Breo Ellipta is a once-daily inhaler that delivers two medications in a single breath: one that reduces inflammation in your airways and another that relaxes the muscles around them to help you breathe more easily. You take exactly one inhalation per day, at the same time each day, and the entire process takes under a minute once you know the steps.
Step-by-Step Inhalation
Before your first use, check the dose counter on the side of the inhaler. It shows how many doses remain. Each Breo Ellipta device contains 30 doses, which is a full month’s supply at one puff per day.
Hold the inhaler upright with the mouthpiece facing you. Do not shake it. Pull the cover straight down until you hear a click. That click means a dose of powder is loaded and ready. If the counter doesn’t move down by one number when you open the cover, the dose hasn’t loaded properly. Close the cover and try again.
Sit or stand up straight. Breathe out fully, away from the inhaler. Never exhale into the device, because moisture from your breath can clump the powder and ruin future doses. Tilt your head back slightly, place the curved mouthpiece between your teeth, and close your lips tightly around it. Make sure you’re not blocking the small air vents on either side of the mouthpiece.
Take one long, steady, deep breath in through your mouth. You won’t taste much or feel much powder on your tongue, and that’s normal. Remove the inhaler from your mouth, then hold your breath for up to 5 seconds. Breathe out slowly, away from the device. Close the cover to protect the inhaler until your next dose.
Rinse Your Mouth After Every Use
Breo Ellipta contains an inhaled corticosteroid, which can leave traces of medication in your mouth and throat. Over time, this creates an environment where yeast can overgrow, leading to oral thrush, a condition marked by white patches, soreness, and difficulty swallowing. Roughly 3% of people using inhaled corticosteroids develop it.
The fix is simple: rinse your mouth with water and spit it out after every inhalation. Brushing your teeth works too. Don’t skip this step, even if you’re in a hurry. It’s the single most effective way to prevent thrush from becoming a recurring problem.
Dosing for Asthma vs. COPD
Breo Ellipta comes in two strengths: 100/25 and 200/25. The first number is the dose of the anti-inflammatory component (in micrograms), and the second is the airway-relaxing component.
For COPD, the only approved strength is 100/25, taken as one inhalation once daily. For asthma, your prescriber may start you on either 100/25 or 200/25, depending on the severity of your symptoms. The maximum for asthma is one inhalation of the 200/25 strength per day. Regardless of your condition or strength, the rule is the same: one puff, once a day, no more than once every 24 hours.
What to Do if You Miss a Dose
If you forget a dose and remember later in the day, take it as soon as you can. If it’s already close to the time you’d normally take your next dose, skip the missed one and pick up your regular schedule the following day. Never take two inhalations to make up for a forgotten dose.
Choosing a consistent time helps. Many people tie it to a daily habit like brushing their teeth in the morning or setting a phone alarm. The specific hour doesn’t matter as long as it’s roughly the same each day.
Tracking Your Doses and Replacing the Inhaler
The dose counter counts down from 30 each time you open the cover. When the numbers drop into single digits, the counter background turns red to warn you it’s time to get a refill. Once it reads “0,” the inhaler is empty and should be discarded even if it feels like there’s something left inside.
There’s also a time limit. You need to discard the inhaler 6 weeks after you first open the foil tray it comes in, even if doses remain. The powder can absorb moisture from the air over time, which reduces its effectiveness. If you opened the tray but didn’t start using the inhaler right away, write the discard date (6 weeks out) on the label so you don’t lose track.
Storage and Handling
Keep Breo Ellipta at room temperature in a dry place. Leave it in the sealed foil tray until you’re ready to start using it. Once the tray is open, store the inhaler with the cover closed to keep moisture out. Don’t keep it in a bathroom, where shower steam can damage the powder.
The inhaler requires no priming, no shaking, and no spacer. It’s designed so that your breath pulls the powder out of a foil blister strip inside the device. As long as you can breathe in steadily, the dose is delivered.
Important Safety Notes
Breo Ellipta is a maintenance inhaler, meaning it’s designed to be used every day to prevent symptoms. It is not a rescue inhaler. If you’re having sudden breathing difficulty or an asthma attack, use a separate fast-acting rescue inhaler instead.
The powder inside contains lactose (milk sugar) as a carrier. People with a severe milk protein allergy should not use Breo Ellipta. There have been reports of serious allergic reactions in milk-allergic patients using lactose-containing inhaled powders. A mild lactose intolerance from drinking milk is not the same thing and is generally not a concern, but a true milk protein allergy is a contraindication.
You may not feel the full benefit of Breo Ellipta for the first week or two. It works by gradually reducing inflammation, so consistent daily use is what makes it effective. Stopping because it doesn’t seem to work after a few days is a common mistake that prevents the medication from reaching its potential.