Dulera vs. Singulair
See how Dulera and Singulair compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Dulera is an inhaled steroid and bronchodilator combination taken twice daily for ongoing asthma control, while Singulair is a once-daily pill that also treats allergic rhinitis.
Both carry boxed warnings, but Dulera's concerns a LABA-related asthma death risk, and Singulair's concerns serious neuropsychiatric side effects including suicidal thoughts.
Neither medication is approved to stop an asthma attack once it starts; both are meant for daily, ongoing control.
Dulera vs. Singulair Drug Summary
Dulera
Dulera is an inhaled corticosteroid and long-acting beta2-agonist (ICS/LABA) combination approved for twice-daily maintenance treatment of asthma in people 5 and older. It pairs mometasone, a steroid that reduces airway inflammation, with formoterol, a bronchodilator that keeps airways open between doses. It is not intended to relieve sudden asthma symptoms.
Singulair
Singulair is a leukotriene receptor antagonist taken once daily as a tablet, chewable tablet, or oral granules. It is approved for ongoing asthma control, prevention of exercise-triggered breathing problems, and relief of seasonal and year-round allergy symptoms. Like Dulera, it is not used to treat an asthma attack already underway.
Dulera vs. Singulair Side Effects
Dulera
Singulair
Dulera vs. Singulair Dosage
Dulera
Singulair
| 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 | 4 mg once daily | At the start |
| Maximum dose | 10 mg 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 |
Singulair
| STAGE | DOSE | WHEN |
| Starting dose | 4 mg once daily | At the start |
| Maximum dose | 10 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Dulera vs. Singulair Indications
Dulera
Dulera is FDA-approved for twice-daily maintenance treatment of asthma in patients 5 years and older who need both an inhaled steroid and a long-acting bronchodilator. It is typically prescribed when asthma is not adequately controlled on an inhaled corticosteroid alone. It does not replace a rescue inhaler for sudden symptoms.
Asthma maintenance in patients 5 and older
For patients not controlled on ICS alone
Not for acute bronchospasm or rescue use
Requires twice-daily inhaler technique
Singulair
Singulair is FDA-approved for ongoing asthma control, prevention of exercise-induced bronchoconstriction, and relief of both seasonal and year-round allergic rhinitis symptoms. It can be used alone or alongside other asthma medications. It is not intended to treat an asthma attack once it starts.
Asthma prophylaxis and chronic treatment
Prevention of exercise-induced bronchoconstriction
Seasonal allergic rhinitis relief
Perennial allergic rhinitis relief
Dulera vs. Singulair Pros and Cons
Dulera
Dulera combines a steroid and a bronchodilator in one inhaler, which can offer more complete asthma control for people who need both. It carries a boxed warning about LABA-related asthma death risk and requires attention to inhaler technique and local steroid side effects. There is currently no generic version available.
Pros
Combines steroid and bronchodilator in one device
Treats airway inflammation and bronchospasm together
Two dose strengths for step-up therapy
Only two inhalations twice daily
Cons
Boxed warning for LABA-related asthma death risk
Risk of oral thrush and other local steroid effects
No generic version available
Requires proper inhaler technique to work correctly
Singulair
Singulair is a once-daily pill that avoids inhaler technique issues and also treats allergic rhinitis alongside asthma. It carries a boxed warning for serious neuropsychiatric events, including suicidal thoughts, and is generally considered less effective than ICS/LABA inhalers for moderate-to-severe asthma. A generic version is widely available.
Pros
Oral tablet, no inhaler technique required
Also treats seasonal and year-round allergies
Generic version widely available
Chewable and granule forms for children
Cons
Boxed warning for suicidal thoughts and behavior
Rare risk of Churg-Strauss syndrome
Generally less effective for moderate-severe asthma
No fast-acting bronchodilator effect
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