Advair vs. Dulera

See how Advair and Dulera compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Both Advair and Dulera combine an inhaled steroid with a long-acting bronchodilator, but only Advair is FDA-approved for COPD in addition to asthma.

  • Advair has a generic version (Wixela Inhub) that can lower cost, while Dulera currently has no generic option.

  • Advair uses a dry-powder Diskus inhaler and Dulera uses a pressurized aerosol inhaler, a difference that can affect technique and personal preference.

Advair vs. Dulera Drug Summary

Advair

Advair pairs an inhaled corticosteroid (fluticasone) with a long-acting bronchodilator (salmeterol), making it an ICS/LABA combination inhaler. It is taken twice daily through a Diskus powder inhaler for long-term asthma control in patients 4 and older, and for COPD maintenance and reducing flare-ups. It is not meant to treat a sudden asthma or COPD attack.

Dulera

Dulera combines an inhaled corticosteroid (mometasone) with a long-acting bronchodilator (formoterol) in one aerosol inhaler, also an ICS/LABA combination. It is used twice daily for long-term asthma control in patients 5 and older but is not FDA-approved for COPD. Like Advair, it is not intended for relieving a sudden breathing attack.

Advair vs. Dulera Side Effects

Advair

Most common
headache (≥3%)
throat irritation (≥3%)
bronchitis/cough (≥3%)
hoarseness (≥3%)

Dulera

Most common
headache (≥3%)
nasopharyngitis (≥3%)
sinusitis (≥3%)
influenza (≥3%)

Advair vs. Dulera Dosage

Advair

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 100 mcg/50 mcg twice daily At the start
Maximum dose 500 mcg/50 mcg twice daily If needed
Dose changes 2 increases As tolerated

Dulera

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 2 inhalations 100/5 mcg BID At the start
Maximum dose 2 inhalations 200/5 mcg BID If needed
Dose changes 1 increase As tolerated

Advair vs. Dulera Indications

Advair

Advair is FDA-approved for long-term asthma control in people 4 and older, and for COPD maintenance therapy, including reducing flare-ups in patients with a history of exacerbations. It is not meant for relieving a sudden asthma or COPD attack.

  • Maintenance asthma treatment (ages 4+)

  • COPD maintenance for airflow obstruction

  • Reduces exacerbations in high-risk COPD patients

  • Not for acute bronchospasm or status asthmaticus

Dulera

Dulera is FDA-approved for long-term asthma control in people 5 and older. It does not carry an FDA approval for COPD, so any use for that condition would be off-label. Like Advair, it is not intended for treating a sudden flare-up.

  • Maintenance asthma treatment (ages 5+)

  • Not FDA-approved for COPD

  • Off-label COPD use occurs but is unapproved

  • Not for acute bronchospasm relief

Advair vs. Dulera Pros and Cons

Advair

Advair has been on the market longer and now comes in a generic form (Wixela Inhub), which often makes it more affordable. Its FDA approval covers both asthma and COPD, a broader label than Dulera's. Its powder-based Diskus inhaler requires a forceful, fast inhale, which can be harder for some patients to manage well.

Pros

  • Available as a lower-cost generic (Wixela Inhub)

  • FDA-approved for COPD as well as asthma

  • No boxed warning after FDA safety review update

Cons

  • Dry powder inhaler needs a strong, fast inhale

  • Contraindicated with severe milk protein allergy

  • Only available as a dry powder, no aerosol option

Dulera

Dulera pairs mometasone with formoterol in an aerosol inhaler, a different delivery method than Advair's dry powder. It is approved only for asthma, not COPD, and its FDA label still carries a boxed warning about LABA-related risk of asthma death. It also has no generic option, unlike Advair.

Pros

  • Aerosol inhaler may suit those who struggle with dry powder technique

  • Simpler two-strength dosing lineup

  • No milk-protein allergy contraindication like Advair

Cons

  • Not FDA-approved for COPD, only asthma

  • No generic version currently available

  • Still carries boxed warning for LABA-related asthma death risk

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