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Dulera vs Symbicort
Introduction
For patients with chronic lung conditions such as asthma or Chronic Obstructive Pulmonary Disease (COPD), certain inhaler medications that contain combinations of bronchodilators and corticosteroids can help in controlling symptoms and preventing flare-ups. Dulera and Symbicort are two such drugs that are prescribed for these respiratory diseases. Both combine a long-acting beta agonist (LABA) to open the airways, with an inhaled corticosteroid to reduce inflammation within the lungs. Dulera incorporates mometasone furoate as its steroid component, while formoterol fumarate serves as its LABA component. On the other hand, Symbicort uses budesonide as its steroid component and formoterol fumarate dihydrate as its LABA component.
Dulera vs Symbicort Side By Side
| Attribute | Dulera | Symbicort |
|---|---|---|
| Brand Name | Dulera | Symbicort |
| Contraindications | Worsening of breathing problems after use, taking certain antifungal medications (e.g., ketoconazole) or specific antibiotics (e.g., clarithromycin) | Worsening of breathing problems after use, taking certain antifungal medications (e.g., ketoconazole) or specific antibiotics (e.g., clarithromycin) |
| Cost | $310 to $385 for 120 doses | $350 to $430 for 120 doses |
| Generic Name | mometasone/formoterol | budesonide/formoterol |
| Most Serious Side Effect | Worsening of asthma symptoms or sudden breathing problems immediately after use, allergic reactions, chest pain and fast heartbeat, signs of high blood sugar | Allergic reactions, difficulty breathing or sudden worsening of breathing problems after use, chest pain or tightness, rapid heart rate, blurred vision |
| Severe Drug Interactions | Certain types of antifungal medication and specific types of antibiotics | Certain types of antifungal medication and specific types of antibiotics |
| Typical Dose | 2 inhalations of 100 mcg/5 mcg or 200 mcg/5 mcg strength twice a day | 1 inhalation of 80/4.5 mcg or 160/4.5 mcg strength twice a day, up to a maximum of 4 inhalations of 160/4.5 mcg twice daily |
What is Dulera?
Dulera and Symbicort are both combination inhalers used to manage the symptoms of chronic obstructive pulmonary disease (COPD) and asthma. Dulera combines formoterol, a long-acting beta agonist (LABA), with mometasone, an inhaled corticosteroid (ICS). Similarly, Symbicort contains budesonide, another ICS, along with formoterol as its LABA component. These medications work by reducing inflammation in the lungs while also relaxing airway muscles to improve breathing. Both drugs were approved by the FDA for treating asthma: Dulera in 2010 and Symbicort earlier in 2006.
Although they utilize different steroids - mometasone versus budesonide - their primary functions remain essentially similar; however, individual patients may respond differently based on their specific health conditions or genetic factors. Potential side effects can include oral thrush and hoarseness due to the steroid components' localized activity within the respiratory tract. It's essential that users rinse their mouths after each dosage to minimize these risks.
What conditions is Dulera approved to treat?
Dulera is approved for the long-term treatment of the following lung conditions:
- Moderate to severe asthma in people aged 12 years and older
- Chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema
On the other hand, Symbicort has been FDA-approved to manage:
- Asthma in patients six years or older
- COPD, including chronic bronchitis and emphysema. It should be noted that unlike Dulera, Symbicort is not approved for managing acute bronchospasm.
How does Dulera help with these illnesses?
Dulera aids in managing asthma symptoms by combining two medications: formoterol and mometasone. Formoterol is a long-acting beta agonist (LABA) that works by relaxing muscles in the airways to improve breathing. Mometasone, on the other hand, is a corticosteroid that reduces inflammation in the lungs.
These two medicines work together to prevent episodes of asthma attacks; however, they do not relieve an acute attack once it has started. The long-lasting action of formoterol maintains open air passages for extended periods while mometasone minimizes inflammation, helping patients with chronic obstructive pulmonary disorders manage their condition more effectively.
It's important to note that individuals with severe asthma should have regular medical follow-ups as LABAs can increase the risk of serious or fatal asthma-related events if used without an accompanying steroid like mometasone.
What is Symbicort?
Symbicort is a brand name for the combination of two drugs, budesonide and formoterol. Budesonide is a corticosteroid that reduces inflammation in the lungs, while formoterol is a long-acting beta-adrenoceptor agonist (LABA) which works to relax muscles in the airways to improve breathing. Symbicort was first approved by the FDA in 2006. As it does not inhibit serotonin reuptake like SSRI antidepressants, its side-effect profile differs notably from such medications. Specifically, it doesn't cause sedation or lead to weight gain and sexual dysfunction; these are common side effects associated with SSRIs like Prozac. Also noteworthy is that Symbicort's effects can be particularly beneficial for managing asthma or chronic obstructive pulmonary disease (COPD), especially in patients who do not respond well to "typical" single-medicine inhalers.
What conditions is Symbicort approved to treat?
Symbicort is a combination medication that has been approved for the management and treatment of:
- Asthma in patients aged six years and older
- Chronic obstructive pulmonary disease (COPD) including chronic bronchitis and/or emphysema
How does Symbicort help with these illnesses?
Symbicort is a combination medication used to help manage the symptoms of asthma and chronic obstructive pulmonary disease (COPD). It consists of two active ingredients: budesonide, a corticosteroid that reduces inflammation in the lungs, and formoterol, a long-acting bronchodilator that helps relax muscles in the airways to improve breathing. Symbicort works by increasing airflow into the lungs while simultaneously reducing inflammation - this dual action can alleviate many of the symptoms associated with respiratory conditions. While Dulera also provides similar benefits for patients suffering from these conditions, it may not have the same level of effectiveness across all patient groups as Symbicort does. The exact response varies between individuals; therefore, doctors often consider patient history and individual health factors when deciding between these medications.
How effective are both Dulera and Symbicort?
Both Dulera (mometasone/formoterol) and Symbicort (budesonide/formoterol) have been effectively used in managing symptoms of asthma, having received FDA approval within a few years of each other. These combination drugs contain both an inhaled corticosteroid to reduce inflammation and a long-acting beta agonist to open airways. The effectiveness of Dulera and Symbicort was directly studied in several clinical trials; the two medications demonstrated similar efficacy at controlling symptoms of asthma, with comparable safety profiles.
A 2010 study reported that patients treated with either medication experienced improved lung function compared to those given placebo or only one component of the combination therapies. None of the different metrics used to measure efficacy differed significantly between patients receiving Dulera and those receiving Symbicort.
An extensive review conducted by the Cochrane Collaboration found that budesonide, one ingredient in Symbicort, is effective from the start of treatment at alleviating symptoms such as wheezing and shortness of breath. It also noted its favorable side effect profile compared with other corticosteroids when appropriately dosed.
On the other hand, data suggests that mometasone - part of Dulera's composition - has fewer systemic effects than some other steroids while still being effective for symptom control. However, just like bupropion is typically considered after SSRIs for depression treatment due to less robust data on standalone use, mometasone's role as first-line therapy isn't as clear cut due to lackluster evidence supporting its monotherapy use.
Nonetheless, because these medicines combine distinct drug classes targeting different aspects contributing to asthma pathology – inflammation via steroids and bronchospasm via long acting beta agonists – they could be optimal treatments for patients who didn’t respond well solely on either class alone.
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At what dose is Dulera typically prescribed?
Dosages of Dulera for adults and children over 12 years old typically range from 2 inhalations of the 100 mcg/5 mcg strength or the 200 mcg/5 mcg strength twice a day, in the morning and evening. Studies have shown that starting at a lower dose is effective for managing asthma symptoms in most people. Dosage can be increased after a few weeks if there is no response to treatment. The maximum dosage should not exceed two inhalations of the 200mcg/5mcg strength per day, as excessive use may lead to adverse side effects.
At what dose is Symbicort typically prescribed?
Symbicort therapy typically begins with one inhalation of the 80/4.5 mcg strength twice a day, morning and evening, about 12 hours apart. Dosage can then be increased to two inhalations of the 160/4.5 mcg strength twice daily if necessary for symptom control or during periods of worsening asthma. The maximum recommended dosage is four inhalations of Symbicort 160/4.5 mcg twice daily, which may be considered if there is no response to lower doses after several weeks. As always, patients should follow their healthcare provider's instructions closely when using this medication.
What are the most common side effects for Dulera?
The common side effects of Dulera may include:
- Headache
- Sinusitis (inflammation of the sinus cavities in the head)
- Pharyngitis (inflammation in the back of the throat)
- Upper respiratory tract infection or inflammation
- Nasal congestion
- Sore throat
- Hoarseness or voice changes
On another hand, Symbicort can cause similar side effects with a few additions such as:
- Throat irritation and pain
- Stomach discomfort, nausea, vomiting
- Back pain, muscle cramps
- Changes in taste Please note that these are not exhaustive lists. If you experience any severe reactions while using either medication, seek medical help right away.
Are there any potential serious side effects for Dulera?
Similar to Symbicort, Dulera can also have possible side effects. These might include:
- Worsening of asthma symptoms or sudden breathing problems immediately after use
- Allergic reactions such as skin rash, itching or hives, swelling of the face, lips, or tongue
- Chest pain and fast heartbeat
- Tremor and nervousness
- Signs of high blood sugar: confusion, feeling sleepy or tired; very dry mouth, flushed dry skin; fruit-like breath odor; loss of appetite but unusual increase in thirst or urination.
- Bone thinning or weakness (osteoporosis)
- Lowered immune system and increased likelihood of infections - fever; sore throat; sores in your mouth or nose; new painful white patches in your mouth and/or throat.
If you experience any severe symptoms like these while taking Dulera it's important to seek immediate medical attention. It's crucial that you do not abruptly stop using this medication without consulting with a healthcare professional first due to the risk for exacerbation of asthma symptoms.
What are the most common side effects for Symbicort?
The potential side effects associated with Symbicort include:
- Dry mouth, sore throat, hoarseness in voice
- Stuffy nose, sinusitis
- Blurry vision
- Nausea, vomiting and abdominal pain
- Difficulty sleeping (insomnia)
- Shaking hands or tremors
- Sweating more than usual
- Feeling nervous or anxious
- Palpitations or rapid heartbeat
- Mood changes such as confusion, agitation, hostility
-Rash or itching skin -Slight weight loss may occur over a long term use
-Increased urination could be noticed as an idiosyncratic reaction
-Potential for headache and dizziness. -Joint pain due to generalized body weakness. Remember each person’s response to medication can vary; these are possible but not guaranteed side effects. Always consult your healthcare provider about any concerns you may have regarding your treatment plan.
Are there any potential serious side effects for Symbicort?
While Symbicort is generally well-tolerated, like any medication it carries the risk of potential side effects. Some of these may be serious and warrant immediate medical attention. These include:
- Allergic reactions such as hives, itching, skin rash or a severe skin reaction with symptoms including fever, sore throat, swelling in your face or tongue, burning eyes or a red/purple skin rash that spreads causing blistering and peeling.
- Difficulty breathing or sudden worsening of breathing problems after using Symbicort
- Chest pain or tightness; rapid heart rate
- Blurred vision and other eye issues such as seeing halos around lights
- White patches in the mouth and throat while using Symbicort could indicate oral thrush (a fungal infection)
- Signs of high blood sugar levels: intense thirst/hunger accompanied by frequent urination If you observe any of these symptoms while on Symbicort treatment, it's critical to seek immediate medical aid.
Contraindications for Dulera and Symbicort?
Both Dulera and Symbicort, like most other corticosteroid medications, could potentially worsen symptoms in people with certain conditions. If you notice a worsening of breathing problems after using these medications, or an increase in wheezing, shortness of breath or coughing attacks, please seek immediate medical attention.
Neither Dulera nor Symbicort should be taken if you are taking certain types of antifungal medication (such as ketoconazole) or specific types of antibiotics (like clarithromycin), due to the potential for dangerous interactions. Always inform your physician about any medications you are currently taking; it may take some time for these drugs to clear from the system before starting on Dulera and Symbicort to avoid adverse reactions.
How much do Dulera and Symbicort cost?
Pricing for the brand name versions of these drugs:
-
The price of Dulera (mometasone/formoterol) inhaler containing 120 doses ranges from $310 to $385, depending on your location and pharmacy. This works out to around $2.60–$3.20 per day if you are using it twice daily.
-
Symbicort (budesonide/formoterol) inhaler also contains 120 doses but is slightly more expensive with a cost ranging between $350 and $430, which translates to approximately $2.90–$3.60 per day when used twice daily.
This indicates that if you're in the higher usage range i.e., two puffs a day or more, then brand-name Dulera might be less costly on a per-day treatment basis than Symbicort.
Please note that pricing should not be your primary consideration when determining which medication is best suited for your condition.
For generic alternatives:
As of now, there are no generic equivalents available for either Dulera or Symbicort in the United States.
Popularity of Dulera and Symbicort
Dulera and Symbicort are both combination medications used in the management of asthma and chronic obstructive pulmonary disease (COPD). They combine a long-acting beta2-adrenergic agonist (LABA) to relax the muscles around the airways, with an inhaled corticosteroid to reduce inflammation within them.
In 2020, approximately 1.4 million prescriptions for Dulera were filled in the US. This accounts for about 7% of all LABA/corticosteroid combo inhaler prescriptions nationally. The use of Dulera has been on a steady rise since its introduction into the market back in 2010.
Symbicort, on the other hand, is one of the leading brands among combination inhalers. In fact, it accounted for nearly 40% of all LABA-corticosteroid combo inhaler prescriptions last year with over 8 million written scripts. Like fluoxetine mentioned above, Symbicort's usage has remained relatively stable over recent years.
Conclusion
Both Dulera (mometasone/formoterol) and Symbicort (budesonide/formoterol) are well-established in the treatment of asthma, backed by numerous clinical studies indicating their effectiveness over placebo treatments. They belong to a class of drugs known as combination corticosteroid and long-acting beta-agonist inhalers, with both components working together for better control of asthma symptoms.
As per their mechanisms of action, Dulera's mometasone component reduces inflammation in the lungs while formoterol relaxes airway muscles; similarly, Symbicort uses budesonide for reducing inflammation and formoterol to relieve bronchospasm. Therefore, these medications can often be used interchangeably based on individual patient response.
Both medications come as brand-name products since there are no generic forms available currently. This may impact patients who need to pay out-of-pocket costs due to lack of insurance coverage.
The side effect profiles between these two drugs are quite similar—potential issues include throat irritation or dryness, hoarseness, headache or change in voice tone. Both could potentially cause serious allergic reactions which would require immediate medical attention. As they contain corticosteroids that suppress immune response locally within the respiratory tract system it is important for patients using either medication regularly to monitor any signs of infection like fever or persistent sore throat.
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Refrences
- Berger, W. E., & Noonan, M. J. (2010, May). Treatment of Persistent Asthma With Symbicort® (Budesonide/Formoterol Inhalation Aerosol): An Inhaled Corticosteroid and Long-Acting β<sub>2</sub>-Adrenergic Agonist in One Pressurized Metered-Dose Inhaler. Journal of Asthma. Informa UK Limited.http://doi.org/10.3109/02770901003725684
- Halpin, D. M. (2008, January). Symbicort: a pharmacoeconomic review. Journal of Medical Economics. Informa UK Limited.http://doi.org/10.3111/13696990802210984
- Meltzer, E. O., Kuna, P., Nolte, H., Nayak, A. S., LaForce, C., & on behalf of the P04073 Study Investigators. (2011, August 4). Mometasone furoate/formoterol reduces asthma deteriorations and improves lung function. European Respiratory Journal. European Respiratory Society (ERS).http://doi.org/10.1183/09031936.00020310
- Edwards, S. J., von Maltzahn, R., Naya, I. P., & Harrison, T. (2010, April). Budesonide/formoterol for maintenance and reliever therapy of asthma: a meta analysis of randomised controlled trials. International Journal of Clinical Practice. Hindawi Limited.http://doi.org/10.1111/j.1742-1241.2009.02320.x
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- Buhl, R. (2003, August). Budesonide/formoterol for the treatment of asthma. Expert Opinion on Pharmacotherapy. Informa UK Limited.http://doi.org/10.1517/14656566.4.8.1393
- Emami, M., Tayebi, A., Gharipour, M., Farzamnia, S., & Temyarti, A. (2014). Comparing clinical efficacy of Symbicort versus Pulmicort in reducing asthma symptom and improving its control. Advanced Biomedical Research. Medknow.http://doi.org/10.4103/2277-9175.127999
- Price, D., Wirén, A., & Kuna, P. (2007, September 5). Cost‐effectiveness of budesonide/formoterol for maintenance and reliever asthma therapy. Allergy. Wiley.http://doi.org/10.1111/j.1398-9995.2007.01466.x