How Fast Does Trelegy Start Working for COPD and Asthma?

October 9, 2025 •

3 min read

In a 52-week study, Trelegy reduced the annual rate of moderate to severe COPD exacerbations by 15% compared to a dual-therapy inhaler [1.6.3]. Many users wonder, how fast does Trelegy start working? While it begins to work after the first dose, the most significant benefits are seen over time [1.2.1, 1.2.4].

Quick Summary

Trelegy Ellipta starts working after the first dose, with some patients noticing improved breathing within 15 minutes [1.2.2]. However, its full effects for controlling daily COPD and asthma symptoms may take several weeks to become apparent [1.2.6].

Key Points

Initial Effects: Trelegy starts working after the first dose, with some patients feeling breathing improvement in as little as 15 minutes [1.2.2].
Long-Term Control: The full benefits for long-term symptom control in COPD and asthma may take several weeks to become apparent [1.2.5, 1.2.6].
Not a Rescue Inhaler: Trelegy is a once-daily maintenance medication and should not be used for sudden, acute breathing problems [1.2.3, 1.3.7].
Triple-Action Formula: It combines an ICS (fluticasone) to reduce inflammation with a LAMA (umeclidinium) and a LABA (vilanterol) to keep airways open [1.5.1].
Proven Efficacy: Clinical trials show Trelegy significantly improves lung function and reduces flare-ups compared to dual-therapy inhalers [1.6.3, 1.6.6].
Daily Use is Key: Consistent daily use is essential to maintain the medication's effectiveness and control respiratory symptoms [1.2.5].
Rinse After Use: Rinsing your mouth with water after inhaling can help prevent oral thrush, a common side effect [1.5.3].

Understanding Trelegy's Onset of Action

Trelegy Ellipta is a once-daily maintenance inhaler for Chronic Obstructive Pulmonary Disease (COPD) and asthma, not a rescue inhaler for sudden breathing problems [1.2.3, 1.3.7]. It combines three long-acting medicines to provide 24-hour therapeutic effects [1.2.7]. While it starts to work with the very first dose, the patient experience can be divided into initial effects and long-term improvements. Some individuals might notice breathing improvement within 15 minutes of their first dose, but the medication's primary goal is to provide stable, long-term symptom control, which can take a few weeks to become fully established [1.2.2, 1.2.6].

The Triple-Action Mechanism

Trelegy's effectiveness comes from its three active ingredients, each with a distinct mechanism of action [1.5.1, 1.5.6]:

Fluticasone Furoate: An inhaled corticosteroid (ICS) that reduces inflammation and swelling in the lungs [1.5.1]. This anti-inflammatory action is crucial for managing the chronic inflammation associated with both asthma and COPD.
Umeclidinium: A long-acting muscarinic antagonist (LAMA) that acts as a bronchodilator. It works by blocking the tightening of muscles around the airways, helping to keep them open [1.5.1, 1.5.4].
Vilanterol: A long-acting beta2-adrenergic agonist (LABA), another type of bronchodilator. It relaxes the muscles surrounding the airways, further promoting airflow [1.5.1, 1.5.7].

This combination provides both bronchodilation (opening the airways) and anti-inflammatory effects to manage respiratory symptoms comprehensively [1.3.5].

What to Expect: First Few Days vs. Long-Term

In the initial days of treatment, you may not feel a dramatic change. Trelegy is designed for gradual, sustained improvement [1.2.1]. It's important to continue taking it every day as prescribed, even if you feel better, to maintain its benefits [1.2.5]. Over several weeks, the full effects become more noticeable as the inflammation in your lungs decreases and your airways remain more consistently open [1.2.5, 1.3.1].

Clinical studies have quantified these improvements. For instance, in a 52-week landmark study known as IMPACT, Trelegy demonstrated a significant 97 mL improvement in lung function (FEV1) compared to Breo (an ICS/LABA) and a 54 mL improvement compared to Anoro (a LAMA/LABA) [1.6.3]. Furthermore, it reduced the annual rate of moderate to severe COPD exacerbations by 15% versus Breo and 25% versus Anoro [1.6.3]. For asthma patients, studies have also shown significant improvements in lung function compared to dual-therapy inhalers [1.3.4, 1.6.2].

Comparison of Respiratory Medications


Feature	Trelegy Ellipta	Breztri Aerosphere	Symbicort	Advair Diskus
Active Ingredients	Fluticasone/Umeclidinium/Vilanterol (ICS/LAMA/LABA) [1.5.5]	Budesonide/Glycopyrrolate/Formoterol (ICS/LAMA/LABA) [1.2.2]	Budesonide/Formoterol (ICS/LABA) [1.3.4]	Fluticasone/Salmeterol (ICS/LABA) [1.6.1]
Indications	COPD & Asthma [1.2.2]	COPD only [1.2.2]	Asthma & COPD [1.3.4]	Asthma & COPD
Dosing Frequency	One puff, once daily [1.2.2]	Two puffs, twice daily [1.2.2]	Two puffs, twice daily	One puff, twice daily
Type of Inhaler	Dry Powder Inhaler (DPI) [1.2.2]	Metered Dose Inhaler (MDI) [1.2.2]	Metered Dose Inhaler (MDI)	Dry Powder Inhaler (DPI)

This table is for informational purposes only and is not a substitute for professional medical advice.

Potential Side Effects and Considerations

As with any medication, Trelegy can cause side effects. Common side effects include upper respiratory tract infections, headache, back pain, and oral thrush (fungal infection in the mouth) [1.4.2]. To reduce the risk of oral thrush, it's recommended to rinse your mouth with water without swallowing after each dose. More serious side effects can include pneumonia, weakened immune system, heart effects, and eye problems like glaucoma or cataracts [1.4.3]. Patient experiences can vary; some report significant improvement quickly, while others may experience side effects like hoarseness or muscle aches [1.4.4]. It's essential to discuss any side effects with your healthcare provider.

Conclusion

To answer how fast does Trelegy start working?, it begins to act from the first dose, with some immediate bronchodilator effects possible within minutes [1.2.2]. However, its primary role as a long-term maintenance therapy means the most significant and stable improvements in daily symptoms and reduction in flare-ups for COPD and asthma are typically observed after several weeks of consistent, once-daily use [1.2.6]. Clinical data strongly supports its effectiveness in improving lung function and reducing exacerbations over time compared to dual therapies [1.6.3, 1.6.6]. Always follow your doctor's instructions and use Trelegy as part of a comprehensive treatment plan that includes a rescue inhaler for acute symptoms [1.2.3].

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your medical treatment.

For more information directly from the manufacturer, you can visit the official Trelegy Website.

Frequently Asked Questions

Trelegy starts working after the first dose, but its full effect on daily symptoms often takes a few weeks of consistent use. Some people may notice easier breathing within 15 minutes [1.2.2, 1.2.6].

No, Trelegy is not a rescue inhaler. It is a long-term, once-daily maintenance medication for COPD and asthma. You should use a separate rescue inhaler, like albuterol, for sudden breathing problems [1.2.3, 1.3.7].

Trelegy contains three active ingredients: fluticasone furoate (an inhaled corticosteroid to reduce inflammation), umeclidinium (a LAMA to keep airways from tightening), and vilanterol (a LABA to relax airway muscles) [1.5.1, 1.5.5].

If you miss a dose, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed one. Do not take more than one dose in a single day [1.2.6].

No, you should not stop taking Trelegy without consulting your healthcare provider, even if your breathing improves. It is a long-term treatment, and stopping it could cause your symptoms to worsen again [1.2.5].

Weight gain was not reported as a side effect in the clinical studies for Trelegy Ellipta. If you experience unexpected weight gain, discuss it with your doctor [1.2.2].

Both are triple-therapy inhalers, but they contain different active ingredients. Trelegy is approved for both COPD and asthma, while Breztri is only approved for COPD. Trelegy is a once-daily dry powder inhaler, whereas Breztri is a twice-daily spray inhaler [1.2.2].