmithKline (Ireland) Limited Tql: +357 80070017	Sverige GlaxoSmithKline AB Tel: + 46 (0)8 638 93 00
Latvija SIA Berlin-Chemie/Menarini Baltic Tel: +371 67103210	United Kingdom (Northern Ireland) GlaxoSmithKline (Ireland) Limited Tel: + 44 (0)800 221441

This leaflet was last revised in < {MM/YYYY }>

Other sources of information

Detailed information on this medicine is available on the European Medicines Agency web site:

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Step by step instructions

What is the Ellipta inhaler?

When you first use the Ellipta inhaler you do not need to check that it is working properly, and you do not need to prepare it for use in any special way. Just follow these step-by-step instructions.

Your Relvar Ellipta inhaler carton contains

The inhaler is packaged in a tray. Don’t open the tray until you are ready to start using your new inhaler. When you are ready to use your inhaler, peel back the lid to open the tray. The tray contains a desiccant sachet, to reduce moisture. Throw this desiccant sachet away – don’t open, eat or inhale it.

When you take the inhaler out of its tray, it will be in the ‘closed’ position. Don’t open the inhaler until you are ready to inhale a dose of medicine. When the tray is opened, write the “Discard by” date on the inhaler label in the space provided. The “Discard by” date is 6 weeks from the date you opened the tray.

After this date the inhaler should no longer be used. The tray can be discarded after first opening.

The step-by-step instructions shown below for the 30-dose Ellipta inhaler (30 day supply) also apply to the 14-dose Ellipta inhaler (14 day supply).

• 1. Read this before you start

If you open and close the cover without inhaling the medicine, you will lose the dose.

The lost dose will be securely held inside the inhaler, but it will no longer be available.

It is not possible to accidentally take extra medicine or a double dose in one inhalation.

Cover

Dose counter _____________­_______

This shows how many doses of medicine are left in the inhaler.

Before the inhaler has been used, it shows exactly 30 doses.

It counts down by 1 each time you open the cover.

When fewer than 10 doses are left, half of the dose counter shows red.

After you have used the last dose, half of the dose counter shows red and the number 0 is displayed. Your inhaler is now empty.

If you open the cover after this, the dose counter will change from half red to completely red.

• 2. Prepare a dose

Wait to open the cover until you are ready to inhale your dose. Do not shake the inhaler.

• Slide the cover down until you hear a “click”.

Your medicine is now ready to be inhaled.

The dose counter counts down by 1 to confirm.

• If the dose counter does not count down as you hear the “click”, the inhaler will not deliver medicine. Take it back to your pharmacist for advice.

• 3. Inhale your medicine

• While holding the inhaler away from your mouth, breathe out as far as is comfortable. Don’t breathe out into the inhaler.
• Put the mouthpiece between your lips, and close your lips firmly around it.

Don’t block the air vent with your fingers.

• Take one long, steady, deep breath in. Hold this breath for as long as possible (at least 3–4 seconds).
• Remove the inhaler from your mouth.
• Breathe out slowly and gently.

You may not be able to taste or feel the medicine, even when you are using the inhaler correctly.

If you want to clean the mouthpiece, use a dry tissue, before you close the cover.

• 4. Close the inhaler and rinse your mouth

• Slide the cover upwards as far as it will go, to cover the mouthpiece.
• Rinse your mouth with water after you have used the inhaler, do not swallow.

This will make it less likely that you will develop a sore mouth or throat as side effects.

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