Breo vs. Dulera
See how Breo and Dulera compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Breo is approved for both asthma and COPD, while Dulera is approved only for asthma.
Breo is a once-daily dry powder inhaler, while Dulera is an aerosol inhaler used twice a day.
Both carry a boxed warning about LABA-related asthma death risk and are not rescue inhalers for sudden symptoms.
Breo vs. Dulera Drug Summary
Breo
Breo combines an inhaled corticosteroid (ICS) and a long-acting beta-agonist (LABA) to provide maintenance treatment for both asthma and COPD. It's delivered through a single once-daily dry powder inhaler called Ellipta, available in three strengths for different ages and conditions.
Dulera
Dulera is also a combination ICS/LABA inhaler, but it treats asthma only, not COPD. It's delivered through an aerosol metered-dose inhaler used twice daily, with two available strengths for step-up therapy.
Breo vs. Dulera Side Effects
Breo
Dulera
Breo vs. Dulera Dosage
Breo
Dulera
| STAGE | DOSE | WHEN |
| Starting dose | 50 mcg/25 mcg once daily | At the start |
| Maximum dose | 200 mcg/25 mcg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
| 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 |
Breo
| STAGE | DOSE | WHEN |
| Starting dose | 50 mcg/25 mcg once daily | At the start |
| Maximum dose | 200 mcg/25 mcg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Dulera
| 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 |
Breo vs. Dulera Indications
Breo
Breo is FDA-approved as a once-daily maintenance treatment for asthma in patients 5 and older, as well as for COPD, including chronic bronchitis and emphysema. It is not a rescue inhaler and won't relieve sudden breathing problems.
Maintenance treatment of asthma, ages 5 and up
Maintenance treatment of COPD, including bronchitis and emphysema
Not for acute asthma or COPD flare-ups
200/25 mcg strength approved for asthma only, not COPD
Dulera
Dulera is FDA-approved as a twice-daily maintenance treatment for asthma in patients 5 and older. It does not treat COPD and, like Breo, is not intended for relief of sudden bronchospasm.
Maintenance treatment of asthma, ages 5 and up
Not approved for COPD
Not for relief of sudden bronchospasm
Two dose strengths for step-up therapy
Breo vs. Dulera Pros and Cons
Breo
Breo's once-daily dosing and dual approval for asthma and COPD make it a versatile option for patients managing either condition. Its dry powder Ellipta inhaler is breath-activated, requiring no shaking or priming before use.
Pros
Once-daily dosing instead of twice daily
Approved for both asthma and COPD, unlike Dulera
Breath-activated dry powder device needs no shaking or priming
Cons
Contraindicated in patients with severe milk protein allergy due to lactose carrier
Not approved for children under 5
Carries a specific warning about increased pneumonia risk in COPD patients
200/25 mcg strength cannot be used for COPD or under age 12
Dulera
Dulera's twice-daily aerosol inhaler is a familiar delivery method for many patients already using metered-dose devices. It is approved only for asthma, so it isn't an option for COPD management.
Pros
Aerosol metered-dose delivery familiar to many inhaler users
No lactose carrier, so no milk protein allergy concern
Two strengths allow simple step-up dosing within one product line
Cons
Requires twice-daily dosing rather than once daily
Not approved for COPD, only asthma
No generic version currently available
Aerosol canister needs shaking and priming before each use
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