Breo for the Treatment of Asthma

What Is Breo?

In May 2015, the FDA approved the use of Breo, an inhaled corticosteroid and long-acting bronchodilator (ICS-LABA) combination, for the treatment of moderate to severe persistent asthma in adults. Breo joins Advair, Symbicort and Dulera as ICS-LABA combination therapies available in a single inhaler device. Breo had previously been available in the United States for the treatment of chronic obstructive pulmonary disease, as well as for the treatment of moderate to severe persistent asthma in European countries and in Japan.

What makes Breo special is that it is taken only once a day, making it a much more convenient way of taking an asthma inhaler to control the symptoms of asthma. Breo contains fluticasone furoate, which is an inhaled corticosteroid effective at treating inflammation of the airways, a problem for people with persistent asthma. It also contains vilanterol, a long-acting bronchodilator (LABA) that acts to relax the smooth muscles in the airways for a full twenty-four hours. Together, fluticasone furoate and vilanterol work to improve lung function and decrease the risk of severe asthma exacerbations. Breo does not replace the use of a short-acting bronchodilator, such as albuterol, which is still needed for the immediate treatment of asthma symptoms.

I am hopeful that Breo will prove to be a very effective medication at treating asthma, especially because it only needs to be taken once a day.

Other medications in this category (ICS-LABA), such as Advair and Symbicort, need to be taken twice a day. Unfortunately, many people only remember to take their asthma medications once a day – which often leads to poorly controlled asthma and even asthma exacerbations. I believe that people will have better controlled asthma as a result of finding it easier to take Breo.

Does Breo Have A Black Box Warning?

Since Breo contains a LABA, the FDA has assigned a black-box warning to this medication. LABAs are NOT adequate controller therapies by themselves for asthma, and can potentially cause life-threatening asthma attacks if used alone. A person with asthma therefore should always use an inhaled corticosteroid (ICS) in the treatment of asthma when a LABA is required. Breo contains both an ICS and a LABA.

The FDA now states that a LABA medication should not be used if a person with asthma is controlled on an inhaled corticosteroid alone. If asthma is not controlled on an inhaled steroid, additional treatment choices include (a) increasing the dose of the inhaled corticosteroid (which may have its own risks) or (b) the addition of other medications such as a LABA, Singulair, theophylline, oral prednisone and/or Xolair. Keep in mind that untreated asthma has its own risks as well, which can include severe, life-threatening asthma attacks.

For most people, the benefits of an ICS-LABA medication far outweigh the risks.

However, it is important for you to know the risks and benefits of these medications so that you can make an informed choice. If you are already using a LABA medication as part of your asthma therapy and are concerned regarding the above information, please DO NOT stop taking your prescribed asthma medications until speaking with your doctor. If you choose not to use a LABA as part of your asthma therapy, please inform your doctor of this decision prior to you stopping your asthma medications.

See the FDA warning letters on medications containing LABAs.


Syed YY. Fluticasone Furoate/Vilanterol: a Review of Its Use in Patients with Asthma. Drugs. 2015;75:407-418.

DISCLAIMER: The information contained in this site is for educational purposes only, and should not be used as a substitute for personal care by a licensed physician. Please see your physician for diagnosis and treatment of any concerning symptoms or medical condition.

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