Symbicort vs. Dulera
See how Symbicort and Dulera compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Symbicort and Dulera are both twice-daily inhaled corticosteroid/LABA combinations, but only Symbicort is FDA-approved for COPD as well as asthma.
Dulera is approved for children as young as 5, while Symbicort's asthma approval starts at age 6.
Both carry the same boxed warning about a small increased risk of asthma-related death from the LABA component.
Symbicort vs. Dulera Drug Summary
Symbicort
Symbicort combines the corticosteroid budesonide with the long-acting bronchodilator formoterol in one inhaler. It's used twice daily for ongoing asthma control in people 6 and up, and it's also approved for maintenance treatment of COPD. It comes in two strengths, with the higher dose specifically indicated for COPD.
Dulera
Dulera combines the corticosteroid mometasone with the long-acting bronchodilator formoterol in one inhaler. It's taken twice daily for ongoing asthma control in people 5 and up, but it is not approved for COPD. It comes in two strengths based on asthma severity.
Symbicort vs. Dulera Side Effects
Symbicort
Dulera
Symbicort vs. Dulera Dosage
Symbicort
Dulera
| STAGE | DOSE | WHEN |
| Starting dose | 2 inh 80/4.5 mcg twice daily | At the start |
| Maximum dose | 2 inh 160/4.5 mcg twice daily | If needed |
| Dose changes | 1 increase | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 2 inh 100/5 mcg twice daily | At the start |
| Maximum dose | 2 inh 200/5 mcg twice daily | If needed |
| Dose changes | 1 increase | As tolerated |
Symbicort
| STAGE | DOSE | WHEN |
| Starting dose | 2 inh 80/4.5 mcg twice daily | At the start |
| Maximum dose | 2 inh 160/4.5 mcg twice daily | If needed |
| Dose changes | 1 increase | As tolerated |
Dulera
| STAGE | DOSE | WHEN |
| Starting dose | 2 inh 100/5 mcg twice daily | At the start |
| Maximum dose | 2 inh 200/5 mcg twice daily | If needed |
| Dose changes | 1 increase | As tolerated |
Symbicort vs. Dulera Indications
Symbicort
Symbicort is FDA-approved for maintenance treatment of asthma in people 6 and older, and for maintenance treatment of COPD, including chronic bronchitis and emphysema. It is not meant for sudden asthma or COPD symptoms and should be used with a separate rescue inhaler for that.
Asthma maintenance treatment, ages 6 and up
COPD maintenance treatment and exacerbation reduction
Not approved for acute bronchospasm relief
Twice-daily inhaled aerosol
Dulera
Dulera is FDA-approved for maintenance treatment of asthma in people 5 and older. It does not carry a COPD indication, so it's used specifically for ongoing asthma control rather than chronic bronchitis or emphysema. Like Symbicort, it is not intended for sudden symptom relief.
Asthma maintenance treatment, ages 5 and up
Not approved for COPD
Not approved for acute bronchospasm relief
Twice-daily inhaled aerosol
Symbicort vs. Dulera Pros and Cons
Symbicort
Symbicort covers both asthma and COPD, which broadens who it can be prescribed for compared to Dulera. It has been available since 2006 and now has a generic option, while Dulera remains brand-only. Its main tradeoffs are a slightly older minimum age and dual-purpose dosing strengths.
Pros
FDA-approved for COPD as well as asthma, unlike Dulera which only covers asthma
A generic version is available, which Dulera does not currently have
On the market since 2006, giving it a longer real-world track record than Dulera
Cons
Approved for asthma only from age 6, one year older than Dulera's age 5 minimum
Its two strengths serve both asthma and COPD, which can make dose selection less clear-cut
The COPD-indicated 160/4.5 mcg strength delivers more inhaled steroid, slightly raising local side effect risk
Dulera
Dulera is approved for slightly younger children than Symbicort and uses strengths built specifically around asthma severity rather than a shared asthma-COPD dosing scheme. It does not treat COPD and has no generic option, so it may cost more for some patients without insurance. It has also been on the market for a shorter time than Symbicort.
Pros
Approved for asthma in children as young as 5, one year younger than Symbicort's minimum age
Both strengths are designed specifically for asthma, without doubling as a COPD dose
Offers mometasone as an alternative corticosteroid option for patients who don't tolerate budesonide
Cons
Not FDA-approved for COPD, so patients with COPD need a different medication
No generic version available, unlike Symbicort
Approved more recently, in 2010, giving it a shorter track record than Symbicort
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