Hi, Brief answer: Breo Ellipta has not been shown to interact with warfarin or increase/decrease INR. Detailed answer: Both Breo Ellipta and Advair contain the inhaled corticosteroid, fluticasone. Corticosteroids in oral and injectable forms have been shown to interact with warfarin and increase the INR, and therefore the risk of bleeding. Inhaled corticosteroids have not been linked to such effects. Many medications, including herbal supplements, can interact with warfarin and affect the INR. I recommend that patient s who take warfarin be mindful of consuming large quantities of foods rich in vitamin K because these foods decrease the effect of warfarin. This includes not eating too many leafy greens like kale, mustard greens, spinach as well as avocado. Additionally avoid cranberry juice and alcohol because these increase the effect of warfarin, and thus the risk of bleeding. I encourage your husband to let his doctor know if he is taking any over the counter medications or herbal supplements as well as any changes to diet. Hope this helps answer your query. Let me know if I can assist you further. Regards, Dr. Aaron Shapiro