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

Most common
headache (up to 3%)
nasopharyngitis (up to 3%)
upper resp infection (up to 3%)
oral candidiasis (up to 3%)

Dulera

Most common
headache (up to 3%)
nasopharyngitis (up to 3%)
sinusitis (up to 3%)
thrush (up to 3%)

Breo vs. Dulera Dosage

Breo

Dosage
Dosage Table
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

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

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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