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Qvar vs Dulera
Introduction
For patients with chronic obstructive pulmonary disease (COPD) or asthma, certain medications can help control and prevent symptoms. Qvar and Dulera are two such drugs that doctors typically prescribe for these conditions. Both have the ability to reduce inflammation in the airways which helps in managing breathing difficulties associated with COPD and asthma. Qvar is a corticosteroid inhaler that contains beclomethasone dipropionate, which reduces inflammatory responses within the lungs. On the other hand, Dulera is classified as a combination inhaler since it contains both an anti-inflammatory medicine called mometasone furoate and a long-acting bronchodilator known as formoterol fumarate dihydrate; this combination not only targets inflammation but also relaxes muscles around your airways to improve breathing.
Qvar vs Dulera Side By Side
| Attribute | Qvar | Dulera |
|---|---|---|
| Brand Name | Qvar | Dulera |
| Contraindications | Should not be taken if you are taking, or have been taking monoamine oxidase (MAO) inhibitors (MAOIs) or tricyclic antidepressants within the past two weeks. | Should not be used as a rescue inhaler or for people whose asthma is well controlled with low or medium dose inhaled corticosteroids. Should not be taken if you are taking, or have been taking monoamine oxidase (MAO) inhibitors (MAOIs) or tricyclic antidepressants within the past two weeks. |
| Cost | $200 to $240 for 120 doses | $250 to $300 for 120 doses |
| Generic Name | Beclomethasone dipropionate | Mometasone furoate and formoterol fumarate dihydrate |
| Most Serious Side Effect | Signs of allergic reactions, breathing problems, chest pain or chest tightness, rapid heartbeat, tremors in hands, vision changes, high blood sugar. | Signs of an allergic reaction, worsening asthma symptoms, chest pain and fast, pounding heartbeats, tremors or nervousness, choking or other breathing problems, white patches in your mouth or throat, blurred vision. |
| Severe Drug Interactions | MAO inhibitors (MAOIs), tricyclic antidepressants. | MAO inhibitors (MAOIs), tricyclic antidepressants. |
| Typical Dose | 40-320 mcg/day, starting dose often 40-80 mcg twice daily | 2 inhalations twice daily, each inhalation consists of either 100 mcg or 200 mcg dose |
What is Qvar?
Beclomethasone dipropionate (the generic name for Qvar) is a corticosteroid medication used primarily as an anti-inflammatory agent in the maintenance treatment of asthma. This inhaler was first approved by the FDA in 2000. Qvar reduces inflammation and swelling in the airways, effectively "calming" them for more prolonged periods than usual. It is administered to patients who have been diagnosed with severe persistent or moderate persistent asthma. Qvar has a localized effect on lung tissues with negligible systemic effects, which results in it having fewer side effects than other corticosteroids that have stronger systemic influences.
On the other hand, Dulera combines two medications: formoterol and mometasone furoate. Mometasone acts similarly to Beclomethasone by reducing inflammation while Formoterol belongs to a class of drugs known as long-acting beta agonists (LABAs). LABAs relax and open air passages in the lungs, improving breathing symptoms such as wheezing and shortness of breath.
What conditions is Qvar approved to treat?
Qvar and Dulera are approved for the treatment of various conditions related to lung diseases:
- Qvar is used as a maintenance treatment for asthma, which includes prevention of asthma attacks and long-term control.
- Dulera is utilized for the management of Asthma in patients 12 years or older. It combines two medicines (mometasone furoate and formoterol fumarate) that work together to reduce inflammation and relax airway muscles to improve breathing.
How does Qvar help with these illnesses?
Qvar helps to manage asthma by reducing inflammation in the airways. It does this by delivering beclomethasone, a corticosteroid, directly to the lungs through inhalation. Corticosteroids are anti-inflammatory medications that work by suppressing immune responses and decreasing inflammation. Inflammation in the airways is a key component of asthma, leading to symptoms such as wheezing, shortness of breath, chest tightness, and coughing. By reducing inflammation with Qvar, patients can limit the negative effects of asthma and help manage their condition effectively.
On the other hand, Dulera takes an additional step in managing asthma as it contains two active ingredients: mometasone (a corticosteroid) like Qvar; but also formoterol (a long-acting bronchodilator). While mometasone works similarly to beclomethasone in Qvar by reducing inflammation within the airways; formoterol targets smooth muscles around these airways causing them to relax and open up for easier breathing. Henceforth combining both anti-inflammatory and muscle-relaxant properties; Dulera may provide more comprehensive control over severe or persistent types of asthma compared to single-ingredient drugs like Qvar.
What is Dulera?
Dulera is a brand name for a combination of mometasone and formoterol, used to manage asthma symptoms. Mometasone is a corticosteroid that reduces inflammation in the airways while formoterol, as a long-acting beta2-adrenergic agonist (LABA), works by relaxing muscles around the airways to help them open up. Dulera was first approved by the FDA in 2010.
Unlike Qvar which contains only beclomethasone (a corticosteroid), Dulera's dual action not only reduces inflammation but also relaxes muscle constriction, potentially offering more comprehensive management of asthma symptoms. It must be noted that this does not make one superior over the other; rather it provides an alternative based on individual patient needs and responses.
The side effects profile of Dulera differs from Qvar due largely to its additional component - Formoterol. Potential side effects include increased heart rate, tremors or nervousness which are less common with monotherapy like Qvar.
What conditions is Dulera approved to treat?
Dulera is a prescribed medication that's approved by the FDA in the United States for treating:
- Asthma, specifically moderate to severe persistent asthma
- Reduction of exacerbations in patients with chronic obstructive pulmonary disease (COPD)
Note that Dulera should not be used as a rescue inhaler or for people whose asthma is well controlled with low or medium dose inhaled corticosteroids.
How does Dulera help with these illnesses?
Like Qvar, Dulera is a medication used in the management of asthma. It operates by reducing inflammation and relaxing muscles in the airways to improve breathing. Dulera distinguishes itself by being a combination inhaler that contains both an inhaled corticosteroid (mometasone) and a long-acting beta2-adrenergic agonist (formoterol). The dual action of these two active ingredients offers broader control over asthma symptoms, making it particularly beneficial for patients who do not respond adequately to single ingredient medications like Qvar. Mometasone works by decreasing inflammation in the lungs while formoterol aids in keeping the airways open, improving overall lung function and reducing exacerbations. Since it affects different aspects of asthma pathophysiology simultaneously, Dulera can be more effective than single agent therapies such as Qvar and might be opted for when improved symptom control is required.
How effective are both Qvar and Dulera?
Both beclomethasone dipropionate (Qvar) and mometasone/formoterol (Dulera) have established histories of success in managing asthma symptoms. They were initially approved by the FDA just a few years apart, with Qvar gaining approval in 2000 and Dulera following suit in 2010. As they act on different aspects of the inflammatory process associated with asthma, they may be prescribed under differing circumstances.
The effectiveness of Qvar, an inhaled corticosteroid (ICS), has been studied extensively for long-term control and prevention of symptoms in patients with persistent asthma. It works by reducing inflammation within the lungs to improve lung function over time. A meta-analysis published in 2008 demonstrated that low-dose ICSs like Qvar could significantly reduce severe exacerbations and improve overall quality of life for adults with persistent asthma.
On the other hand, Dulera combines two active ingredients: mometasone furoate, another type of ICS similar to Qvar's main ingredient; and formoterol fumarate dihydrate—a long-acting beta2-adrenergic agonist (LABA). This combination is designed not only to reduce inflammation but also to relax muscles around airways for immediate relief from bronchospasm or difficulty breathing—something that Qvar cannot do alone.
In a head-to-head trial conducted over 12 weeks involving subjects aged 12 years old or older diagnosed with moderate-to-severe persistent Asthma who previously took medium-dose ICSs alone or combined LABA/ICS treatments, those administered Dulera maintained symptom control better than those solely given high doses of an ICS such as what one might experience using an equivalent dose of Qvar.
While both medications are generally well-tolerated according to numerous studies conducted over several decades now, patients must always consider potential side effects: oral candidiasis can occur more commonly among users inhaling steroids like those found in either medication due to immune suppression at mucous membranes; whereas tremors or palpitations could happen more frequently among individuals sensitive towards stimulatory effects brought about by LABAs such as formoterol present only within Dulera. Overall though, these drugs tend to cause fewer systemic side effects compared against traditional oral counterparts because preponderant amounts delivered remain confined within respiratory tracts instead getting absorbed systemically through gut walls into bloodstreams directly leading towards various organs throughout bodies.
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At what dose is Qvar typically prescribed?
Inhaled dosages of Qvar range from 40-320 mcg/day, but studies have indicated that an initial dose of 40-80 mcg twice daily is often sufficient for managing asthma in many individuals. Children may be started on a lower dose, commonly 40 mcg twice daily. In either population, if control of asthma symptoms is not achieved after a week or two, the dosage can be gradually increased under physician guidance. The maximum dosage that should not be exceeded in any case is 320 mcg/day for children and 640 mcg/day for adults.
At what dose is Dulera typically prescribed?
Dulera treatment, used for the management of asthma and COPD, is generally started at a dosage of 2 inhalations twice daily. Each inhalation consists of either 100 mcg or 200 mcg dose depending on severity of the disease. The doses should be spaced approximately 12 hours apart. Maximum recommended dose is four inhalations per day divided into two doses which may be considered if there's no significant improvement in symptoms after initial weeks of treatment. It’s crucial to note that Dulera is not intended for instant relief and must not be used as a rescue medication.
What are the most common side effects for Qvar?
Common side effects of Qvar and Dulera can include:
- Headache
- Throat irritation or pain
- Cough
- Upper respiratory tract infection (common cold symptoms)
- Sinusitis (inflammation of the sinus cavities in the head)
- Oral candidiasis (a fungal infection, also known as thrush)
- Nausea
- Vomiting
- Diarrhea
As with any medication, if these side effects persist or worsen, it's important to consult your healthcare provider. These two medications are used primarily for asthma management and should be taken under strict medical supervision due to their potential for serious side effects such as adrenal insufficiency, bone loss, glaucoma and cataracts.
Are there any potential serious side effects for Qvar?
While Qvar and Dulera both aim to control and prevent asthma symptoms, they can have different side effects. For instance:
- Signs of allergic reactions: skin rash, itching or hives; swelling of the face, lips or tongue.
- Breathing problems after using either inhaler
- Chest pain or chest tightness
- Rapid heartbeat (tachycardia)
- Tremors in hands
- Vision changes
- High blood sugar - increased thirst, increased urination, dry mouth, fruity breath odor.
For Dulera specifically:
Severe nervous system reaction - muscle cramps or stiffness, feeling restless or jittery.
If you experience these side effects with either Qvar or Dulera it's essential to contact your healthcare provider immediately.
What are the most common side effects for Dulera?
Dulera may potentially cause the following side effects:
- Throat irritation or dry mouth
- Sinus congestion and headaches
- Blurred vision or problems with focus
- Nausea, vomiting, abdominal discomfort, decreased appetite or changes in bowel habits
- Sleep disturbances such as insomnia
- Increased feelings of anxiety and nervousness
- Rapid heartbeat or palpitations
- Mood changes including agitation and hostility
- Potential for skin rash
- Unintended weight loss
- Frequent urination
-Dizziness and potential muscle weakness or joint pain.
As always, it is important to remember that not every patient will experience these side effects and some might experience other symptoms not listed here. It is best to consult your healthcare provider if you have any concerns about taking Dulera.
Are there any potential serious side effects for Dulera?
While Dulera is generally well tolerated, it can also cause severe side effects in rare cases. These may include:
- Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Worsening asthma symptoms
- Chest pain and fast, pounding heartbeats
- Tremors or nervousness
- Choking or other breathing problems after using this medicine
- White patches in your mouth or throat after use
- Blurred vision, tunnel vision, eye pain or seeing halos around lights If you happen to experience any of these symptoms while on Dulera therapy, seek immediate medical attention.
Contraindications for Qvar and Dulera?
Both Qvar and Dulera, along with most other inhaled corticosteroids or long-acting beta agonists (LABAs), may worsen symptoms of asthma in some people. If you notice your asthma worsening, a decrease in lung function test results, or an increase in the use of quick-relief inhalers, please seek immediate medical attention.
Neither Qvar nor Dulera should be taken if you are taking, or have been taking monoamine oxidase (MAO) inhibitors (MAOIs) or tricyclic antidepressants within the past two weeks. Always tell your physician which medications you are taking; these drugs will require a period to clear from the system to prevent dangerous interactions with both Qvar and Dulera.
How much do Qvar and Dulera cost?
For the brand name versions of these drugs:
- The price for one Qvar Redihaler, which contains 120 doses, ranges from $200 to $240. This ends up being roughly $1.66–$2 per day if you're taking two puffs daily.
- Dulera inhalers (which also contain 120 doses) are in a similar price range, costing between $250 and $300; this works out to approximately $2.08–$2.50 per day assuming two puffs daily.
Thus, on a per-day treatment basis, if your prescribed dosage is equivalent for both medications (for instance: using each twice a day), then brand-name Qvar is less expensive than Dulera.
Please note that cost should not be the primary consideration in determining which of these drugs is appropriate for you. Both have different active ingredients and may vary significantly in their effects depending on individual factors like your specific diagnosis and overall health status.
As it stands presently, there are no generic equivalents available for either Qvar or Dulera given patent protections still apply to both medicines' unique formulations. Therefore costs remain relatively high compared to many other older respiratory treatments where generics exist.
Popularity of Qvar and Dulera
Beclomethasone dipropionate, commonly known as Qvar, was estimated to have been prescribed to about 1.6 million people in the US in 2020. Qvar is a corticosteroid used primarily for long-term management of asthma and accounted for nearly 5% of all inhaled steroid prescriptions in the US last year. Its popularity has been fairly consistent over recent years.
Mometasone/formoterol, sold under the brand name Dulera among others, was prescribed to about 1.2 million individuals in the USA during that same period. This combination medicine accounts for roughly 4% of overall inhaler prescriptions intended for control (rather than immediate relief) of asthma symptoms across America. Over time, its prescription rate has experienced some fluctuations but generally remained stable within this range over the past decade.
Conclusion
Both Qvar (beclomethasone dipropionate) and Dulera (mometasone furoate and formoterol fumarate dihydrate) have proven track records in managing asthma symptoms. They are supported by numerous clinical trials showing their efficacy over placebo treatments. The drugs may be used concurrently, subject to a physician's approval, as they possess different mechanisms of action: Qvar is an inhaled corticosteroid that reduces inflammation within the lungs while Dulera combines an inhaled corticosteroid with a long-acting bronchodilator which relaxes muscles around the airways allowing them to stay open longer.
Qvar is typically considered for use as maintenance therapy to control and prevent asthma symptoms whereas Dulera would usually be prescribed when patients do not respond adequately to low or medium dose inhaled corticosteroids alone, or those who require both an inhaled corticosteroid and a long-acting bronchodilator.
Both medications are available through prescription only but come at differing costs due to their compositions – which can impact out-of-pocket expenses for patients. Both Qvar and Dulera require continued usage before effects become noticeable; this period varies between individuals.
While side effect profiles are generally similar between the two drugs, they're well-tolerated overall but can cause common issues like throat irritation and hoarseness. With any medication for chronic respiratory conditions, it's crucial that patients monitor their symptoms closely especially when starting treatment or changing doses – if there's worsening of asthma or other unusual effects, immediate medical help should be sought.
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Refrences
- Van Schayck, C. P., & Donnell, D. (2004, July 21). The efficacy and safety of QVAR (hydrofluoroalkane-beclometasone diproprionate extrafine aerosol) in asthma (Part 1): an update of clinical experience in adults. International Journal of Clinical Practice. Hindawi Limited.http://doi.org/10.1111/j.1368-5031.2004.00273.x
- Davies, R., Leach, C., Lipworth, B., & Shaw, R. (1999, April). Asthma management with HFA-BDP (Qvar™). Hospital Medicine. Mark Allen Group.http://doi.org/10.12968/hosp.1999.60.4.1093
- Nobata, K., Fujimura, M., Myou, S., Ishiura, Y., Mizuguchi, M., Nishi, K., & Nakao, S. (2006, January). Bronchial Asthma Showing Reduction in FEV<sub>1</sub>after Inhalation of Qvar™. Journal of Asthma. Informa UK Limited.http://doi.org/10.1080/02770900600710722