From the Guidelines
Alternatives to Dulera include Symbicort (budesonide/formoterol) and Breo Ellipta (fluticasone/vilanterol), which are combination inhaled corticosteroid/long-acting beta agonist (ICS/LABA) medications that work similarly to Dulera (mometasone/formoterol) by combining an anti-inflammatory steroid with a bronchodilator to control asthma or COPD symptoms. These medications are effective because the steroid component reduces airway inflammation while the LABA component provides long-lasting bronchodilation, working together to improve breathing and prevent exacerbations 1.
Key Considerations
- The typical dosing for these alternatives is twice daily for most formulations, except Breo Ellipta which is taken once daily.
- When switching from Dulera, your doctor will determine the appropriate equivalent dose based on your specific condition and response.
- It's essential to continue using these medications regularly as prescribed, even when feeling well, and to rinse your mouth after use to prevent thrush.
Medication Options
- Symbicort (budesonide/formoterol): a combination ICS/LABA medication that can be used as a substitute for Dulera.
- Breo Ellipta (fluticasone/vilanterol): another combination ICS/LABA medication that can be used as an alternative to Dulera.
Important Notes
- Formoterol is a LABA with a rapid onset of action, making it suitable for use in combination with an ICS, such as budesonide or fluticasone 1.
- The choice of ICS to use in combination with formoterol is less settled, but most ICSs could be effectively used in combination with formoterol 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Alternative to Dulera
- Dulera is a combination medication containing mometasone and formoterol, used to control asthma symptoms.
- Alternative options to Dulera include other inhaled corticosteroid (ICS) and long-acting β2 agonist (LABA) combinations, such as:
Comparison of Alternative Options
- A study comparing budesonide/formoterol with fluticasone furoate/vilanterol found that both combinations improved airway inflammation, pulmonary function, and symptoms in asthma patients 2.
- Another study found that once-daily fluticasone furoate/vilanterol was not inferior to twice-daily budesonide/formoterol in clinical effect and improved adherence barriers for stable asthma control therapy 4.
- A retrospective matched cohort study found that fluticasone furoate/vilanterol resulted in lower use of short-acting β2-agonist (SABA) and fewer asthma-related exacerbations compared to budesonide/formoterol 5.
- A real-world observational study found that fluticasone furoate/vilanterol as maintenance and reliever therapy showed similar effectiveness to budesonide/formoterol as maintenance and reliever therapy for asthma control 6.
Key Findings
- Budesonide/formoterol and fluticasone furoate/vilanterol are potential alternative options to Dulera for asthma control 2, 4, 5, 6.
- The choice of alternative medication may depend on individual patient characteristics and treatment goals 2, 3.
- Further studies are needed to fully understand the differences in treatment outcomes between these alternative options 2, 4, 3, 5, 6.