Formoterol Fumarate Dihydrate / Mometasone Furoate

Dulera

Dulera is a prescription inhaler approved by the FDA to manage asthma in adults and children aged five and older. It contains two medications: mometasone, an inhaled corticosteroid that reduces inflammation, and formoterol, a long-acting beta agonist that relaxes airway muscles to improve breathing. Dulera is not suitable for immediate relief from asthma attacks but is instead used twice daily to maintain long-term control of asthma. It is available in different strengths and is not suitable for children under five years old. Patients must adhere to prescribed dosages and follow specific inhalation techniques to ensure effectiveness and minimize side effects, such as oral thrush and potential systemic effects from long-term use.

Product Overview

Dulera, a combination inhaler, is specifically formulated for the management of asthma in individuals five years of age and older. This inhaler combines mometasone, a corticosteroid that helps reduce inflammation within the airways, and formoterol, a long-acting beta2-agonist that aids in relaxing and opening the air passages in the lungs. Dulera is designed for regular, long-term use and is not indicated for the immediate relief of acute asthma symptoms; instead, patients are advised to use a rescue inhaler for sudden asthma attacks.

Administered via a metered-dose inhaler, Dulera comes in three dosing strengths: 50 mcg/5 mcg, 100 mcg/5 mcg, and 200 mcg/5 mcg of mometasone/formoterol respectively, allowing customization of treatment based on the patient’s age and severity of asthma symptoms. Adult patients typically use the 100 mcg/5 mcg or 200 mcg/5 mcg strength, taking two inhalations twice daily, while children between 5 to 11 years are prescribed the lowest strength.

Long-term usage of Dulera can potentially lead to side effects such as oral thrush and an infection of the mouth and throat, and patients are advised to rinse their mouths post-inhalation to mitigate this risk. Serious side effects may include an increased risk of infections, possible glaucoma or cataracts, and effects on growth in pediatric patients. For optimal results, it’s essential for patients to adhere strictly to their prescribed regimen and consult healthcare providers regularly to adjust dosing if necessary. Dulera’s effectiveness is contingent on consistent use, even when symptoms are not present, to maintain lung function and control asthma over time.

Uses of Dulera

Dulera is approved in adults and children (5 years or older) to treat Asthma. It’s off-label uses are:

• Sudden breathing problems
• COPD (Chronic obstructive pulmonary disease)

[Important Warning: Dulera isn’t approved for sudden asthma attacks. Use inhalers that are made for these situations. YOu can talk to your doctor about what else you can do]

How to Use Dulera?

Dosage

Dulera is provided in a metered dose inhaler, identifiable by its blue color and disposable design. It consists of a canister containing the active ingredients, mometasone and formoterol, and an actuator that dispenses premeasured inhalations (puffs). Dulera is offered in three strengths:

• 50 mcg / 5 mcg (mometasone/formoterol)
• 100 mcg / 5 mcg (mometasone/formoterol)
• 200 mcg / 5 mcg (mometasone/formoterol)

The canisters contain either 60 or 120 puffs, equivalent to 30 or 60 doses, respectively. Each dose comprises two puffs from the inhaler.

Recommended Dosage for Different Patients

Dosage for Asthma with Dulera

For adults with asthma, Dulera is available in two strengths:

• 100 mcg / 5 mcg (mometasone/formoterol)
• 200 mcg / 5 mcg (mometasone/formoterol)

Administration:

• Inhale two puffs of Dulera orally twice daily.
• Allow at least 30 seconds between each puff.
• The maximum dosage is two puffs of Dulera (200 mcg/5 mcg strength) twice daily.

Dulera is not intended for immediate relief of asthma symptoms. If asthma symptoms occur between Dulera doses, a rescue inhaler like a short-acting beta2-agonist (SABA) is typically recommended.

Pediatric Dosage of Dulera

For children aged 5 to 11 years:

• Dulera strength: 50 mcg / 5 mcg (mometasone/formoterol)
• Recommended dose: Two puffs twice daily

For children aged 12 years and older, the same doses as adults are recommended.

Long-Term Medication

Dulera is intended for long-term treatment. If you and your doctor decide it’s suitable and effective for you, you’ll likely use it for an extended period.

[Note: Remember these recommendations may vary depending on person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Take It?

• The dosage of your medicine prescribed by your doctor will depend on several factors. These include:
  • The type and severity of the condition you’re using Dulera to treat
  • Your age
  • Other medical conditions you may have
• When to take
  • You’ll take Dulera twice a day. You should take your dose of Dulera every 12 hours.
  • Two puffs count as one dose. So you’ll take a total of four puffs each day.
  • To help make sure that you don’t miss a dose, try using a medication reminder.
• Typically, your doctor will adjust it over time to reach the amount that’s right for you. Your doctor will prescribe the smallest dosage that provides you the desired effect.
• The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
• You should take Dulera according to your doctor’s or healthcare provider’s instructions.
• Dulera comes as a metered dose inhaler, which dispenses the drug as a spray. Each inhaler is made up of a canister and an actuator. The canister contains the drug. The actuator holds the canister in place & then releases the drug in pre-measured inhalations also called puffs.
• You’ll use the Dulera inhaler to breathe in the medication.
• You should always rinse your mouth after each dose of Dulera. Once you’ve taken your puffs, rinse your mouth with water and spit it out right away. Don’t swallow the water. This rinsing process helps reduce your risk for mouth and throat infections, such as oral thrush.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Dulera Work?

Dulera operates through a combination of two drugs: mometasone, a corticosteroid, and formoterol, LABA (a long-acting beta2-agonist). Corticosteroids like mometasone alleviate lung inflammation and hinder further inflammation from exacerbating breathing difficulties. On the other hand, long-acting beta2-agonists, such as formoterol, function in the lungs to relax the muscles lining the airways, thereby widening them to facilitate increased airflow during inhalation.

Together, mometasone and formoterol collaborate to enhance breathing and enhance oxygen intake into the lungs. Dulera can provide relief in as little as 5 minutes after administration and typically sustains its effects for approximately 12 hours. Even if immediate relief is experienced, it’s crucial to adhere to the prescribed daily regimen, as Dulera gradually enhances lung function and reduces the likelihood of asthma attacks over time.

Important Safety Information

Side Effects

Common side effects of Dulera may include:

• Sinusitis (sinus infection)
• Headache
• Common cold

Serious side effects of Dulera may include:

• Increased risk of infection, such as measles or chickenpox
• Throat and mouth infections, such as oral thrush. Signs may include:
  • Pain while eating or swallowing
  • White patches in your throat, on your tongue, on your inner cheeks, or on the roof of your mouth
  • Loss of taste
  • Redness or soreness in your mouth or throat
• Glaucoma, cataracts (types of eye disease), or both. Signs may include:
  • Sensitivity to light
  • Blurred or cloudy vision
  • Seeing “halos” around lights
  • Trouble seeing at night
  • Eye redness
• Paradoxical bronchospasm. Signs may include:
  • Shortness of breath
  • Coughing
• Hyperglycemia (high blood sugar). Signs may include:
  • Frequent urination
  • Trouble concentrating
  • Fatigue (lack of energy)
  • Increased thirst
  • Headache
• Adrenal suppression (low levels of a hormone called cortisol). Signs may include:
  • Muscle weakness
  • Joint pain
  • Depression
  • Belly pain
  • Chronic (long-lasting) fatigue
  • Feeling irritable
  • Hypotension (low blood pressure)
  • Weight loss
• Hypokalemia (low level of potassium). Signs may include:
  • Low blood pressure
  • Increased thirst
  • Muscle twitching
  • Muscle weakness
  • Irregular heartbeat
  • Frequent urination
  • Muscle cramps
• Decline in bone density, which may lead to osteoporosis. Signs can include:
  • Stooped posture
  • Loss of height over time
  • Back pain

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Warnings

Before starting treatment with Dulera, it’s crucial to discuss your complete health history with your doctor. Dulera may not be suitable for everyone, especially if you have certain medical conditions or other factors that could affect your health. Considerations before using Dulera include:

• Certain Hormone Disorders: Before taking Dulera, it is important to discuss any hormone-related disorders you may have with your doctor. Dulera contains two active ingredients, mometasone, and formoterol, which could affect hormone levels and exacerbate certain conditions. Mometasone, a component of Dulera, may affect the balance of cortisol. Formoterol, this ingredient, can worsen the symptoms of hyperthyroidism; these hormone imbalances can result in serious side effects, including muscle weakness and abnormal heart rhythms. If you have a known hormone disorder, such as issues with your adrenal or thyroid glands, it’s crucial to let your doctor know. Based on your specific health situation, your doctor may recommend an alternative medication for managing your asthma, ensuring both safety and effectiveness in your treatment plan.
• Diabetes: Dulera may increase blood sugar levels. If you have diabetes, using Dulera could potentially worsen your condition. It’s important to discuss this with your doctor before starting Dulera. They may need to monitor your blood sugar levels more closely during treatment to manage any potential increases.
• High Blood Pressure and Other Heart Problems: Formoterol, one of the active ingredients in Dulera, can exacerbate certain heart conditions, including high blood pressure and abnormal heart rhythms. If you have any heart-related issues, consult with your doctor to determine if Dulera is safe for you. They may evaluate your heart condition and suggest alternative treatments if necessary.
• Rapidly Worsening Asthma: Dulera is not recommended if you are experiencing rapidly worsening asthma. It is not suitable as a substitute for intense medical treatment or hospitalization in life-threatening asthma situations. If you are unsure about the stability of your asthma or whether it is appropriate to start Dulera, have a detailed discussion with your doctor. They can assess the severity of your asthma and advise whether Dulera is an appropriate treatment option.
• Seizures or Other Convulsive Disorders: Formoterol, one of the active components in Dulera, might exacerbate seizure disorders. If you have a history of seizures or other convulsive disorders, it is crucial to consult with your doctor before starting Dulera. They may evaluate your condition and consider recommending a safer medication for your asthma.
• Serious Infections: Dulera can impair your body’s ability to fight infections. If you currently have a serious infection like tuberculosis (TB) or have had one in the past, using Dulera may not be advisable. Discuss your medical history thoroughly with your doctor before using Dulera, especially if you have ongoing symptoms of a serious infection.
• Use of Oral Corticosteroids: If you are transitioning from using an oral corticosteroid (like prednisone) to Dulera, it’s important to manage this process carefully. Abruptly stopping oral corticosteroids can lead to withdrawal symptoms such as joint and muscle pain or depression. Therefore, your doctor may recommend tapering off the oral corticosteroid gradually to prevent these symptoms. Make sure to discuss your current medication regimen with your doctor before making any changes, including starting Dulera.
• Allergic reaction: Like most medications, there is a potential for allergic reactions when taking Dulera. While statistics on the prevalence of allergic reactions to Dulera are not available, it’s important to be aware of the symptoms of such reactions, which can range from mild to severe. Mild allergic reactions may include symptoms such as skin rash, itchiness, and flushing (warmth and redness in your skin). Though mild reactions are more common, severe allergic reactions are rare but can occur. If you experience a severe reaction, it’s crucial to seek medical attention immediately. Contact your doctor right away if you think you are having a severe allergic reaction to Dulera. If your symptoms feel life-threatening or if you believe you’re experiencing a medical emergency, call 911. Symptoms of a severe allergic reaction include:
  • Swelling of your mouth, tongue, or throat
  • Swelling under your skin, typically in your lips, eyelids, feet, or hands
  • Hives (itchy welts on your skin)
  • Trouble breathing
• Withdrawal symptoms: Withdrawal symptoms are generally not expected when discontinuing treatment with Dulera. This contrasts with experiences some individuals have when stopping systemic steroids like prednisone, where withdrawal symptoms are more common. This difference is partly due to the method of delivery and the body’s exposure to the drug. Inhaled corticosteroids, such as mometasone—one of the active ingredients in Dulera—result in a lower systemic level of the drug compared to oral steroids. To date, no studies have specifically linked Dulera to withdrawal symptoms. However, it is important to monitor your health after discontinuing any steroid medication, including Dulera. If you notice symptoms such as Joint or muscle pain, Low energy, or Feelings of depression, You should contact your doctor promptly.

Precautions

• It is crucial for your doctor to monitor your progress, or that of your child, during regular visits while using Dulera. These check-ups help ensure the medication is effective and to identify any potential side effects. You may also need to have your eyes examined during these visits, so be sure to keep all scheduled appointments.
• While Dulera can reduce the frequency of asthma episodes, it’s important to note that it may increase the likelihood of a severe asthma episode when one does occur. If you have any questions or concerns about this, discuss them with your doctor or pharmacist to ensure you understand the risks and management strategies.
• Do not use Dulera if you or your child is experiencing an asthma attack that has already begun or if the attack is severe. Dulera is not designed to provide immediate relief in such situations. Instead, your doctor will likely prescribe a different medication, such as a short-acting inhaler, for use during acute asthma attacks.
• Do not use any other asthma medications or medicines for breathing problems without first consulting your doctor. Dulera should not be used in conjunction with certain other medications due to potential interactions or overlapping effects. Specifically, you should avoid using Dulera with the following medications: Arformoterol (Brovana), Formoterol (Foradil, Perforomist), Salmeterol (Serevent), Budesonide/formoterol (Symbicort)
• These medications contain active ingredients similar to those in Dulera, and using them together could increase the risk of side effects or lead to other complications. Always communicate with your healthcare provider about all the medications you are currently using, including over-the-counter drugs, prescriptions, and any herbal supplements. This will help ensure your asthma treatment is both safe and effective.
• It’s important to monitor the effectiveness of Dulera closely and seek medical attention promptly under certain circumstances. Contact your doctor or seek medical care immediately if you or your child experience any of the following:
  • Lack of Improvement or Worsening Symptoms: If there is no improvement in asthma symptoms after using Dulera for one week, or if the symptoms worsen, it’s crucial to inform your healthcare provider.
  • Increased Use of Short-Acting Inhalers: If your short-acting inhaler is not providing the usual relief, or if you find yourself needing to use it more often than usual—for example, using one whole canister within eight weeks, or needing four or more inhalations for two or more consecutive days—it may indicate that your asthma is not being adequately controlled.
  • Decrease in Peak Flow Rates: A significant drop in your or your child’s peak flow measurements, as directed by your doctor, can be a sign of worsening asthma. This requires immediate medical evaluation. These signs may indicate that your current asthma management plan, including the use of Dulera, needs to be reassessed or adjusted. Early intervention in response to these warning signs can help manage the condition more effectively and prevent serious complications.

Other Important Precautions

• Other Drugs: Dulera is designed for the long-term management of asthma. It is vital to take Dulera daily, regardless of whether you are experiencing good or bad breathing days. This consistent use is crucial for maintaining control over your asthma symptoms and preventing exacerbations. It’s important to note that Dulera is not suitable for the immediate relief of sudden breathing problems, also known as asthma attacks. Dulera does not act quickly enough to be used as a rescue medication during an acute asthma episode. Always make sure to have your rescue inhaler with you and discuss its proper use with your doctor to ensure you are prepared to handle sudden asthma symptoms effectively.
• Alcohol: Currently, there are no known interactions specifically between Dulera and alcohol. However, it’s important to be aware that long-term alcohol consumption can cause damage to the cilia in your airways. Cilia are small, hair-like structures in the lungs that play a crucial role in trapping and removing germs with each breath. Damage to these cilia can impair your body’s ability to clear germs from the airways, potentially increasing your risk of infections. Such infections could complicate your breathing, particularly if you are managing a respiratory condition like asthma. If you consume alcohol, it is advisable to discuss with your doctor the amount of alcohol that you may safely drink while undergoing treatment with Dulera. Your doctor can provide guidance tailored to your specific health needs and circumstances, helping you manage your overall health and the effectiveness of your asthma treatment.
• Pregnancy: The safety of using Dulera during pregnancy is not conclusively known. While no clinical studies with Dulera have been conducted on pregnant animals, studies on the individual ingredients, mometasone, and formoterol, have shown that these substances can cause birth defects in offspring when administered to pregnant animals. However, it’s important to note that results from animal studies may not always directly apply to humans. Managing asthma effectively during pregnancy is crucial, as uncontrolled asthma can pose risks to both you and your baby. These risks include complications such as low birth weight, premature birth, and preeclampsia (a condition characterized by high blood pressure during pregnancy). Properly managing your asthma can significantly reduce these risks. Current guidelines for asthma treatment during pregnancy indicate that using a combination of an inhaled corticosteroid and a long-acting beta2-agonist, which are the components of Dulera, is generally considered safe for pregnant women with asthma. If you are pregnant or planning to become pregnant and have asthma, it’s essential to discuss with your doctor the potential benefits and risks of using Dulera. Your doctor can help you weigh the pros and cons and decide on the most appropriate asthma management plan during your pregnancy.
• Birth Control: The safety of Dulera during pregnancy has not been established. If you are sexually active and there is a possibility of pregnancy, it is important to discuss your birth control options with your doctor while you are using Dulera. This conversation will help ensure that you are adequately informed about how to manage your health and the potential risks involved with the medication during pregnancy. Your doctor can provide guidance on effective birth control methods to prevent pregnancy while you are being treated with Dulera.
• Breastfeeding: The safety of using Dulera while breastfeeding is not fully established. This uncertainty arises because it is not clear if Dulera passes into human breast milk. While mometasone, one of the components of Dulera, has been detected in human breast milk, and formoterol (another ingredient) is present in animal milk, results from animal studies may not directly correspond to human outcomes. If you are using Dulera and considering breastfeeding, it is essential to have a thorough discussion with your doctor. You and your healthcare provider can evaluate the potential benefits and risks associated with using Dulera during breastfeeding and decide on the best feeding method for your child. This conversation will help ensure both your health and the well-being of your baby.

Contraindications

• Dulera should not be used in patients experiencing status asthmaticus or other acute asthmatic episodes requiring intensive therapy.
• It is also not suitable for individuals with hypersensitivity to any component of Dulera.

Missed Dose

• If you forget to take a dose of Dulera, just skip it and take the next one at your usual time.
• Avoid taking two doses together to make up for the missed one, as it can raise the risk of serious side effects.
• Consider using a medication reminder to help you stay on track with your doses.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

Overdose

Taking more Dulera than prescribed can cause serious side effects. Signs of an overdose may include 

• Seizures (changes in the electrical activity of your brain)
• Chest pain
• Shakiness
• Fast heart rate
• Changes in heart rhythm
• High blood pressure or low blood pressure
• Dizziness
• Dry mouth
• Muscle cramps
• Nervousness
• Headache
• Fatigue (lack of energy)

If you believe you’ve taken too much Dulera, contact your doctor immediately. You can also reach out to the American Association of Poison Control Centers or use their online tool. In severe cases, call 911 or visit the nearest emergency room without delay.

[Note: If you consumed more than recommended dose, get medical help right away, or call the Poison Help line at 1-800-222-1222.]

Storage

• Store your Dulera inhaler at room temperature, ideally between 68°F and 77°F (20°C and 25°C), away from light.
• If necessary, you can temporarily store the inhaler at temperatures between 59°F and 86°F (15°C and 30°C).
• Avoid storing Dulera in areas prone to dampness or moisture, such as bathrooms, as this can affect its efficacy.
• Ensure that the medication is not exposed to excessive heat, as it may cause the canister to burst.
• When disposing of leftover Dulera medication, do so safely to prevent accidental ingestion by others, including children and pets.
• Visit the FDA website or consult your pharmacist for guidance on proper medication disposal methods.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Dulera Interactions

Dulera can interact with various medications, certain supplements, and specific foods. These interactions can lead to different outcomes. For example, some interactions might interfere with the effectiveness of Dulera or another drug. Others could increase the frequency or severity of side effects. 

Interaction with Other Medications

Below is a list of medications that can interact with Dulera. Please note that this list is not exhaustive and does not include all possible drug interactions. Before starting Dulera, it is important to discuss all medications you are currently taking with your doctor and pharmacist. This consists of all prescription and over-the-counter drugs, as well as any vitamins, herbs, and supplements you use. Sharing this comprehensive information helps prevent potential drug interactions and ensures your treatment is as safe and effective as possible. If you have any questions about drug interactions that may affect you, do not hesitate to ask your doctor or pharmacist for more information.

Interaction with Certain HIV Drugs: Taking Dulera along with specific medications used to treat HIV can result in increased levels of Dulera in your body. This occurs because certain HIV medications inhibit the breakdown of Dulera, leading to elevated concentrations that may heighten the risk of serious side effects. Examples of these HIV medications include:

• Crixivan (indinavir)
• Reyataz (atazanavir)
• Viracept (nelfinavir)
• Invirase (saquinavir)
• Norvir (ritonavir)

If you are currently taking one of these HIV medications, your doctor might consider prescribing a different medication for your asthma to avoid potential adverse interactions. Always ensure your healthcare provider is aware of all the medications you are taking to manage your treatment safely and effectively.

Interaction with Some Antifungal or Antibiotic Medicines: Using Dulera in combination with specific antibiotic or antifungal medications can increase the level of Dulera in your system. This happens because some antibiotics and antifungals inhibit the breakdown of Dulera in your body, leading to elevated levels that can cause serious side effects.

Examples of these antibiotic drugs include:

• Ketek (telithromycin)
• Biaxin (clarithromycin)

Examples of these antifungal drugs include:

• Ketozole (ketoconazole)
• Nizoral (ketoconazole)
• Xolegel (ketoconazole)
• Onmel (itraconazole)
• Sporanox (itraconazole)
• Tolsura (itraconazole)

Typically, it’s not recommended to use these medications while taking Dulera. However, if it is necessary for you to be treated with one of these drugs while on Dulera, your doctor will closely monitor you to manage and promptly address any potential side effects.

Interaction with Certain Diuretics: Taking specific diuretics, commonly known as water pills, alongside Dulera can increase your risk of developing hypokalemia, which is a condition characterized by low potassium levels. Additionally, this combination may elevate your risk for serious cardiac issues, such as abnormal heart rhythms. Examples of these diuretics include:

• Demadex (torsemide)
• Lasix (furosemide)
• Chlorthalidone
• Microzide (hydrochlorothiazide, also known as HCTZ)

If it’s necessary for you to take one of these diuretics while using Dulera, your doctor will monitor you closely. This monitoring will focus on detecting any changes in your heart rhythm and potassium levels to ensure your safety while on these medications.

Interaction with Certain Antidepressants: Using the Dulera inhaler along with certain antidepressants can significantly increase your risk of serious side effects, including abnormal heart rhythms. It is recommended not to take Dulera within two weeks of using these antidepressants. Examples of these antidepressants include:

• Emsam (selegiline)
• Marplan (isocarboxazid)
• Elavil (amitriptyline)
• Nardil (phenelzine)
• Pamelor (nortriptyline)

If you are currently taking one of these antidepressants, your doctor might choose a different asthma medication for you. Always inform your doctor if you are using an antidepressant before starting treatment with Dulera. This ensures that your treatment plan is safe and appropriate for your health needs.

Interaction with Certain Heart Rate and Blood Pressure Medications: Taking certain medications for heart rate and blood pressure in conjunction with Dulera may increase your risk for serious respiratory issues, such as bronchospasm—a sudden tightening of the muscles in the walls of your lungs. This interaction can interfere with Dulera’s ability to effectively manage your asthma. Examples of heart rate and blood pressure medications that could cause this issue include:

• Tenormin (atenolol)
• Coreg (carvedilol)
• Toprol XL (metoprolol)
• Inderal (propranolol)
• Normodyne (labetalol)
• Lopressor (metoprolol)
• Bystolic (nebivolol)

These medications should only be combined with Dulera in critical situations, such as during a heart attack or if no other suitable medications are available. If you need to take any of these drugs with Dulera, your doctor will closely monitor you to prevent any serious breathing problems.

Interaction with Herbs & Supplements

There are no specific herbs or supplements that have been reported to interact with Dulera. However, it is still important to consult with your doctor or pharmacist before using any herbal or supplemental products while you are taking Dulera. This precaution helps ensure that all aspects of your treatment are safe and effective.

[Note: This isn’t a complete list, and there could be other drugs that interact with Dulera. Make sure to tell your doctor any prescription, over-the-counter medicines, and herbal products you’re taking.]

Dulera Alternatives

• Arnuity Ellipta (fluticasone furoate)
• Symbicort (budesonide/formoterol)
• Xopenex HFA (levalbuterol)
• Ventolin HFA (albuterol)
• Flovent HFA (fluticasone propionate)
• Xolair (omalizumab)
• Zyflo (zileuton)
• Advair (fluticasone propionate/salmeterol)
• Singulair (montelukast)
• Flovent Diskus (fluticasone propionate)
• Accolate (zafirlukast)
• Proventil HFA (albuterol)
• ProAir HFA (albuterol)
• Nucala (mepolizumab)
• Cromolyn sodium
• Pulmicort Flexhaler (budesonide)
• Qvar RediHaler (beclomethasone dipropionate)
• AirDuo RespiClick (fluticasone propionate/salmeterol)
• Theophylline
• Xopenex (levalbuterol)
• Atrovent HFA (ipratropium bromide)
• Asmanex HFA (mometasone furoate)
• Asmanex Twisthaler (mometasone furoate)
• Breo Ellipta (fluticasone furoate/vilanterol)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

Should I rinse out my mouth after inhaling my dose of Dulera?

Yes, it is recommended to rinse your mouth with water and spit it out after inhaling a dose of Dulera. This practice helps prevent potential mouth and throat infections, including oral thrush, which can occur due to the medication remaining in your mouth and throat area.

Can Dulera slow my child’s growth?

It is possible. This medication has mometasone, which is a type of inhaled corticosteroid (ICS). ICSs have been associated with a slight slowing of growth in children. To minimize this risk, doctors usually prescribe the lowest effective dose necessary to manage asthma symptoms effectively. Additionally, it’s important that your child’s growth is monitored regularly by their doctor while they are using Dulera. This allows for timely adjustments to their treatment if necessary.

Is Dulera similar to Breo?

Yes, Dulera and Breo are similar medications in that both are approved by the Food and Drug Administration (FDA) to treat asthma in adults, and Dulera is additionally approved for children ages 5 and older. Each of these medications combines an inhaled corticosteroid (ICS) with a long-acting beta2-agonist (LABA) to manage and prevent asthma symptoms:

• Dulera: have formoterol as the LABA & mometasone as the ICS.
• Breo: have vilanterol trifenatate as the LABA & fluticasone furoate as the ICS.

The delivery method differs between the two. Dulera comes as a metered-dose inhaler, which releases the medication as a spray, making it easier to inhale directly into the lungs. Breo, on the other hand, is a dry powder inhaler that delivers the medication as a fine powder.

It’s important to discuss with your doctor which medication might be best for your specific asthma management needs, as well as how to properly use these inhalers to ensure effective treatment.

Can Dulera cause weight loss or weight gain?

Dulera has not been directly linked to causing weight loss or weight gain. However, there is a possibility that Dulera could affect the function of your adrenal glands. The adrenal glands are important for hormone production, including hormones that regulate metabolism and weight maintenance. If Dulera impacts these glands, it could potentially lead to changes in hormone levels, which in turn could affect your weight.

If you are concerned about any potential weight changes while using Dulera, it’s important to discuss these concerns with your doctor. They can provide more personalized advice and monitor any changes related to the medication’s effects on your body.

Can I use Dulera as a rescue inhaler for sudden breathing problems?

Dulera is not specifically approved as a rescue inhaler for treating sudden breathing problems. However, recent treatment guidelines suggest that for individuals aged 12 and older, using an inhaler that includes both an inhaled corticosteroid (ICS) and formoterol during an asthma attack can be beneficial. Since Dulera contains mometasone (an ICS) and formoterol, some doctors might prescribe it for this purpose. This type of use would be considered off-label.

Despite these guidelines, it’s common for doctors to recommend a separate rescue inhaler designed explicitly for quick relief during an asthma attack, especially if you’re already taking other asthma medications. For children ages 6 to 11 years, it’s particularly important to have a separate rescue inhaler available.

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