I'm trying Dulera

Dulera was approved in June 2010

My doctor recommended for kicks and grins I try Symbicort instead of Advair. Yet after searching his cupboard realized he didn't have any free samples left, so he grabbed a Dulera and tossed it at me. "Try this," he said. "It's basically the same as Symbicort."

Dulera was approved by the FDA as another option in the line of Advair and Symbicort. The LABA in it is the same as what's in Symbacort, and the inhaled corticosteroid is the same as Azmanex twisthaler, which was approved by the FDA in 2005.

I have read in a few places that the particle size of fluticasone (the inhaled steroid in Advair) is larger due to the fact it's a dry powder inhaler. The particle size of Dulera are smaller and may reach deeper into the lungs to provide a more even dispersion of the medicine.

However, I have not been able to set my eyes on any studies other than the initial studies completed by the company that prove that using Dulera is better than not using any asthma controller medications. I would like to see some studies proving that Dulera is better than Advair or Symbicort.

Formoterol, the LABA in Dulera and Symbicort, is faster acting than Salmeterol, the LABA in Advair. Other than that I'm not sure of any proven benefits of one of these combination inhalers over the others.

However, unlike Advair, Dulera is a metered dose inhaler, and therefore to get the maximum effect a spacer device must be used. That should make it a little more inconvenient because I think spacers are more of a bother than they're worth. Yet we'll see how that goes.

So if any of my readers has access to any further Dulera studies let me know. Other than that, I'll report back in a month when my sample of Dulera is used up, if the side effects of formoterol don't get to me first.

Time released meds great for asthma compliance

So asthma used to suck worse than it does today. Of course before 1903 there was no epi, and before the 1950s no inhalers and nebulizers. Yet, in the 1980s there were so many asthma meds that being compliant was a daily battle.

If you want a good example of what I'm writing about, click here. I was on so many meds back in 1985 that I was taking some asthma medicine at least every four hours. While it got better by 1998, I was still taking meds every four hours. Theophylline was every 8 hours, Azmacort was 4 puffs every 4 hours during the day, and plus there were a few others mixed in.

Finally in 1998 Flovent came along. It was a stronger inhaled corticosteroid and was only needed twice a day. That solved the problem of the Azmacort. I actually liked the taste of Azmacort, but there was no way I was going to lug that big thing around with me. So, basically, the only times I took it were when I so happened to be home.

My point here is, that asthmatics today should be very happy. I was a little slow getting on this train, but in 2007 I was finally started on Advair. Actually, I was introduced to Serevent CFC back in 1998, but the side effects were too great. Advair, however, made my life so much easier. That's 2 puffs a day. One puff when you brush your teeth in the morning, and one puff when you brush your teeth in the evening. That's it.

I remember just before I was admitted to the asthma hospital in 1985 my doctor put me on a time delayed theophylline pill -- the first of its kind -- so I only had to take it twice a day. My doctor at the asthma hospital said those time delayed pills were a bad idea, and he put me back on the 300 mg dose every 8 hours.

I guess he was a little behind the times, as it was 25 years later most asthma controller meds are on a time released system. The time released system allows for asthma meds to be taken twice a day and that's it. It's great.