Dulera Inhaler (Mometasone and Formoterol)

One inhaler, two active ingredients

Dulera puts two medicines into a single pressurised device rather than requiring two separate inhalers. Every actuation of this metered-dose inhalation aerosol releases a fixed combination of 5 mcg formoterol fumarate and 200 mcg mometasone furoate. The ratio between the long-acting bronchodilator and the corticosteroid is therefore fixed at this strength. If a prescriber wants to adjust the corticosteroid independently of the bronchodilator, a fixed-combination aerosol does not provide that flexibility. Separate inhalers allow the components to be adjusted individually, whereas Dulera provides both through one canister and one inhalation technique. That distinction is worth confirming before choosing a package quantity because it affects how the medicine fits into an ongoing asthma treatment plan.

Dulera's role in asthma care

The active ingredients are mometasone and formoterol. They combine an inhaled corticosteroid with a long-acting beta2 agonist (LABA) in a single canister administered by oral inhalation. This type of combination inhaler is used for the maintenance treatment of asthma in people aged 12 years and over. Dulera is not a rescue inhaler and should not be used to treat a sudden asthma attack or as an occasional substitute for a prescribed reliever. We offer Dulera only at the strength of 5 mcg formoterol fumarate plus 200 mcg mometasone furoate per actuation, in packages containing two, four, or six inhalers. Comparisons with other products therefore focus mainly on the active corticosteroid, inhaler design, dosing routine, and individual treatment history rather than on alternative Dulera strengths in our catalogue.

Who may consider this inhaler, and what should shape the choice?

Deciding whether Dulera is an appropriate option starts with matching its fixed strength and device to an established asthma treatment plan, ideally with a prescriber. Several practical and clinical factors can influence that discussion:

• Age: established use of this strength begins at 12 years. Its safety and effectiveness have not been established in younger children.
• Current asthma control: Dulera is intended for regular maintenance rather than sudden symptoms. Patients using it should continue to have access to the reliever inhaler recommended by their prescriber.
• Diabetes: formoterol can raise blood glucose temporarily, and corticosteroid exposure may also affect glucose control. Closer monitoring may be appropriate after treatment begins or changes.
• Pregnancy or breastfeeding: the expected benefit and possible risk require an individual discussion with a prescriber rather than a default decision either way.
• Known hypersensitivity: Dulera should not be used by someone with a known allergy to mometasone, formoterol, or one of the inhaler ingredients. Unrelated allergies do not automatically prevent its use.

Other considerations include the ability to coordinate pressing the canister with a slow inhalation, previous experience with inhaled corticosteroids, and whether the fixed combination matches the intended dosing plan. These factors help identify useful questions for a prescriber; they do not establish that Dulera is suitable for a particular individual.

How does the combination work in everyday use?

Mometasone furoate is a corticosteroid that reduces inflammation in the airways over time. Formoterol fumarate is a long-acting beta2 agonist that relaxes the surrounding smooth muscle and helps keep the airways open. Because both medicines are released together, every actuation delivers the same fixed combination.

Dulera is generally used regularly twice a day, in the morning and evening, rather than only when symptoms appear. Missing doses works against consistent control of airway inflammation, while stopping treatment without clinical advice may allow symptoms or inflammation to worsen even if breathing feels normal at the time. The formoterol component should not be used without an inhaled corticosteroid for asthma; Dulera supplies both components in the same actuation. Any reduction or discontinuation should be discussed with the prescriber overseeing the treatment plan.

A consistent inhaler routine

Because Dulera is a pressurised, dose-metered inhaler, technique affects how much medicine reaches the lungs. The patient information leaflet and advice from a pharmacist or prescriber should take priority, but the usual sequence includes the following steps:

1. Shake the inhaler. If it is new or has not been used for the period specified in its leaflet, prime it before taking a dose.
2. Breathe out fully away from the mouthpiece.
3. Close your lips around the mouthpiece, press the canister to release one actuation, and breathe in slowly and deeply at the same time.
4. Hold your breath for several seconds if comfortable, then breathe out gently.
5. After completing the prescribed dose, rinse your mouth with water and spit it out. This helps reduce the risk of oral thrush and hoarseness associated with inhaled corticosteroids.
6. Replace the mouthpiece cover, keep the mouthpiece clean as directed in the leaflet, and store the inhaler with the mouthpiece facing down.

A prescriber should confirm the number of actuations per dose. Keep track of the dose counter or remaining actuations according to the device instructions so that a replacement can be arranged before the inhaler is empty. Do not increase the number of actuations or use Dulera more frequently to manage sudden symptoms unless a prescriber has specifically changed the treatment plan.

Choosing an available package quantity

We offer packages containing two, four, or six Dulera inhalers. Every option has the same strength of 5 mcg formoterol fumarate plus 200 mcg mometasone furoate per actuation, so package selection changes only the number of inhalers supplied.

• Two inhalers: this is the smallest quantity available in our catalogue.
• Four inhalers: this is the middle option for an established treatment plan requiring more than the minimum package quantity.
• Six inhalers: this is the largest available quantity and requires enough suitable storage space for every pressurised canister.

The package quantity alone does not establish how long the supply will last. Duration depends on the prescribed number of actuations, the dosing frequency, the number of usable actuations in each inhaler, and whether doses have been released during priming. Check the expiry information and ensure that every inhaler can be stored correctly before selecting a larger quantity.

What outcomes and timing are realistic?

Dulera is a maintenance treatment, not a substitute for a rescue inhaler. Formoterol starts opening the airways relatively quickly, but the anti-inflammatory effect of mometasone develops with consistent use over time. A patient should not use an early change in breathing after one dose as a reason to alter the prescribed routine.

The treatment aims to improve day-to-day asthma control, reduce symptoms and flare-ups, and lessen the need for a rescue inhaler. The timing and degree of benefit vary between individuals. Keeping a record of symptoms, night-time waking, reliever use, and activity limitations can make a follow-up review more informative. Worsening symptoms, increasing reliever use, or a reliever that no longer provides its usual benefit requires prompt medical advice. Severe or rapidly worsening breathing difficulty requires urgent medical help.

Important safety priorities

Several safety points are especially relevant when weighing Dulera against another maintenance inhaler:

• Dulera treats ongoing airway inflammation and narrowing, but it does not replace a fast-acting reliever prescribed for sudden symptoms.
• People with diabetes may experience changes in blood glucose and may need closer monitoring.
• Use during pregnancy or breastfeeding requires an individual assessment of the expected benefit and possible risk.
• This strength has established use from 12 years of age; safety and effectiveness have not been established in younger children.
• Dulera should not be combined with another medicine containing a long-acting beta2 agonist unless a prescriber has specifically arranged the treatment.
• The canister is pressurised. Do not puncture or burn it, even when it appears empty, and do not expose it to temperatures above 49°C.

Store Dulera at 20°C to 25°C. Temporary temperatures between 15°C and 30°C are permitted. Keep the inhaler with the mouthpiece facing down and away from direct heat. Seek medical advice if breathing becomes worse immediately after an actuation, as this may represent paradoxical bronchospasm and requires prompt assessment.

Interactions and practical precautions

Beta blockers, including some medicines used for blood pressure or heart conditions, can reduce formoterol's effect on the airways and may provoke bronchospasm in susceptible people. Other bronchodilators with similar stimulant effects can increase adverse effects if used together without a planned clinical reason. Medicines that affect heart rhythm may also increase the cardiovascular risks associated with a beta2 agonist.

Strong CYP3A4 inhibitors can increase exposure to mometasone. This can be relevant with certain antifungal or antiviral medicines. Monoamine oxidase inhibitors and tricyclic antidepressants may increase cardiovascular effects when combined with formoterol. The beta2 agonist component can also lower potassium levels or increase heart rate, particularly when combined with some diuretics or in people with cardiovascular disease.

Tell a pharmacist or prescriber about all current medicines, including non-prescription products and supplements, before starting Dulera. It is also important to mention heart rhythm disorders, high blood pressure, thyroid disease, seizures, low potassium, diabetes, active infections, tuberculosis, glaucoma, cataracts, or reduced bone density. This allows advice to account for risks that a general interaction list cannot assess individually.

Which alternative inhaler is the most relevant comparison?

Dulera is one of several fixed-dose corticosteroid and LABA combinations. The most useful comparison depends on the active ingredients, device, dosing schedule, and the patient's previous response rather than on a general claim that one brand is superior. Symbicort pairs budesonide with formoterol rather than mometasone. This may be relevant when a prescriber is considering a different inhaled corticosteroid or a treatment plan with product-specific dosing options.

Advair Diskus combines fluticasone with salmeterol in a dry-powder device rather than a pressurised aerosol. A breath-activated powder inhaler may suit someone who finds it difficult to coordinate pressing a canister with inhalation, although the ability to generate an adequate inhalation through the device must also be considered. Breo Ellipta may be discussed when a once-daily combination is relevant, while Fostair offers a beclometasone-and-formoterol comparison familiar in UK asthma care.

These differences do not make any one option universally preferable. They help narrow the discussion according to inhaler technique, dosing routine, previous corticosteroid response, and the treatment options available through a prescriber. Our asthma category provides a useful starting point for exploring relevant product information beyond Dulera.

UK access and prescription context

Dulera, including the strength of 5 mcg formoterol fumarate plus 200 mcg mometasone furoate per actuation, has not been identified as a UK-authorised medicine in the MHRA medicines register. The UK prescription classification of this exact product is therefore unknown because no UK marketing authorisation has been identified. This regulatory position is separate from our ordering policy.

Our ordering process for Dulera does not require a prescription document to be submitted. That policy does not establish UK marketing authorisation or determine whether Dulera is clinically suitable for an individual. If UK authorisation or selection of an authorised alternative is important, discuss that point with a GP, asthma nurse, prescriber, or community pharmacist. Suspected medicine side effects can be reported through the MHRA Yellow Card scheme.

Our pharmacist-supported team is available 24/7 by email, online chat, and phone for questions about the catalogue strength, package quantities, storage requirements, or ordering process. Clinical changes to an asthma treatment plan should still be made with the prescriber responsible for the patient's care.

Ordering and receiving Dulera

We display our prices in pounds sterling and offer Dulera in packages of two, four, or six inhalers. Before ordering, check that the product name, fixed strength, package quantity, and metered-dose inhalation aerosol form match the intended treatment. This is particularly important because Dulera is not identified as a UK-authorised medicine and should not be assumed to be interchangeable with a UK inhaler solely because it contains medicines from the same classes.

After receiving the order, check the product and package details before use. Store each inhaler at 20°C to 25°C, with permitted temporary temperatures between 15°C and 30°C, and keep it with the mouthpiece facing down. Do not use a canister that appears damaged or has been exposed to excessive heat. Our support team, including a pharmacist, is available by email, online chat, and phone if a question arises about the order, product identity, or stated storage requirements.

Making the decision

Before choosing Dulera, confirm that the fixed strength of 5 mcg formoterol fumarate plus 200 mcg mometasone furoate per actuation matches the treatment under consideration and that a pressurised metered-dose inhaler suits the intended technique. Age, current asthma control, other medicines, diabetes, pregnancy, breastfeeding, cardiovascular conditions, and known hypersensitivity can all affect the discussion with a prescriber.

If the priority is a different corticosteroid, a dry-powder device, once-daily dosing, or an inhaler used successfully before, one of the alternatives above may be a more relevant comparison. If Dulera's ingredients, fixed strength, device, and routine are appropriate, the remaining catalogue choice is the number of inhalers required. Select that quantity according to the established treatment plan and the ability to store every canister correctly, rather than assuming that a larger package is automatically the better option.