Dulera vs. Pulmicort
See how Dulera and Pulmicort compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Dulera combines a steroid and a long-acting bronchodilator in one inhaler, so it carries a boxed warning about LABA-related asthma risk that steroid-only Pulmicort does not.
Both are twice-daily maintenance inhalers meant to prevent asthma symptoms over time, and neither is approved to stop a sudden asthma attack.
Dulera is approved starting at age 5 as an aerosol inhaler, while Pulmicort is approved from age 6 as a dry powder inhaler, with a separate nebulized version for younger children.
Dulera vs. Pulmicort Drug Summary
Dulera
Dulera is a combination inhaler that pairs an inhaled corticosteroid (mometasone) with a long-acting beta-agonist (formoterol) to reduce airway inflammation and keep airways open. It is approved as twice-daily maintenance therapy for asthma in people 5 and older, taken as two inhalations from a metered-dose inhaler each morning and evening. It is not meant to treat sudden asthma attacks.
Pulmicort
Pulmicort is an inhaled corticosteroid (budesonide) that reduces airway inflammation to prevent asthma symptoms over time. It is approved as twice-daily maintenance therapy for asthma in people 6 and older, delivered through a dry powder inhaler called the Flexhaler, with a nebulized Respules version available for younger children. It does not relieve a sudden asthma attack.
Dulera vs. Pulmicort Side Effects
Dulera
Pulmicort
Dulera vs. Pulmicort Dosage
Dulera
Pulmicort
| 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 |
| STAGE | DOSE | WHEN |
| Starting dose | 180 mcg twice daily | At the start |
| Maximum dose | 720 mcg twice 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 |
Pulmicort
| STAGE | DOSE | WHEN |
| Starting dose | 180 mcg twice daily | At the start |
| Maximum dose | 720 mcg twice daily | If needed |
| Dose changes | 2 increases | As tolerated |
Dulera vs. Pulmicort Indications
Dulera
Dulera is FDA-approved for twice-daily maintenance treatment of asthma in patients 5 years of age and older. It combines an inhaled corticosteroid with a long-acting bronchodilator to control symptoms over time. It is not approved to stop an asthma attack once it starts.
Maintenance therapy for asthma in patients 5 and older
Combines an ICS and a LABA in one inhaler
Not for treatment of a sudden asthma attack
Twice-daily dosing via metered-dose inhaler
Pulmicort
Pulmicort is FDA-approved for maintenance treatment of asthma as prophylactic therapy in patients 6 years of age and older. It is sometimes used off-label to manage eosinophilic esophagitis, a different inflammatory condition. Like Dulera, it is not approved for relieving an asthma attack in progress.
Maintenance treatment for asthma in patients 6 and older
ICS only, with no bronchodilator component
Off-label use for eosinophilic esophagitis
Not for a sudden asthma attack or status asthmaticus
Dulera vs. Pulmicort Pros and Cons
Dulera
Dulera's combination of an inhaled steroid and a long-acting bronchodilator can offer stronger symptom control for people not managed on a steroid alone. That added bronchodilator comes with a boxed warning about a small increased risk of asthma-related death, a warning steroid-only inhalers do not carry.
Pros
Adds a long-acting bronchodilator for extra symptom control
One inhaler covers both anti-inflammatory and airway-opening needs
Aerosol metered-dose format some patients find easier than dry powder
Cons
Boxed warning for LABA-related asthma death risk
No generic version currently available
Not approved for children under 5
Extra caution needed for patients with heart conditions due to the LABA
Pulmicort
Pulmicort uses a steroid alone, so it does not carry the LABA boxed warning that comes with combination inhalers like Dulera. It offers more delivery formats, including a nebulized version for young children, but people who need added bronchodilator support may end up needing a second inhaler.
Pros
No LABA component, so no boxed warning for asthma death risk
Nebulized Respules version available for younger children
Available in generic form, unlike Dulera
Cons
Contains trace milk proteins, a risk for milk-protein allergy
May need an added bronchodilator if asthma isn't controlled on steroid alone
Dry powder technique requires proper inhalation effort
Not approved for children under 6 with the Flexhaler
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