From the Guidelines
The most effective alternative to Dulera inhaler is a combination inhaler that contains both an inhaled corticosteroid and a long-acting beta-agonist, such as Advair (fluticasone/salmeterol) or Symbicort (budesonide/formoterol), as recommended by the 2020 focused updates to the NIH asthma management guidelines 1. When considering alternatives to Dulera, it's essential to prioritize medications that reduce airway inflammation and provide bronchodilation.
- Inhaled corticosteroids, such as fluticasone or budesonide, are the most consistently effective long-term control medications for persistent asthma, as stated in the expert panel report 3 (EPR-3) guidelines 1.
- Long-acting beta-agonists, such as salmeterol or formoterol, are used in combination with inhaled corticosteroids for long-term control and prevention of symptoms in moderate or severe persistent asthma, as recommended by the medical therapy for asthma updates from the NAEPP guidelines 1. The appropriate alternative depends on the individual's specific condition, insurance coverage, and response to medications.
- Typical dosing for these alternatives ranges from once to twice daily, with specific doses determined by the healthcare provider based on asthma or COPD severity.
- It's crucial to learn the proper technique for the new device when switching between inhalers, as each has different instructions for use.
- Abrupt discontinuation of the current inhaler can lead to worsening respiratory symptoms, so it's essential to consult a healthcare provider before making any changes 1.
From the FDA Drug Label
The recommended dosage of Fluticasone Furoate/Vilanterol ELLIPTA 100/25 mcg (containing fluticasone furoate 100 mcg and vilanterol 25 mcg) is 1 actuation once daily by oral inhalation The FDA drug label does not answer the question.
From the Research
Alternative to Dulera Inhaler
- Dulera is a combination inhaler containing formoterol and mometasone, used for asthma and COPD treatment.
- Alternative options may include other combination inhalers, such as:
Comparison of Alternative Options
- A study comparing budesonide/formoterol with fluticasone furoate/vilanterol found that both treatments improved airway inflammation, pulmonary function, and symptoms, but budesonide/formoterol showed greater improvement in some parameters 2.
- Another study found that budesonide/formoterol maintenance and reliever therapy was similarly effective to fluticasone/salmeterol fixed-dose therapy in patients with COPD, with a lower daily ICS dosage 3.
- A review of studies comparing formoterol with salmeterol in combination with an inhaled corticosteroid found that the evidence was insufficient to show a difference in safety profile between the two 6.
- A retrospective matched cohort study found that fluticasone furoate/vilanterol was associated with lower use of short-acting β2-agonists and fewer asthma-related exacerbations compared to budesonide/formoterol 4.
- 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 5.