Symptoms can include: Some people experience asthma symptoms throughout the day. Prednisone is in a class of medications called corticosteroids. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Its possible for Trelegy Ellipta to cause thrush. Ask your doctor ahead of time what you should do if you have new or worsening cough or shortness of breath, wheezing, increased sputum, waking up at night with trouble breathing, if you use your quick-relief inhaler more often, or if your quick-relief inhaler does not seem to be working well. National Library of Medicine, DailyMed. Should I avoid certain foods while taking Trelegy Ellipta Blister, With Inhalation Device? Box 2 lists select outpatient medications that have clinically relevant drug-drug interactions with ritonavir-boosted nirmatrelvir. Properly discard this product when it is expired or no longer needed. Brian Bezack, DO, is board-certified in pediatric pulmonology and pediatrics. Tell your doctor if your condition does not get better or if it gets worse. eHealthMe is studying from 531,290 Prednisone users for its effectiveness, alternative drugs and more. Factors to consider include those in the list below. One of the side effects of prednisone is bradycardia , an abnormally slowed heart rate. This can help prevent thrush, a possible side effect of Trelegy Ellipta. Avoid smoking and other things that can worsen breathing problems. If you notice other effects not listed above, contact your doctor or pharmacist. Our original studies have been referenced on 600+ medical publications including The Lancet, Mayo Clinic Proceedings, and Nature. All of these minerals play a role in the rhythm and rate of heartbeats. Your doctor or pharmacist can tell you about any interactions these items may cause with Trelegy Ellipta. Inhale this medication by mouth as directed by your doctor, usually once daily. Albuterol is a bronchodilator. A mild increase in blood pressure might not cause any noticeable symptoms. Food and Drug Administration. Other tips for keeping your medications safe from the heat are keep all medications in a cool dry place, experts say the bathroom cabinet might not be a good place to store meds since its hot and . However, poorly controlled asthma can also slow down growth. Box 1 lists select outpatient medications that are not expected to have clinically relevant interactions with ritonavir-boosted nirmatrelvir. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Symptoms of a mild allergic reaction can include: A more severe allergic reaction is rare but possible. This article contains information about other treatments used for COPD, including other inhalers. b The FDA EUA for ritonavir-boosted nirmatrelvir suggests that individuals who use contraceptive products containing ethinyl estradiol consider using a backup, nonhormonal contraceptive method because coadministration may result in low ethinyl estradiol levels. To learn more about Trelegy Ellipta and Anoro Ellipta, check out this detailed comparison. Nick Blackmer is a librarian, fact-checker, and researcher with more than 20 years experience in consumer-oriented health and wellness content. Read the Patient Information Leaflet and Instructions for Use provided by your pharmacist before you start using this medication and each time you get a refill. Results of our real-world drug study have been referenced on 600+ medical publications, including The Lancet, Mayo Clinic Proceedings, and Nature. If you have sudden trouble breathing with Trelegy Ellipta, your doctor will likely have you permanently stop using this drug. They can also discuss safe feeding options if needed. Using dextroamphetamine together with alcohol can increase the risk of cardiovascular side effects such as increased heart rate, chest pain, or blood pressure changes. Anoro Ellipta- umeclidinium bromide and vilanterol trifenatate powder [drug label]. Ask questions to help you learn more about Trelegy Ellipta. Available for Android and iOS devices. If you have symptoms that feel life threatening, call 911 (or your local emergency number) or get immediate medical help. Trelegy Ellipta, Advair, and Spiriva are all inhalers used to manage COPD in adults. Patients should be counseled about ritonavir-boosted nirmatrelvirs drug-drug interaction potential and the signs and symptoms of potential adverse effects. Stader F, Khoo S, Stoeckle M, et al. There is increasing evidence on the negative effects of low dose prednisone. Talk with your doctor about your risk, and about available treatments for osteoporosis. These include brentuximab vedotin, enfortumab vedotin, polatuzumab vedotin, and tisotumab vedotin. Trelegy Ellipta is a prescription medicine used to treat the symptoms of Asthma and Chronic Obstructive Pulmonary Disease ( COPD ). Theyll provide you with details, such as how often to check it. While taking Trelegy Ellipta, continue to use your rescue inhaler (such as albuterol) as your doctor tells you to. 2023 eHealthMe.com. So, dont hesitate to ask questions or offer feedback on your treatment. If withholding a statin is not clinically appropriate (e.g., the patient had a recent myocardial infarction), the doses of atorvastatin and rosuvastatin can be adjusted and continued, and lovastatin and simvastatin should be switched to an alternative statin.g The guidance on managing drug-drug interactions between certain benzodiazepines and ritonavir-boosted nirmatrelvir can vary significantly between resources. Consult your doctor for details. It's not known if Breztri Aerosphere is safe to use while breastfeeding. If you use this eHealthMe study on publication, please acknowledge it with a citation: study title, URL, accessed date. Because the flu virus can also worsen breathing problems, ask your doctor or pharmacist if you should have a flu shot every year. Patients who are receiving higher doses of dexamethasone will be at a greater risk of AEs.k Patients should take ritonavir-boosted nirmatrelvir at least 3 hours after receipt of brincidofovir.l Ritonavir-boosted nirmatrelvir interacts with certain conjugated monoclonal antibodies, such as those conjugated to the drug monomethyl auristatin E (or vedotin). These include what your insurance plan covers and which pharmacy you use. In rare cases, you may experience sudden trouble breathing after taking a dose of Trelegy Ellipta. What should I know about Trelegy Ellipta vs. Symbicort? Certain activities can also trigger asthma symptoms or make symptoms worse. Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor. Information for this minor interaction is available on the professional version. And they want you to get the best care possible. QVAR Redihaler- beclomethasone dipropionate HFA aerosol, metered [drug label]. Below are some common questions about Trelegy Elliptas dosage. aThis list is primarily based on the most common medication searches by U.S. users on the Liverpool COVID-19 Drug Interactions website between January 1 and July 31, 2022 (internal communication, August 2022). Do not use it more than one time each day. You should let your rheumatologist or primary care doctor know if you develop COVID-19 symptoms or have been in close contact with someone who has it. Keep all medical and lab appointments. Moderately clinically significant. National Library of Medicine, DailyMed. They can suggest ways to reach or maintain a weight thats healthy for you. Now on 3 inhalers, nebulizer, singular, claritin, nose spray, prednisone, water pill, potassium, cough med, Unsure about so much med. What to Know About Combination Asthma Inhalers, What to Know About Advair Diskus (Fluticasone/Salmeterol), When Your Allergy Medicine Doesn't Work Anymore. * Approximation only. Stiolto Respimat- tiotropium bromide and olodaterol spray, metered [drug label]. Drug interactions are reported among people who take Prednisone and Trelegy ellipta. If its hard for you to read the label on your prescription, tell your doctor or pharmacist. can't seem to get off prednisone, when do go down hill quick. By injection. Symbicort contains two active drugs: budesonide and formoterol. Do not increase your dose, use this medication more often, or stop using it without first consulting your doctor. Other medications can affect the removal of fluticasone from your body, which may affect how fluticasone works. The phase IV clinical study analyzes which people take Trelegy ellipta and have Gastritis. Doing so can expose you to double the medication, leading to overdosing and an increased risk of side effects. As effective as these drugs are, not all can be used together. Keep all medications away from children and pets. Learn more. It works to treat other conditions by reducing swelling and redness and by changing the way the immune system works.. National Library of Medicine, DailyMed. If you have symptoms that feel life threatening, call 911 (or your local emergency number) or get immediate medical help. Other drugs are known to interact, causing severe drops in blood potassium and heart rhythm problems. Talk with your doctor if youre concerned about hair loss with any medications you take. If you think youre having a medical emergency, you should call 911 or your local emergency number. Trelegy Ellipta contains three active drugs,* which are fluticasone, vilanterol, and umeclidinium. Add an Answer. Consider the magnitude and significance of the potential drug-drug interaction when choosing management strategies for patients who will be receiving ritonavir-boosted nirmatrelvir. Like most drugs, Trelegy Ellipta may cause mild or serious side effects. Add your drug list to My Med List to view medical information in a simple, easy-to-read, personalized format. The list isn't long but doctors are warning patients about taking some medications before and after getting the shot. Inhaled glucocorticoids (also known as inhaled steroids) are commonly used in combination with other inhaled drugs to control COPD. You may have questions about Trelegy Ellipta and your treatment plan. Overview. This document does not contain all possible drug interactions. This report displays the potential drug interactions for the following 2 drugs: Applies to: prednisone and Trelegy Ellipta (fluticasone / umeclidinium / vilanterol). If your symptoms feel life threatening, call 911 (or your local emergency number) or get immediate medical help. Consult your doctor before breast-feeding. If you have switched from a corticosteroid taken by mouth (such as prednisone tablets) to this inhaler within the past 12 months, or if you have been using this product in higher-than-usual doses for a long time, it may be more difficult for your body to respond to physical stress. Key: EUA = Emergency Use Authorization; FDA = Food and Drug Administration, Clinicians should be aware that, in some cases, drug-drug interactions with ritonavir-boosted nirmatrelvir may lead to serious or life-threatening drug toxicities. Before your appointment, write down questions such as: How will Trelegy Ellipta affect my body, mood, or lifestyle? Always consult your healthcare provider before making changes to your medications or dosage. The phase IV clinical study analyzes what interactions people who take Prednisone and Trelegy ellipta have. Thrush wasnt common in studies of Trelegy Ellipta. Hypercapnia: What Is It and How Is It Treated? Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. To avoid wasting a dose, do not close the cover until after you have inhaled the medication. Trelegy Ellipta is not approved for the treatment of asthma. Our analysis results are available to researchers, health care professionals, patients (testimonials), and software developers (open API). Find answers to some commonly asked questions about Trelegy Ellipta. This can help you decide if its right for you. See the American Society of Transplantation statement for more information.f Withhold lovastatin and simvastatin for at least 12 hours before initiating ritonavir-boosted nirmatrelvir, during treatment, and for 5 days after treatment completion. But I do not think this is a black and white issue. Each Trelegy Ellipta inhaler contains three active drugs* in the following strengths: These strengths might be written as 100/62.5/25 mcg and 200/62.5/25 mcg. But some research has shown that heavy drinking can worsen your lung function over time. Be sure to mention any prescribed or over the counter medications and other supplements you're taking. Ellipta refers to the inhaler you use to take the medication. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch. Always consult your healthcare provider before making changes to your medications or dosage. National Library of Medicine, DailyMed. 2005 - 2023 WebMD LLC. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. With medical big data and proven AI algorithms, eHealthMe provides a platform for everyone to run phase IV clinical trials. Personalize this study to your gender and age, Atrial fibrillation/flutter (atrial fibrillation and flutter are abnormal heart rhythms in which the atria, or upper chambers of the heart, are out of sync with the ventricles), Rheumatoid arthritis (a chronic progressive disease causing inflammation in the joints), Chronic obstructive pulmonary disease (a progressive disease that makes it hard to breathe), Heparin Lock Flush and Pulmonary Function Test Decreased, Levonorgestrel And Ethinyl Estradiol and Dyspnea Exacerbated. 2005-2023 Healthline Media a Red Ventures Company. Hold the inhaler well away from your mouth and breathe out to the end of a normal breath. Before using this medication, tell your doctor or pharmacist your medical history, especially of: current/past infections (such as tuberculosis, herpes), heart problems (such as chest pain, irregular heartbeat), high blood pressure, bone loss (osteoporosis), personal or family history of eye problems (such as cataracts, glaucoma), difficulty urinating (such as due to an enlarged prostate), seizures, overactive thyroid, diabetes, liver disease. Let your doctor know if you experience severe or frequent headaches, chest pain, and/or a . belly pain, which may include cramps, nausea, or vomiting, sudden trouble breathing after taking a dose*, burning sensation or soreness inside your mouth, white or yellow patches and bumps on your inner cheeks, gums, lips, tongue, or tonsils. Note: Trelegy Ellipta should not be used as a rescue inhaler for exacerbations or sudden breathing problems. Updated on August 12, 2022 Key takeaways: Singulair (montelukast) is an oral medication that can be used to treat allergies and asthma. Creams and ointments can help heal many skin conditions. * Trelegy Ellipta contains three active drugs: fluticasone (an inhaled corticosteroid), umeclidinium (an anticholinergic), and vilanterol (a type of LABA). Prednisone is used to treat many conditions including allergies, Crohn's disease, and chronic obstructive pulmonary disease (COPD). prednisone (Rayos) hydrocortisone (Cortef) mometasone (Asmanex, Elocon) . Ritonavir-boosted nirmatrelvir is contraindicated in this setting, because strong CYP3A4 inducers may reduce the concentrations of nirmatrelvir and ritonavir, rendering the treatment ineffective against SARS-CoV-2. For more information about how Trelegy Ellipta compares to other drugs like Advair and Spiriva, talk with your doctor. COPD exacerbations often require treatment in the hospital. Advil is widely available and well-known as a pain-reliever and fever-reducer. Does Trelegy Ellipta Blister, With Inhalation Device interact with other medications? Trelegy refers to the medication, and Ellipta refers to the inhaler you use to take the medication. Trelegy has less steroid in it. The effectiveness of the drug will depend on one's biological makeup and condition. Store at room temperature away from light, heat, and moisture. The guidance in this document is based on the drug-drug interaction potential of the FDA-authorized 5-day course of ritonavir-boosted nirmatrelvir. This may also be called an asthma attack or flare-up. If you have serious side effects from Trelegy Ellipta, call your doctor right away. However, the low level is not expected to be clinically significant during the 5 days of therapy. Or go to the nearest emergency room. To view step-by-step instructions for using Trelegy Ellipta, check out this site from the drugs manufacturer. If sudden breathing problems occur, use your quick-relief inhaler as prescribed. If ritonavir-boosted nirmatrelvir is prescribed to patients who take certain recreational drugs, those patients will require counseling and careful monitoring for adverse effects. Phase IV trials are used to detect adverse drug outcomes and monitor drug effectiveness in the real world. If withholding is not clinically appropriate, use an alternative concomitant medication or COVID-19 therapy. Your doctor will recommend whether you should keep using Trelegy Ellipta if you have thrush. I have an allergy to milk. The progestin concentration of a combined hormonal contraceptive is expected to remain similar or increase with coadministration, which would maintain the effectiveness of the oral contraceptive. Codeine, morphine, and hydrocodone are opioids that doctors prescribe to treat pain. While using Trelegy Ellipta, continue to use your rescue inhaler (such as albuterol) as your doctor tells you to. I'd never advocate for long term use because of TSW. After each dose, you should rinse your mouth with water. Trelegy Ellipta is used every day to help manage symptoms. By inhaler and intranasal spray. You can also look at Trelegy Elliptas patient information sheet. Serious side effects from Trelegy Ellipta can occur, but they arent common. Trelegy Ellipta contains a corticosteroid that you inhale, called fluticasone. Do not stop taking them. Lab and/or medical tests (such as cortisol levels, lung function, blood pressure, pulse/heart rate, eye exams) should be done while you are using this medication. If you are regularly taking corticosteroids by mouth (such as prednisone), continue to follow your doctor's instructions on taking them. Yes. Prednisone is a corticosteroid drug that works by regulating immune and metabolic function. They can recommend other treatment options for your condition. When you have severe asthma, its important to openly and regularly discuss your symptoms and treatments with your doctor. Breo Ellipta ( fluticasone furoate and vilanterol inhalation powder) and albuterol sulfate are both used to treat asthma and chronic obstructive pulmonary disease ( COPD ). Not all medications that may interact with ritonavir-boosted nirmatrelvir are included in Box 2. Bronchodilator or Steroid Inhaler: Which Should Be Used First? Older adults may be more sensitive to the side effects of this drug, especially QT prolongation (see above). Beta-2 adrenergicagonists (also known as beta-agonists)are a mainstay treatment for COPD. Before taking Trelegy Ellipta, its important to talk with your doctor. 4 How Different Categories of High Cholesterol Are Treated 4 Sources By Jennifer Moll, PharmD To prevent dry mouth, hoarseness, and oral yeast infections from developing, gargle, rinse your mouth with water and spit out after each use. There are short-acting versions used as rescue inhalers and long-acting versions that are used to control COPD. Lactose can trigger an allergic reaction if you have a milk allergy. This type of drug is sometimes used to treat exacerbations (flare-ups) of chronic obstructive pulmonary disease (COPD) or asthma. Do not use more than one dose each day. Created for people with ongoing healthcare needs but benefits everyone. Do not share this medication with others. This figure from a review of the topic in the European Respiratory Journal shows where in the process ICS could influence COVID-19, either increasing or decreasing risk of 1) initial infection, 2). Applies to: Trelegy Ellipta (fluticasone / umeclidinium / vilanterol) and Trelegy Ellipta (fluticasone / umeclidinium / vilanterol). Your list includes two medicines belonging to the 'cortisones' category: Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. One of Trelegy Elliptas active drugs,* fluticasone, is an inhaled corticosteroid. Asthma is when the muscles surrounding the smaller airways become tight (bronchoconstriction), swollen and. One example of this type of drug is prednisone (Rayos). Talk with your doctor if youre concerned about your weight or weight gain. This is a fungal yeast infection that develops in your mouth or throat. Lauren Van Scoy, MD, is a board-certified physician in internal medicine, pulmonary medicine, and critical care. Using alternative COVID-19 therapies (see, Cobicistat- or ritonavir-boosted antiretrovirals. Before you start treatment with Trelegy Ellipta, your doctor will evaluate your risk of side effects, including raised blood pressure. This product may cause a condition that affects the heart rhythm (QT prolongation). Each time you open the cover, you prepare a dose of the medication. Dry/irritated throat, hoarseness, or coughing may occur as your body adjusts to the medication. Do not open the cover of the inhaler until you are ready to use it. Common side effects of Singulair include upper respiratory infection, fever, and sore throat. [deleted] 3 mo. Consult the. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of Trelegy Ellipta. Add an Answer. Atrovent HFA- ipratropium bromide aerosol, metered [drug label]. In the form of eye drops. This use is described below in Is Trelegy Ellipta used for asthma?). If you dont understand something related to your condition or treatment, ask your doctor to explain it to you. Pre-emptive dose adjustment is not required but may be considered based on an individualized assessment of the patients risk for adverse reactions. Youll typically take one inhalation each day, at about the same time each day. National Library of Medicine, DailyMed. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, Medication can help you manage COPD and live a long life. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment. Topically. Ritonavir may also increase blood concentrations of certain concomitant medications. Keep in mind that side effects of a drug can depend on: Your doctor or pharmacist can tell you more about the potential side effects of Trelegy Ellipta. Breztri Aerosphere also contains three active drugs: budesonide, glycopyrrolate, and formoterol fumarate. Stopping lopinavir/ritonavir in COVID-19 patients: duration of the drug interacting effect. There is, however, one possible problem you want to be aware of. It can also block muscle spasms (tightening) in your airways. Educate patients about potential adverse effects. Lauren Van Scoy, MD, is a board-certified physician in internal medicine, pulmonary medicine, and critical care. Some are used once or twice a day to manage COPD and prevent acute exacerbations (attacks). COPD refers to a group of lung diseases (including bronchitis and emphysema) that make it harder to breathe. Trelegy Ellipta contains the active drugs* fluticasone, vilanterol, and umeclidinium. With medical big data and AI algorithms, eHealthMe is running millions of phase IV trials and makes the results available to the public. These lists dont include all possible side effects. It should not be used as a rescue inhaler for sudden breathing problems. The most common symptom of COVID-19 is fever, which often goes hand-in-hand with a dry cough and shortness of breath. Flovent Diskus- fluticasone propionate powder, metered [drug label]. Before taking Trelegy Ellipta, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Consult 1 or more of the following resources for information on identifying and managing drug-drug interactions: Consider consulting with an expert (e.g., with a pharmacist, an HIV specialist, or the patients specialist providers), especially for patients receiving highly specialized therapies or drugs prone to concentration-dependent toxicities, such as certain anticonvulsant, anticoagulant, antiarrhythmic, chemotherapeutic, neuropsychiatric, and immunosuppressant drugs. Every effort has been made to ensure that all information is accurate, up-to-date, and complete, but no guarantee is made to that effect. Doctor's Assistant: What medications are you already using, if any? Common interactions include breast cancer among females and dyspnoea among males. A very serious allergic reaction to this drug is rare. If you have an existing heart problem, raised blood pressure could make your condition worse. If you're prescribed a steroid, such as prednisone, that's a drug that . It's a brand-name prescription drug used for COPD or asthma in adults.. Also, talk with your doctor about the treatment thats right for you. Its not known how often this occurred in people taking the drug in studies. These drugs include: This list does not contain all types of drugs that may interact with Trelegy Ellipta. Its a possible side effect of any inhaler. Adjusting the dose of the concomitant medication. What should I know about Trelegy Ellipta vs. Breztri Aerosphere? For more information about how Trelegy Ellipta and Breo Ellipta compare, see this detailed comparison. Although more than one inhaler may be prescribed to treat COPD, they can't all be used together. c Ritonavir-boosted nirmatrelvir interacts with certain conjugated monoclonal antibodies, such as those conjugated to the drug monomethyl auristatin E (or vedotin). These effects are called interactions. To help prevent osteoporosis later in life, encourage children to exercise and eat a healthy diet (including calcium). This side effect is caused by vilanterol, one of the three active drugs* in Trelegy Ellipta. Trelegy Ellipta contains vilanterol. Yes steroids are effective short term, although it comes back quicker and more aggressively for many people. Drug interactions are reported among people who take Prednisone and Trelegy ellipta. Controlling symptoms of breathing problems helps you stay active. "These are usually taken after an organ transplant to prevent the body from 'rejecting' the transplanted organ." Keep reading to see what he thinks you can take. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. Raised blood pressure is a possible side effect of Trelegy Ellipta. Most people with chronic obstructive pulmonary disease (COPD) use an inhaler every day to control shortness of breath and other symptoms of this progressive lung disease. However, this does not necessarily mean no interactions exist. Combivent Respimat- ipratropium bromide and albuterol spray, metered [drug label]. Learn about asthma complications, what to do about them, and how to decrease your risk of developing them. Using more than this can lead to serious side effects. This inhaler contains 3 medications: fluticasone, umeclidinium, and vilanterol. For patients with a lower risk for arterial or venous thrombosis, clinicians may consider administering low-dose aspirin while rivaroxaban is being withheld.e The use of another COVID-19 therapy may need to be considered. All rights reserved. Use TRELEGY only once every 24 hours. Sometimes you just don't have the choice but to figure out what it is that's causing it, and remove it for good. Consult your doctor for more details. What should I know regarding pregnancy, nursing and administering Trelegy Ellipta Blister, With Inhalation Device to children or the elderly? Other drugs that have the same active ingredients (e.g. You should avoid or limit the use of alcohol while being treated with dextroamphetamine. You can use the study as a second opinion to make health care decisions. In Canada - Call your doctor for medical advice about side effects. See the What should be considered before taking Trelegy Ellipta? below for details. Note: Trelegy Ellipta should not be used as a rescue inhaler for exacerbations or sudden breathing problems. Some mixtures of medications can lead to serious and even fatal consequences. This use is described above in Is Trelegy Ellipta used for COPD?. QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away. Any suggestions. Its also used to manage chronic obstructive pulmonary disease (COPD) symptoms. This medication may raise your blood pressure. This medication may temporarily slow down a child's growth if used for a long time. To improve breathing: Albuterol serves to dilate, or "open up" narrowed airways due to spasm, while the Prednisone is to relieve any narrowing that may be due to inflammation. Some chemotherapeutic agents may decrease the effectiveness of ritonavir-boosted nirmatrelvir. Trelegy Ellipta 100 mcg-62.5 mcg-25 mcg powder for inhalation.