Dulera vs. Xopenex
See how Dulera and Xopenex compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Dulera is a twice-daily maintenance inhaler that controls asthma inflammation, while Xopenex is a fast-acting bronchodilator used for immediate bronchospasm relief.
Dulera carries a boxed warning about LABA-related asthma death risk, while Xopenex's main risks involve overuse and cardiovascular side effects.
Xopenex typically costs less per month than Dulera, which has no generic version currently available.
Dulera vs. Xopenex Drug Summary
Dulera
Dulera is an inhaled corticosteroid and long-acting beta2-agonist (ICS/LABA) combination used for daily asthma control. It is taken twice a day through an aerosol inhaler, combining mometasone to reduce airway inflammation with formoterol to keep airways open. It is not meant to treat sudden asthma symptoms.
Xopenex
Xopenex is a short-acting beta2-agonist (SABA) bronchodilator used to treat or prevent bronchospasm in asthma and other reversible airway conditions. It is delivered through a nebulizer solution or an HFA inhaler, working quickly to open airways during flare-ups. It is not intended for long-term daily control of asthma.
Dulera vs. Xopenex Side Effects
Dulera
Xopenex
Dulera vs. Xopenex Dosage
Dulera
Xopenex
| STAGE | DOSE | WHEN |
| Starting dose | 2 puffs, 100/5 mcg BID | At the start |
| Maximum dose | 2 puffs, 200/5 mcg BID | If needed |
| Dose changes | 1 increase | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 0.31 mg TID | At the start |
| Maximum dose | 90 mcg (2 puffs) q4-6h | If needed |
| Dose changes | 4 increases | As tolerated |
Dulera
| STAGE | DOSE | WHEN |
| Starting dose | 2 puffs, 100/5 mcg BID | At the start |
| Maximum dose | 2 puffs, 200/5 mcg BID | If needed |
| Dose changes | 1 increase | As tolerated |
Xopenex
| STAGE | DOSE | WHEN |
| Starting dose | 0.31 mg TID | At the start |
| Maximum dose | 90 mcg (2 puffs) q4-6h | If needed |
| Dose changes | 4 increases | As tolerated |
Dulera vs. Xopenex Indications
Dulera
Dulera is FDA-approved for twice-daily maintenance treatment of asthma in patients 5 years of age and older. It combines a corticosteroid to reduce airway inflammation with a long-acting bronchodilator for daily control. It is not intended for sudden asthma symptoms or acute attacks.
Maintenance therapy only, not a rescue inhaler
Approved for ages 5 and up
Reduces airway inflammation and bronchospasm together
Requires twice-daily dosing even without symptoms
Xopenex
Xopenex is FDA-approved to treat and prevent bronchospasm in people with reversible obstructive airway disease, including asthma. It works as a fast-acting bronchodilator delivered by nebulizer or inhaler when symptoms occur or before known triggers. It is not designed for daily long-term asthma control on its own.
Used for quick relief of bronchospasm
Approved for reversible obstructive airway disease
Available as nebulizer solution or HFA inhaler
Can be used before exercise to prevent symptoms
Dulera vs. Xopenex Pros and Cons
Dulera
Dulera pairs an inhaled steroid with a long-acting bronchodilator to control asthma symptoms over time, but it carries a boxed warning about LABA safety. Because no generic exists, it also tends to cost more each month than short-acting rescue options.
Pros
Treats underlying airway inflammation, not just symptoms
Combines two medications in one inhaler
Only needs to be taken twice a day
Cons
Carries a boxed warning about LABA-related asthma death risk
Not for use during an asthma attack
No generic version, roughly $230 to $500 a month without insurance
Xopenex
Xopenex is a fast-acting rescue bronchodilator that relieves bronchospasm quickly and typically costs less each month. It does not address the airway inflammation that drives asthma over time, so it is often used alongside a separate controller medication.
Pros
Works fast for immediate symptom relief
Can be used as needed rather than on a fixed schedule
Available in nebulizer form for those who struggle with inhalers
Cons
Does not treat the airway inflammation behind asthma
May require dosing as often as every 4 hours
Overuse can raise heart rate and blood pressure
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