Trelegy Ellipta is a once-daily prescription maintenance inhaler for adults with Chronic Obstructive Pulmonary Disease (COPD) and asthma [1.5.1]. It combines three active ingredients: fluticasone furoate, an inhaled corticosteroid (ICS); umeclidinium, a long-acting muscarinic antagonist (LAMA); and vilanterol, a long-acting beta2-adrenergic agonist (LABA) [1.5.4]. Together, they work to reduce lung inflammation and open airways to make breathing easier [1.5.2]. While effective, potential side effects are a consideration for any medication.
The Link Between Trelegy and Diarrhea
So, can Trelegy cause diarrhea? Yes, it is a documented side effect. In 12-week clinical trials involving patients with COPD, diarrhea was reported in 2% of subjects using the components of Trelegy, compared to less than 1% in the placebo group [1.2.1, 1.3.4]. Other sources confirm it as a known, albeit less common, adverse reaction [1.2.4, 1.4.3]. Interestingly, studies have noted that digestive system side effects like diarrhea were reported by people using Trelegy for COPD, but not by those using it for asthma [1.2.2, 1.8.5].
How Can an Inhaled Medication Affect the Gut?
While Trelegy is inhaled to target the lungs directly, a portion of the medication can be swallowed and absorbed into the bloodstream. This systemic absorption can lead to effects in other parts of the body, including the gastrointestinal (GI) tract [1.6.1]. The medication powder itself may irritate the digestive system lining. Furthermore, one of the components, umeclidinium, has anticholinergic properties which affect the nervous system's control over various bodily functions, including gut motility [1.5.2]. While these agents more commonly cause constipation, they can sometimes disrupt normal digestive rhythm and lead to diarrhea.
Comparison of Respiratory Inhaler Side Effects
Understanding how Trelegy's side effects compare to other common maintenance inhalers can provide valuable context for patients and clinicians. Advair and Symbicort are two other widely used combination inhalers.
| Medication | Active Ingredients | Common GI Side Effects | Other Common Side Effects |
|---|---|---|---|
| Trelegy Ellipta | Fluticasone (ICS), Umeclidinium (LAMA), Vilanterol (LABA) [1.5.2] | Diarrhea, constipation, gastroenteritis, change in taste, mouth/throat pain [1.3.2, 1.8.2] | Headache, back pain, upper respiratory infections, bronchitis, sinusitis [1.4.5] |
| Advair Diskus | Fluticasone (ICS), Salmeterol (LABA) [1.7.1] | Nausea, vomiting, stomach upset [1.7.5] | Upper respiratory infections, sore throat, hoarseness [1.7.1, 1.7.2] |
| Symbicort | Budesonide (ICS), Formoterol (LABA) [1.7.2] | Stomach upset, nausea, vomiting [1.7.5] | Throat irritation, headache, upper respiratory infections, nasal congestion [1.7.2] |
All three medications list oral thrush (a fungal infection in the mouth) as a potential side effect, which is why rinsing the mouth with water after each use is recommended [1.4.5, 1.7.2].
Managing Diarrhea and Other Side Effects
If you experience mild diarrhea while taking Trelegy, it may resolve within a few days or weeks [1.2.6]. Simple at-home strategies can help manage symptoms:
- Stay Hydrated: Drink plenty of water and other clear fluids to prevent dehydration.
- Adjust Your Diet: Consider a bland diet (like bananas, rice, applesauce, and toast) and avoid spicy, fatty, or high-fiber foods that can worsen diarrhea.
It is crucial not to stop taking Trelegy or any prescribed medication without consulting your healthcare provider, as this can lead to a worsening of your breathing problems [1.9.5].
When to Contact a Doctor
You should contact your doctor if you experience any of the following:
- Diarrhea that is severe or lasts for more than a few days [1.2.6].
- Signs of dehydration, such as dark urine, dizziness, or extreme fatigue.
- The presence of other serious side effects like fever, chills, chest pain, or increased breathing problems [1.4.5, 1.6.1].
- An allergic reaction, indicated by rash, hives, or swelling of the face, mouth, and tongue [1.9.5].
Trelegy can also be associated with more serious side effects, including an increased risk of pneumonia, heart problems, eye issues like glaucoma, and bone thinning (osteoporosis) with long-term use [1.4.5, 1.9.4].
Conclusion
While Trelegy is a highly effective medication for managing COPD and asthma, it can cause diarrhea in a small percentage of users, particularly those being treated for COPD [1.2.1, 1.8.5]. The effect is generally mild and may be caused by systemic absorption or direct irritation from the inhaled powder. The benefits of improved breathing often outweigh the inconvenience of this less common side effect. However, persistent or severe GI issues should always be discussed with a healthcare provider to rule out other causes and determine the best management strategy. Never alter your dosage or stop your medication without professional medical advice [1.9.5].
For more detailed information, you can consult the official Trelegy prescribing information on the FDA's website [1.9.2].
