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

Most common
headache (≥3%)
nasopharyngitis (≥3%)
sinusitis (≥3%)

Singulair

Most common
headache (≥5%)
fever (≥5%)
pharyngitis (≥5%)

Dulera vs. Singulair 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

Singulair

Dosage
Dosage Table
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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