Dulera (100 mcg/5 mcg inhaler)
Dulera® is a combination inhaler that contains two active ingredients:
| Ingredient |
Class |
Dose per actuation (puff) |
Typical use |
Key notes |
| Budesonide |
Inhaled corticosteroid |
100 µg |
Reduces airway inflammation |
Most effective when taken regularly, even if you feel fine |
| Formoterol |
Long‑acting β₂‑agonist |
5 µg |
Provides bronchodilation for up to 12 h |
Starts working in about 3–5 min, lasts 12 h |
1. What it’s prescribed for
- Asthma – for maintenance (regular) therapy only; never as a “rescue” inhaler.
- COPD (Chronic Obstructive Pulmonary Disease) – used for long‑term control to improve breathing and reduce exacerbations.
2. How to use the inhaler
- Check the dose counter – you should have 2 puffs (one dose) in each of the morning and evening treatments.
- Shake the inhaler – helps keep the medication evenly mixed.
- Prime the device – if you’ve not used it in a few days or if it’s the first time, spray 10–12 puffs into the air.
- Exhale fully – then place the mouthpiece in your mouth and close your lips around it.
- Press down on the canister while inhaling deeply.
- Hold your breath for ~5 seconds (or as long as comfortable).
- Repeat for the second puff (if your dose is 2 puffs).
- Rinse your mouth with water or brush your teeth afterwards to reduce oral thrush.
Tip: If you’re unsure whether you got the correct dose, pause for a few seconds before the next puff; many inhalers have a “second dose” indicator.
3. Typical dosing schedule
| Condition |
Dose |
Frequency |
Notes |
| Asthma (maintenance) |
2 puffs (2×100 µg budesonide / 2×5 µg formoterol) |
Twice daily (morning & evening) |
Take at the same time each day for best effect |
| COPD (maintenance) |
Same as above |
Twice daily |
Can be used in combination with other inhalers (e.g., tiotropium) |
Never increase or decrease the dose without your clinician’s approval. If symptoms worsen, your doctor may prescribe a “step‑up” strategy that could involve higher doses or additional medications.
4. Common side effects
| Category |
Examples |
What to do |
| Local (mouth) |
Hoarseness, sore throat, oral candidiasis (thrush) |
Rinse mouth after use; apply a steroid mouthwash if advised |
| Respiratory |
Cough, wheeze, or chest tightness |
Report persistent symptoms; you may need a different treatment plan |
| Systemic |
Headache, dizziness, palpitations, insomnia |
Keep a symptom diary; discuss with your provider if they’re persistent |
| Rare |
Severe allergic reaction (rash, itching, swelling, difficulty breathing) |
Seek immediate emergency care (call 911) |
5. Contraindications & cautions
- Allergy to budesonide, formoterol, or any component of the inhaler.
- Severe cardiac disease – β‑agonists can increase heart rate and blood pressure.
- Uncontrolled hypertension – monitor BP if you have high blood pressure.
- Cushing’s syndrome – use with caution, as systemic steroid exposure can be a concern.
- Pregnancy & breastfeeding – generally considered safe for maintenance therapy, but discuss with your doctor.
6. Drug interactions
| Drug |
Interaction |
What to watch for |
| Other β‑agonists (e.g., albuterol, salmeterol) |
Additive bronchodilatory effect |
May increase heart rate, tremor |
| Systemic steroids (e.g., prednisone) |
Possible additive immunosuppression |
Higher risk of infections |
| MAO inhibitors (e.g., phenelzine) |
Rare, but may potentiate β‑agonist effects |
Palpitations, hypertension |
| Anticholinergics (e.g., ipratropium) |
Can be combined; may increase dry mouth |
Monitor for dry mouth, constipation |
Always inform your pharmacist or provider of all medications you’re taking, including OTC and herbal supplements.
7. Patient counseling points
- Adherence is key – take it even when you feel fine.
- Proper technique – a poor inhalation technique can reduce efficacy by up to 30 %.
- Check the dose counter – you’re only getting the right amount if the counter says “2” (or your prescribed number).
- Rinse your mouth to prevent thrush.
- Watch for side effects and report them promptly.
- Keep an inhaler diary (dose, time, symptoms) – useful during clinic visits.
- Avoid smoking – it worsens COPD and can reduce inhaler efficacy.
- Maintain your device – replace the propellant canister when the dose counter is low.
8. Quick FAQ
Q: Can I use Dulera as a rescue inhaler during an asthma attack?
A: No. Dulera is for long‑term control only. For quick relief use a short‑acting β₂‑agonist (e.g., albuterol).
Q: I’m 65 years old and have mild COPD. Can I start Dulera?
A: Your clinician will decide based on your symptoms, lung function tests, and other inhalers you’re using. Many older adults benefit from maintenance inhalers like Dulera, but they’ll consider your overall health first.
Q: I’m traveling and won’t have my inhaler handy for a few days. What should I do?
A: Try to keep your inhaler in your carry‑on, and consider bringing a backup inhaler if you’re likely to be away from home for more than 24 h.
Q: Is there a risk of overdose if I accidentally use more than 2 puffs?
A: Taking more than prescribed can increase side‑effect risk (especially with systemic steroids). If you think you’ve overdosed, contact your doctor or local poison control.
Bottom line
Dulera 100 mcg/5 mcg is a maintenance inhaler that pairs an inhaled steroid with a long‑acting bronchodilator. It helps control inflammation and keep airways open in asthma and COPD when taken regularly and correctly. If you have questions about how to fit it into your routine, any side‑effect concerns, or drug interactions, bring them up with your pharmacist or physician—they’ll tailor the plan to your exact needs.