Dulera vs. Advair: Differences, similarities, and which one is better for you

Main differences between Dulera and Advair | Conditions treated by Dulera and Advair | Is Dulera or Advair more effective? | Coverage and cost comparison | Common side effects | Drug interactions | Warnings | FAQ

Dulera and Advair are both inhaled medications indicated for asthma treatment. Advair is also approved to treat chronic obstructive pulmonary disease (COPD) and Dulera is sometimes prescribed off-label for COPD. 

Dulera and Advair are available by prescription and are approved by the FDA. Each drug contains two ingredients: an inhaled corticosteroid (ICS) and a long-acting beta2-adrenergic agonist (LABA). 

The ICS component, which is mometasone in Dulera, and fluticasone in Advair, helps to decrease inflammation in the lungs. The LABA component, which is formoterol fumarate in Dulera and salmeterol in Advair, helps open the airways in the lungs by relaxing the muscles. This helps to control asthma symptoms (such as shortness of breath and wheezing) and helps prevent asthma attacks, or exacerbations. However, these drugs do not treat an acute asthma attack—you should have a rescue asthma inhaler, such as albuterol,  for an acute attack. 

Dulera is available in brand name only; it is made by Organon. Advair is available in brand and generic; the brand is made by GlaxoSmithKline, or GSK. Mylan makes a branded generic (a generic drug with a proprietary name) version of Advair, called Wixela Inhub. There are also several generics of Advair available, made by different manufacturers.

Dulera is an aerosol metered-dose inhaler. Aerosol inhalers push out a spray of medicine. The Advair Diskus is a powder inhaler, meaning that the contents of a capsule are inhaled. (Advair HFA is another form of Advair that is available as a metered-dose inhaler. This article will focus on Advair Diskus, unless otherwise noted.) Continue reading to learn more about the similarities and differences between Dulera and Advair.

What are the main differences between Dulera and Advair?

Dulera and Advair both contain an inhaled corticosteroid (ICS) and long-acting beta-agonist (LABA). 

Dulera contains the ICS mometasone and the LABA formoterol. Dulera is available in brand name only. Dulera is used in adults and children 5 years and older for the treatment of asthma.

Advair contains the ICS fluticasone and the LABA salmeterol. The Advair Diskus is available in brand name and generic, while Advair HFA is only available in brand. The Advair Diskus is used in adults and children 4 years and older for asthma, and in adults with COPD. Advair HFA is indicated for adults and adolescents 12 years and older for asthma.

Conditions treated by Dulera and Advair

Dulera is indicated to treat asthma in adults and children 5 years and older. It is sometimes prescribed off-label to adults with COPD. 

Advair is indicated for asthma treatment in adults and children 4 years and older. It is also indicated to treat adults with COPD. 

Is Dulera or Advair more effective?

There is no data directly comparing Dulera and Advair. Both drugs have been studied for safety and efficacy and the trial information is available in the prescribing information for each drug (you can read more about Dulera here and Advair here). 

The best drug for you can only be determined by your prescriber based on several factors. 

For example, the Advair Diskus is indicated for COPD but Dulera is not. (Although, sometimes Dulera is prescribed off-label for COPD.) Another factor is patient preference. Dulera is a metered-dose inhaler, while the Advair Diskus is a dry powder inhaler. Some patients have a preference toward one or the other. People with a milk protein allergy cannot use dry powder inhalers, so that may be a consideration as well. Insurance coverage is another consideration. Your doctor will take these factors into consideration as well as your medical condition(s), medical history, and other medications you already take that could interact with Dulera or Advair.

Coverage and cost comparison of Dulera vs. Advair

Dulera and Advair coverage by insurance and Medicare prescription plans vary. 
For one Dulera inhaler, the out-of-pocket cost is about $410. You can pay as low as $330 with a free Dulera coupon. 

For an Advair Diskus, the out-of-pocket cost is about $525, but you can pay as low as $99 for generic Advair with a free SingleCare coupon. 

Contact your insurance or Medicare prescription plan for up-to-date coverage information. 

Common side effects of Dulera vs. Advair

The most common side effects of Dulera are common cold, sinus infection, and headache. 

Advair’s most common side effects include upper respiratory infection, headache, sinus infection, and the common cold. 

This is not a full list of side effects and other adverse effects may occur. Consult your healthcare professional for a full list of side effects.

Source: DailyMed (Dulera), DailyMed (Advair)

Drug interactions of Dulera vs. Advair

Certain drugs categorized as CYP3A4 inhibitors (due to the way they affect other medications), interact with Dulera or Advair by increasing the levels of these inhaled medications. Antidepressants in the monoamine oxidase inhibitor (MAOI) class of drugs such as Eldepryl (selegiline) or Azilect (rasagiline), and in the tricyclic antidepressant category—such as Elavil (amitriptyline) or Pamelor (nortriptyline)—also interact with Dulera or Advair. Also, beta blockers, such as metoprolol or atenolol, and diuretics such as furosemide and hydrochlorothiazide, interact with Dulera or Advair. 

This is not a full list of drug interactions. Consult your healthcare provider for a full list of drug interactions. Before you take Dulera or Advair, tell your provider about all of the medications you take, including prescription and OTC drugs, vitamins, and supplements.

Warnings of Dulera and Advair

Warnings of Dulera and Advair include:

• Dulera or Advair should not be started in a life-threatening episode of asthma or COPD.
• Dulera or Advair should be used as directed by your healthcare provider, at the prescribed dose, and should not be taken with another LABA.
• After each dose of Dulera or Advair, rinse and spit with water to avoid oral thrush (yeast).
• Patients taking Dulera or Advair should be monitored for increased risk of pneumonia.
• Patients who are immunosuppressed due to certain medical conditions or medications are at higher risk for infection when taking Dulera or Advair. 
• Use caution when transferring a patient from oral steroids (such as prednisone) to Dulera or Advair.
• Patients should be closely monitored for signs of systemic steroid absorption when taking Dulera or Advair. 
• Dulera or Advair may cause life-threatening paradoxical bronchospasm (airway hyperresponsiveness). If this occurs, the patient should be treated with a short-acting bronchodilator (a drug that quickly opens the airways), such as albuterol.
• The LABA component of Dulera or Advair can cause increases in pulse rate or blood pressure, as well as cardiac arrhythmias. Use cautiously in patients with heart problems.
• Using an ICS long-term may lead to a higher risk of fractures, as well as glaucoma and cataracts.
• Monitor for increased blood sugar and decreased potassium levels while taking Dulera or Advair.
• Growth should be monitored in children and adolescents who take Dulera or Advair.
• Patients should be monitored for immediate hypersensitivity reactions (itching, swelling, rash, cough, low blood pressure), including anaphylaxis. 
• Dulera or Advair should be used cautiously in people with conditions such as convulsive disorders, thyrotoxicosis, diabetes, or ketoacidosis. 
• Patients with a severe milk protein allergy should not use the Advair Diskus.

There are no adequate, well-controlled studies of Dulera or Advair in pregnant women. Women who are pregnant, planning to become pregnant, or are breastfeeding should consult their healthcare provider for medical guidance. If you are already taking Dulera or Advair and find out you are pregnant, consult your healthcare provider.

Frequently asked questions about Dulera vs. Advair

What is Dulera?

Dulera is a combination medication containing an inhaled steroid (mometasone) and LABA (formoterol). It can be used to treat adults and children 5 years and older with asthma. Dulera helps to prevent and control symptoms. It does not treat an acute attack. 

What is Advair?

Advair Diskus is a combination medication that contains an inhaled steroid (fluticasone) and LABA (salmeterol). It is used to treat adults with COPD, or adults and children 4 years and older with asthma. Advair does not treat an acute attack. It helps to prevent and control symptoms. 

Are Dulera and Advair the same?

Dulera and Advair are similar. They both contain a steroid (Dulera contains mometasone and Advair contains fluticasone) and a LABA (Dulera contains formoterol and Advair contains salmeterol). Other drugs in this class that contain both an inhaled steroid and a LABA include:

• AirDuo RespiClick (fluticasone/salmeterol)
• Breo Ellipta (fluticasone/vilanterol)
• Symbicort (budesonide/formoterol)

Some patients take an inhaled steroid as a single-ingredient product on its own, such as:

• Flovent (fluticasone)
• Qvar (beclometasone)

A LABA, such as formoterol or salmeterol, should never be taken alone, because it can increase the risk of death. A LABA should always be taken with an inhaled steroid. This can be done as a combination product, such as Dulera or Advair, or two separate single-ingredient products (an inhaled steroid such as Flovent, and a LABA such as Serevent).  

Is Dulera or Advair better?

Both drugs have undergone testing for safety and efficacy, but there are no studies comparing the two drugs. The best drug for you can be determined by your healthcare provider, who can take into account your medical history and conditions, among other factors, to decide which treatment is appropriate for you.

Can I use Dulera or Advair while pregnant?

Women who are pregnant or planning to become pregnant should consult their healthcare provider for medical advice.

Can I use Dulera or Advair with alcohol?

While Dulera and Advair do not interact with alcohol, alcohol may aggravate asthma symptoms or other medical conditions. Ask your healthcare provider how much, if any, alcohol, is safe for you to consume.

What inhaler is better than Advair?

Other drugs that are similar to Advair and Dulera, containing an inhaled steroid and a LABA, include AirDuo RespiClick (fluticasone/salmeterol), Breo Ellipta (fluticasone/vilanterol), and Symbicort (budesonide/formoterol). All of these drugs work in a similar way but are not exactly the same. There are no studies that compare these drugs to conclude that one is better than another. Talk with your healthcare professional to determine which drug is best for you. 

Is Advair the best for asthma?

Advair is a very effective drug for many patients. There is not one drug that is considered “best,” rather, drugs fit various needs of different patients. For example, Advair is used to control symptoms of asthma or COPD. However, it does not treat acute worsening of symptoms. Patients use a rescue inhaler, such as ProAir HFA, Proventil HFA, or Ventolin HFA (all contain albuterol), to treat acute exacerbations of asthma. Patients with asthma or COPD may use various medications to control symptoms, and Advair is a helpful drug for many.