Anoro

How to order Anoro

1. Find the drug you need on our site.
2. Pick a clinic. See the price.
3. Fill in a short health form.
4. A doctor reads your form.
5. If it is safe for you, they say yes.
6. Your order ships fast to your door.
7. It comes in a plain, sealed box.

Why use us? We compare UK clinics. We show you the price and how fast they ship. We do not sell drugs. We just help you find the best one for you.

Is it safe? Yes. All our clinics are UK-based. A real doctor reads each form. They will not sell to you if it is not safe for you.

Anoro on Prescriptsy

Anoro is described on Prescriptsy as independent product information.

Here you can understand how online consultation works, what medical checks partner clinics carry out, and which factors matter when comparing providers.

We do not sell medicines directly, but help users compare licensed healthcare partners on price, delivery speed, service quality, and overall trustworthiness.

Anoro Ellipta is a prescription-only dual bronchodilator inhaler combining umeclidinium (55 micrograms) and vilanterol (22 micrograms) for once-daily maintenance treatment of chronic obstructive pulmonary disease (COPD) in adults.

It delivers two complementary bronchodilators in a single inhalation through the Ellipta dry powder device: umeclidinium, a long-acting muscarinic antagonist (LAMA), and vilanterol, a long-acting beta2-adrenergic agonist (LABA).

Together, these active substances reduce airflow obstruction by relaxing bronchial smooth muscle through two independent pharmacological pathways.

COPD affects approximately 1.2 million diagnosed individuals in the United Kingdom, with NICE estimating that a further 2 million remain undiagnosed.

The condition encompasses chronic bronchitis and emphysema, typically caused by prolonged exposure to tobacco smoke, occupational dusts, or air pollutants.

When single-bronchodilator therapy proves insufficient for symptom control, NICE guideline NG115 recommends stepping up to LAMA plus LABA combination treatment for patients without features suggesting asthmatic or steroid-responsive disease.

This product information has been reviewed by Dr.

Claire Phipps, MBBS MRCGP (GMC 7014359), and provides a clinical overview of Anoro Ellipta including how it works, correct inhaler technique, dosage, potential side effects, and important safety considerations for COPD patients in the UK.

Important safety information about Anoro Ellipta

Anoro Ellipta is a maintenance treatment and must not be used for relief of sudden breathing difficulties. Always carry a separate short-acting bronchodilator inhaler (such as salbutamol) for rescue use. Three situations require urgent medical attention:

• Paradoxical bronchospasm: sudden worsening of wheeze or breathlessness immediately after using the inhaler. Stop using Anoro and use your rescue inhaler. Seek medical help the same day.
• Signs of acute narrow-angle glaucoma: severe eye pain, blurred vision, seeing coloured haloes around lights, red eyes. Attend A&E immediately.
• Inability to pass urine or painful urinary retention after starting treatment. Contact your GP urgently or attend A&E if severe.

Anoro Ellipta is not licensed for the treatment of asthma.

Using a LABA without an inhaled corticosteroid in asthma has been associated with serious asthma-related events including hospitalisation and death.

If you have not received a confirmed COPD diagnosis through spirometry (breathing tests), discuss this with your GP before starting treatment.

Learn more about online GP consultations if you need to discuss your COPD management remotely.

What Anoro Ellipta is and how it works

Anoro Ellipta delivers two active substances as a dry powder for inhalation. Each actuation provides 55 micrograms of umeclidinium bromide and 22 micrograms of vilanterol (as trifenatate):

Umeclidinium is a long-acting muscarinic antagonist (LAMA). It works by blocking muscarinic M3 receptors on the smooth muscle cells lining the airways.

In COPD, excessive cholinergic (parasympathetic) nerve activity causes airway smooth muscle contraction and increased mucus secretion. Umeclidinium inhibits this cholinergic bronchoconstriction, keeping the airways more open.

The effect lasts at least 24 hours from a single dose, permitting once-daily administration.

Vilanterol is a long-acting beta2-adrenergic agonist (LABA). It selectively stimulates beta2-adrenoceptors on airway smooth muscle, activating adenylyl cyclase and increasing intracellular cyclic adenosine monophosphate (cAMP).

This triggers a signalling cascade that relaxes smooth muscle fibres and reduces airway resistance.

Vilanterol has a rapid onset of action (within 15 minutes) and a sustained duration of effect over 24 hours.

The clinical rationale for combining LAMA and LABA in a single inhaler is well established.

Cholinergic and adrenergic pathways control airway smooth muscle tone through separate mechanisms: blocking one while stimulating the other produces additive or supra-additive bronchodilation compared with either agent alone.

Pivotal registration trials demonstrated that Anoro Ellipta provides statistically significant improvements in trough FEV1 (forced expiratory volume in one second) of approximately 100-120 mL above placebo, and 50-70 mL above the individual components administered as monotherapy.

Who Anoro Ellipta is for

COPD maintenance therapy

Anoro Ellipta is indicated for maintenance bronchodilator treatment to relieve symptoms in adult patients with COPD.

NICE guideline NG115 positions LAMA plus LABA combination therapy as the preferred step-up for COPD patients who remain breathless or experience exacerbations despite initial single-bronchodilator treatment, and who do not have features suggesting asthma-COPD overlap or steroid responsiveness.

Suitable patients typically have a confirmed COPD diagnosis based on spirometry showing a post-bronchodilator FEV1/FVC ratio below 0.7, along with a relevant exposure history (smoking, occupational exposure) and compatible symptoms.

The diagnosis should be established by spirometry before prescribing, as clinical symptoms alone are insufficient. Treatment aims to reduce breathlessness, improve exercise tolerance, and reduce exacerbation frequency.

Patients who are not suitable for Anoro Ellipta

Anoro Ellipta is not indicated for patients with asthma, children or adolescents under 18 years of age, or for the relief of acute bronchospasm.

Patients requiring an inhaled corticosteroid component (those with features suggesting asthma-COPD overlap, raised eosinophils above 300 cells per microlitre, or frequent exacerbations despite LAMA/LABA therapy) should be prescribed triple therapy (ICS/LAMA/LABA) instead.

Patients with unstable cardiovascular disease, uncontrolled narrow-angle glaucoma, or symptomatic prostatic hyperplasia with urinary retention should use Anoro only under close specialist supervision.

Dosage and administration in full detail

The recommended and maximum dose is one inhalation of Anoro Ellipta 55/22 micrograms once daily. Take it at the same time each day to maintain consistent bronchodilation.

If a dose is missed, take it as soon as remembered, then resume the regular schedule the following day.

Do not take a double dose to make up for a missed one.

The Ellipta inhaler device requires no assembly, priming, or hand-breath coordination.

The device is breath-actuated: opening the cover loads the dose, and the patient triggers delivery by inhaling through the mouthpiece.

Each inhaler contains exactly 30 doses, and the built-in dose counter shows the number remaining.

The inhaler should be stored in the sealed foil tray until first use and discarded 30 days after opening (or when the counter reaches 0, whichever comes first), even if doses remain.

No dose adjustment is required for patients aged 65 years and older, or for those with mild-to-moderate renal impairment (eGFR 30 mL/min and above).

In severe renal impairment (eGFR below 30 mL/min), no dose adjustment is formally recommended but monitoring for antimuscarinic side effects is advised.

For patients with mild hepatic impairment (Child-Pugh A), no adjustment is needed; Anoro should be avoided in moderate-to-severe hepatic impairment (Child-Pugh B or C) as no pharmacokinetic data are available for these populations.

After each inhalation, rinse the mouth with water and spit it out. Do not swallow. This practice reduces the risk of oral candidiasis and dry mouth.

Clean the mouthpiece using a dry tissue only; never wash the inhaler with water as moisture will damage the powder formulation.

Comprehensive side effects profile

Common side effects

In clinical trials involving over 6,800 patients with COPD, the most frequently reported adverse reactions with Anoro Ellipta were: upper respiratory tract infection (affecting 2-5% of patients), nasopharyngitis, urinary tract infection, sinusitis, headache, cough, oropharyngeal pain, constipation, and dry mouth.

Most of these effects were mild to moderate in severity and did not require treatment discontinuation.

Dry mouth is attributable to the antimuscarinic action of umeclidinium. It typically improves within the first few weeks of treatment as tolerance develops.

Adequate hydration, sugar-free chewing gum, and regular dental hygiene help manage this effect. Constipation, another antimuscarinic side effect, should be managed with adequate fluid intake and dietary fibre.

Uncommon and rare side effects

Uncommon adverse reactions (affecting fewer than 1 in 100 patients) include: tremor, dysgeusia (altered taste), tachycardia (heart rate above 100 beats per minute), palpitations, atrial fibrillation, supraventricular tachycardia, dysphonia (hoarse voice), and skin rash.

These require monitoring and GP review if persistent or troublesome.

Rare but clinically important effects include: paradoxical bronchospasm (requiring immediate discontinuation and rescue bronchodilator use), anaphylaxis, angioedema, urticaria, acute narrow-angle glaucoma, and urinary retention.

Any of these adverse reactions necessitate urgent medical assessment.

Hypokalaemia and hyperglycaemia may occur as class effects of the LABA component, particularly in patients concurrently taking systemic corticosteroids, diuretics, or xanthine derivatives.

Reporting side effects

In the United Kingdom, suspected adverse reactions should be reported through the Yellow Card Scheme at yellowcard.mhra.gov.uk.

Reporting helps the MHRA monitor the ongoing safety profile of licensed medicines. Your GP, pharmacist, or hospital doctor can also submit Yellow Card reports on your behalf.

Warnings, precautions and interactions

Cardiovascular precautions

Beta2-agonists can produce clinically significant cardiovascular effects in susceptible individuals, including elevated heart rate, elevated blood pressure, and cardiac rhythm disturbances.

Exercise particular caution if you have any of the following conditions: severe cardiovascular disease, coronary artery disease, cardiac arrhythmias (including atrial fibrillation), hypertrophic obstructive cardiomyopathy, idiopathic subvalvular aortic stenosis, severe hypertension, known QTc prolongation, or a history of myocardial infarction within the past 12 months.

Metabolic effects

Vilanterol may cause dose-related prolongation of the QTc interval and reductions in serum potassium concentration.

In patients with diabetes mellitus, additional blood glucose monitoring may be needed during initial treatment.

Patients taking concomitant potassium-lowering medications (thiazide diuretics, loop diuretics, systemic corticosteroids, xanthine derivatives) should have electrolytes checked periodically.

Drug interactions

Clinically significant drug interactions with Anoro Ellipta include the following categories.

Non-selective beta-adrenergic blockers (propranolol, carvedilol, nadolol) may reduce or abolish the bronchodilatory effect of vilanterol and should generally be avoided.

If a beta-blocker is essential, a cardioselective agent (bisoprolol, atenolol) at the lowest effective dose is preferred.

Other long-acting muscarinic antagonists (tiotropium, glycopyrronium, aclidinium) or other LABAs (formoterol, salmeterol, indacaterol, olodaterol) should not be used concurrently with Anoro due to additive antimuscarinic or sympathomimetic effects.

Potent CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir, cobicistat) may increase systemic exposure to vilanterol; co-administration should be avoided where possible.

MAO inhibitors and tricyclic antidepressants may potentiate the cardiovascular effects of vilanterol; concurrent use warrants caution.

Pregnancy, breastfeeding and fertility

There are limited data on the use of Anoro Ellipta during pregnancy.

Animal studies showed no teratogenicity but demonstrated class-consistent effects (skeletal variations, reduced foetal weight) at supratherapeutic doses.

Use during pregnancy only if the expected benefit to the mother outweighs any possible risk to the foetus.

It is not known whether umeclidinium or vilanterol are excreted in human breast milk.

A decision should be made whether to discontinue breastfeeding or discontinue treatment, taking into account the benefit of breastfeeding for the child and the benefit of therapy for the mother.

Discuss family planning with your prescriber.

Storage, handling and disposal

Store Anoro Ellipta below 30 degrees Celsius. Keep the inhaler in the sealed foil tray until ready for first use to protect from moisture.

Once opened, use within 30 days. Do not refrigerate or freeze the inhaler.

Keep the cover closed when not in use to protect the mouthpiece and prevent accidental dose loading. Store out of the sight and reach of children.

Do not use the inhaler after the expiry date printed on the carton, tray, and dose counter.

Return unused or expired inhalers to a pharmacy for safe disposal as part of the NHS take-back scheme.

COPD management in the UK NHS

Chronic obstructive pulmonary disease management in the United Kingdom follows NICE guideline NG115 (updated 2019), which recommends a stepwise approach to pharmacological treatment based on symptom burden and exacerbation history.

Initial treatment is typically a short-acting bronchodilator (SABA or SAMA), escalating to a LAMA or LABA as monotherapy, then to LAMA plus LABA combination, and finally to triple therapy (ICS/LAMA/LABA) for patients with persisting exacerbations and eosinophilic features.

Anoro Ellipta sits at the LAMA/LABA combination step for patients without asthmatic features or high eosinophil counts.

Annual review of COPD patients by their GP or respiratory nurse is recommended to assess inhaler technique, medication adherence, symptom control (using validated tools such as the CAT score or MRC dyspnoea scale), exacerbation frequency, and smoking cessation status.

Pulmonary rehabilitation, an evidence-based exercise and education programme, significantly improves outcomes alongside pharmacological treatment and is available through NHS referral.

Prescription charges for Anoro Ellipta in England are currently set at the standard NHS rate of 9.90 pounds per item.

Patients in Scotland, Wales, and Northern Ireland receive prescriptions free of charge.

Patients in England who require multiple prescriptions may benefit from a Prescription Prepayment Certificate (PPC), currently costing 31.25 pounds for three months or 111.60 pounds for 12 months.

Exemptions from charges apply to patients aged 60 and over, those receiving certain benefits, and those with specific medical exemptions.

Frequently asked questions about Anoro Ellipta

Can I use Anoro Ellipta for asthma?

No. Anoro Ellipta is licensed exclusively for COPD in adults and must not be used for asthma.

The LABA component (vilanterol) used without an inhaled corticosteroid in asthma has been associated with serious adverse outcomes.

If you have asthma, your doctor will prescribe a treatment containing an inhaled corticosteroid as the foundation of your therapy.

What should I do if I forget a dose?

Take the missed dose as soon as you remember. If it is nearly time for your next scheduled dose, skip the missed one and continue as normal.

Never take two inhalations on the same day to compensate for a missed dose, as this increases the risk of side effects including tachycardia and tremor.

How will I know the inhaler is empty?

The Ellipta inhaler has a built-in dose counter visible through the window on the front of the device.

It counts down from 30 to 0 as you use each dose. When the counter shows 0, the inhaler is empty.

The counter will display a red warning when fewer than 10 doses remain.

Obtain a replacement inhaler from your pharmacy before the current one runs out to ensure uninterrupted treatment.

Can Anoro Ellipta be used alongside other inhalers?

Anoro Ellipta should not be combined with other LAMAs or other LABAs, as doubling up on the same drug class increases side effects without proportional benefit.

It can be used alongside a short-acting bronchodilator (salbutamol or ipratropium) for rescue relief.

If your COPD is not adequately controlled on Anoro alone, your GP may consider adding an inhaled corticosteroid, switching to a triple therapy inhaler such as Trelegy Ellipta, or referring you to a respiratory specialist for further assessment.

Does Anoro Ellipta contain steroids?

No. Anoro Ellipta does not contain any corticosteroid. It contains two bronchodilators only.

If your doctor determines that you need a corticosteroid component as well, they may prescribe a separate ICS inhaler or switch you to a combination product that includes an ICS, such as Trelegy Ellipta (fluticasone furoate/umeclidinium/vilanterol).

Sources and further reading

• Anoro Ellipta SmPC - Electronic Medicines Compendium (EMC)
• BNF: Umeclidinium with vilanterol
• NICE guideline NG115: Chronic obstructive pulmonary disease in over 16s
• NHS: Chronic obstructive pulmonary disease (COPD)
• MHRA Yellow Card Scheme