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

Most common
Nasopharyngitis (up to 3%)
Sinusitis (up to 3%)
Headache (up to 3%)
Oral candidiasis (up to 3%)

Pulmicort

Most common
Nasopharyngitis (up to 9.3%)
Nasal congestion (up to 2.7%)
Pharyngitis (up to 2.7%)
Rhinitis allergic (up to 2.2%)

Dulera vs. Pulmicort Dosage

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

Pulmicort

Dosage
Dosage Table
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

Common Symptoms and Related Diseases You Can Explore

Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.