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

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

Xopenex

Most common
Bronchitis (up to 2%)
Rhinitis (up to 2%)
Pharyngitis (up to 2%)
Dizziness (up to 2%)

Dulera vs. Xopenex Dosage

Dulera

Dosage
Dosage Table
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

Dosage
Dosage Table
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

Common Symptoms and Related Diseases You Can Explore

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