Managing asthma effectively means finding the right medication and, more importantly, the right dosage. One widely prescribed maintenance inhaler for asthma is Breo Ellipta, a combination of a corticosteroid and a long-acting beta-agonist (LABA). While many patients achieve stable control using this inhaler, others may find that their current Breo dosage is not producing the desired results.
If you’re asking yourself, “Why isn’t my Breo working?” or “Should I increase my Breo asthma dose?”, you’re not alone. Understanding how to properly assess and adjust your Breo inhaler dosage can help prevent flare-ups and lead to more effective asthma management.
In this comprehensive guide, we’ll break down how Breo works, signs your dosage may need adjusting, and how to work with your healthcare provider to ensure you’re on the right treatment plan.
What Is Breo and How Does It Work?
Breo Ellipta is a once-daily inhaler used to treat asthma and chronic obstructive pulmonary disease (COPD). It combines two key ingredients:
- Fluticasone furoate: an inhaled corticosteroid (ICS) that reduces airway inflammation.
- Vilanterol: a long-acting beta-agonist (LABA) that relaxes the muscles in the airways for easier breathing.
Together, these medications help prevent asthma symptoms like wheezing, coughing, and chest tightness. It is important to remember that Breo is not a rescue inhaler—it is used as a controller medication for long-term asthma management.
Available Breo Inhaler Dosages
In the U.S., there are two Breo asthma dose options approved for treating asthma:
- Breo Ellipta 100/25 mcg: Contains 100 mcg of fluticasone furoate and 25 mcg of vilanterol.
- Breo Ellipta 200/25 mcg: Contains 200 mcg of fluticasone furoate and 25 mcg of vilanterol.
Your Breo inhaler dosage will depend on several factors, including:
- Your age
- The severity of your asthma
- Your history with other inhaled corticosteroids
- How well you’ve responded to previous medications
Doctors typically start adult asthma patients on Breo 100/25 mcg, then evaluate after several weeks to determine if a higher Breo dosage is needed.
Signs Your Breo Dosage May Not Be Working
Even with regular use, your current Breo asthma dose may not be sufficient to keep your symptoms under control. Here are some common signs that you might need an adjustment:
1. Frequent Use of Rescue Inhaler
If you’re using a rescue inhaler (like albuterol) more than twice a week, this may signal that your Breo is not providing adequate control.
2. Nighttime Asthma Symptoms
Waking up frequently due to coughing, wheezing, or shortness of breath could mean that your Breo inhaler dosage needs to be increased.
3. Persistent Daytime Symptoms
If you still experience coughing, wheezing, or tightness during the day even with daily Breo use, your dosage might be too low.
4. Recent Asthma Attacks or ER Visits
An increase in severe asthma episodes requiring emergency care indicates your asthma isn’t well controlled under your current Breo dosage.
5. Reduced Activity or Exercise Tolerance
If asthma symptoms are limiting your ability to exercise or perform daily tasks, it’s a sign your Breo asthma dose may need adjustment.
What to Do If Breo Isn’t Working
If you suspect your Breo is not doing its job, don’t make any changes on your own. Asthma medication adjustments should always be done in consultation with your healthcare provider. Here’s what you should do:
1. Track Your Symptoms
Keep a journal for a week, noting:
- Frequency of asthma symptoms
- Times you use a rescue inhaler
- Any activity limitations or nighttime symptoms
This information helps your doctor assess the effectiveness of your current Breo inhaler dosage.
2. Schedule a Medical Review
A follow-up appointment will help your provider evaluate lung function and adjust your treatment plan. You may need a spirometry test to check your breathing.
3. Discuss Dosage Adjustment
Based on your symptoms and test results, your doctor might increase your dose from 100/25 mcg to 200/25 mcg, or consider adding another controller medication.
Adjusting Breo Inhaler Dosage: How It’s Done
If your doctor determines that your current Breo dosage isn’t sufficient, here’s how a dose increase might work:
From Breo 100/25 mcg to Breo 200/25 mcg
- This change is typical for patients with moderate to severe asthma who haven’t achieved control on the lower dose.
- You’ll still take the inhaler once daily, preferably at the same time each day.
- Expect your doctor to reevaluate your condition after 4–6 weeks to see if the higher dose is effective.
Important: Not Everyone Needs the Higher Dose
The 200/25 mcg dose is not appropriate for everyone. It’s only recommended when the 100/25 mcg dose has been tried for a reasonable time without success. Using too high of a dose unnecessarily increases the risk of side effects.
Possible Side Effects of Higher Breo Dosages
Increasing your Breo inhaler dosage may increase the risk of side effects. Be aware of:
- Hoarseness or sore throat
- Oral thrush (rinse your mouth after each use)
- Headaches
- Fast heartbeat or palpitations
- Muscle cramps
- Potential for systemic steroid effects (with prolonged high-dose use)
If you experience any unusual symptoms, consult your healthcare provider immediately.
Breo Alternatives If Adjustment Fails
If increasing your Breo asthma dose doesn’t lead to better control, your doctor might consider:
- Adding a leukotriene modifier like montelukast (Singulair)
- Prescribing a different ICS/LABA combination like Advair or Symbicort
- Exploring biologic therapy for severe asthma
- Adding a short course of oral corticosteroids during flare-ups
Breo Dosage and Lifestyle Considerations
No medication can do the job alone. Improving asthma control also depends on:
- Avoiding triggers (dust, pollen, smoke, pet dander)
- Using a peak flow meter to monitor your lung function
- Maintaining a healthy weight
- Regular exercise (as tolerated)
- Getting flu and pneumonia vaccinations
Frequently Asked Questions (FAQ)
Q: Can I split doses or take Breo twice daily?
A: No. Breo is formulated for once-daily use. Taking it more than once a day increases the risk of side effects and hasn’t been proven to be more effective.
Q: How long does it take to notice a difference after adjusting my dose?
A: It may take 1–2 weeks to see noticeable improvements. Full benefit may take up to 4–6 weeks.
Q: Can I lower my dose once my asthma improves?
A: Possibly. If your asthma is well-controlled for several months, your doctor may consider stepping down to a lower Breo dosage to minimize steroid exposure.
Final Thoughts from Prohealthsupporter
Adjusting your Breo dosage is a key step toward achieving full asthma control—but it should never be done without medical guidance. Whether you’re starting on Breo or considering a higher Breo inhaler dosage, monitoring your symptoms and working closely with your provider ensures that your treatment stays both effective and safe.
If your current Breo asthma dose isn’t working, don’t get discouraged. Many patients need one or more adjustments before finding the sweet spot. And remember—effective asthma control is not just about medication. Lifestyle habits, avoiding triggers, and regular check-ins all play a role.