Vilanterol

Vilanterol is a selective long-acting beta-2 adrenergic receptor agonist (LABA) used as a maintenance bronchodilator in chronic obstructive pulmonary disease (COPD) and, in fixed-dose combinations with an inhaled corticosteroid, in asthma treatment in some markets. It is formulated for inhalation and is designed for once-daily dosing due to its prolonged duration of action.

In clinical use, vilanterol is most commonly found in combination products with fluticasone furoate, marketed under brand names such as Breo Ellipta. Each inhalation typically delivers vilanterol at a fixed dose together with fluticasone furoate, providing a maintenance therapy intended to improve lung function and reduce exacerbations. The inhaled combination is not intended for relief of acute bronchospasm and should not be used as a rescue inhaler.

Pharmacologically, vilanterol activates beta-2 receptors on airway smooth muscle, leading to relaxation and bronchodilation. Its effects persist for approximately 24 hours, supporting once-daily administration. The onset of bronchodilation occurs within minutes to an hour after inhalation, with peak effects occurring over the following hours.

Safety considerations include the boxed warning that LABAs used without an inhaled corticosteroid in asthma are associated with an increased risk of serious asthma-related events. When used in combination with an ICS, this risk is reduced but not eliminated. Common adverse effects resemble those of other LABAs and may include tremor, tachycardia, headaches, throat irritation, and upper respiratory infections. Patients with cardiovascular disease or a history of hypersensitivity to components should use vilanterol-containing therapies under careful medical supervision.