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Dulera
Dulera is a combination inhaler containing mometasone furoate (a corticosteroid) and formoterol fumarate (a long-acting beta-agonist or LABA) used to treat asthma in patients 12 years and older. Dulera helps manage asthma by reducing inflammation in the airways and relaxing the muscles around the airways to prevent symptoms such as wheezing, shortness of breath, and chest tightness. It is not intended for the relief of acute asthma attacks but is used for long-term asthma control.
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Frequently Asked Questions
Can I use Dulera for asthma attacks?
No, Dulera is not a rescue inhaler. You should use a short-acting bronchodilator like albuterol for asthma attacks.
How long does it take for Dulera to start working?
It may take 1-2 weeks of regular use to notice improvement in asthma symptoms, though some effects can be seen within 24 hours.
Do I need to rinse my mouth after using Dulera?
Yes, rinsing your mouth after using Dulera helps prevent oral thrush, a common side effect of inhaled corticosteroids.
Can I stop using Dulera if my asthma improves?
No, continue using Dulera as prescribed, even if your asthma is well-controlled. Stopping the medication abruptly can lead to worsening symptoms.
What should I do if I miss a dose of Dulera?
Take the missed dose as soon as you remember, unless it is close to your next dose. Do not double up on doses.
Comprehensive Drug Guide
How Does Dulera Work?
Dulera works by combining the anti-inflammatory effects of mometasone, which helps reduce swelling and irritation in the airways, with the bronchodilatory effects of formoterol, which relaxes the muscles around the airways to improve breathing. Together, they prevent asthma symptoms and improve lung function over time.
Common Dosages
- 100 mcg mometasone / 5 mcg formoterol per inhalation
- 200 mcg mometasone / 5 mcg formoterol per inhalation
Typical Dosing
- The typical dosing for Dulera involves two inhalations twice daily, with the dose depending on the severity of asthma and the patient’s response to treatment. The starting dose is often based on previous asthma treatments.
Typical Dosing
FDA Approved Indications
- Asthma in patients 12 years of age and older
Who Shouldn't Take Dulera?
- Acute asthma attacks (it is not a rescue inhaler)
- Known hypersensitivity to mometasone, formoterol, or any other components of the inhaler
- Severe milk protein allergies
Advice From The Pharmacist
- Dulera is for long-term asthma control and should be used every day as prescribed, even if you feel well.
- After each use, rinse your mouth with water and spit it out to reduce the risk of oral thrush (fungal infection in the mouth).
- Always keep a rescue inhaler (like albuterol) on hand for acute asthma symptoms.
- Store Dulera at room temperature and avoid exposure to extreme heat or cold.
Side Effects of Dulera
Common Side Effects
- Headache
- Throat irritation
- Hoarseness
- Nausea
Uncommon/Severe Side Effects
- Oral thrush (fungal infection in the mouth)
- Increased heart rate or palpitations
- Worsening of asthma or paradoxical bronchospasm
- Adrenal insufficiency
Risks and Warnings of Dulera
- Increased Risk of Asthma-Related Death: LABA medications, including formoterol, may increase the risk of asthma-related death when used without an inhaled corticosteroid. However, Dulera combines both medications, reducing this risk.
- Adrenal Suppression: Long-term use of inhaled corticosteroids like mometasone can suppress adrenal function, especially at higher doses.
- Paradoxical Bronchospasm: Rarely, Dulera can cause sudden worsening of breathing (bronchospasm). If this occurs, discontinue use immediately and use a rescue inhaler.
Interactions with Dulera
Common Drug Interactions
- Beta-blockers: These can reduce the effectiveness of formoterol and may worsen asthma symptoms.
- CYP3A4 inhibitors (such as ketoconazole): Can increase the levels of mometasone, leading to increased side effects.
- Diuretics: May increase the risk of low potassium (hypokalemia) when combined with Dulera.
Alternatives to Dulera
- Advair Diskus: A combination of fluticasone and salmeterol, another ICS/LABA inhaler for asthma control.
- Symbicort: Contains budesonide and formoterol for long-term asthma management.
- Breo Ellipta: A combination of fluticasone and vilanterol, used once daily for asthma or COPD control.
