Are There Risks With Dulera?
Specific Precautions and Warnings for DuleraSome warnings and precautions to be aware of prior to taking this drug include the following:
- Dulera contains a long-acting beta-adrenergic agonist (or beta agonist for short). In some studies, people taking beta agonists were more likely to have severe asthma attacks. Some of these asthma attacks resulted in death. In some of these studies, children taking beta agonists had an increased risk for being hospitalized due to their asthma.
Because of the potential for these effects, Dulera should only be used in people whose asthma is not well controlled on other asthma medications. Once your asthma is controlled, your healthcare provider may try to "step down" your asthma treatment by stopping or decreasing Dulera. If your asthma symptoms become worse while taking Dulera, let your healthcare provider know immediately.
- Dulera may have stimulating effects on the heart and blood pressure. This may result in a fast heart rate (tachycardia), high blood pressure (hypertension), or an irregular heart rhythm (arrhythmia). In some cases, people may also develop low blood pressure (hypotension).
If you have heart disease or high blood pressure, make sure your healthcare provider knows. He or she may want to use particular caution if prescribing Dulera in your case.
- Dulera can increase the risk of getting a yeast infection in the mouth or throat (thrush). You can reduce your risk of getting this infection by rinsing out your mouth after every dose. Make sure to tell your healthcare provider if you develop a cottony feeling in your mouth or get creamy white sores on your tongue or in your mouth or throat.
- People with an overactive thyroid (hyperthyroidism), diabetes, or epilepsy should use caution when using Dulera, as it can make these conditions worse or increase the risk of side effects.
- If you are switching from an oral steroid to Dulera, which contains an inhaled steroid, your healthcare provider will decrease your dose of the oral steroid very slowly. Stopping an oral steroid too quickly can be very dangerous.
- In some people, Dulera can cause an immediate worsening of asthma symptoms, including bronchospasms and wheezing. This worsening of symptoms may lead to life-threatening complications. If this happens, use your rescue inhaler (such as albuterol) and contact your healthcare provider immediately.
- Dulera is not a fast-acting asthma medication and cannot replace fast-acting rescue inhalers. Do not use Dulera to treat an asthma attack after it starts. Make sure you have a rescue asthma medication, such as albuterol, available at all times. Let your healthcare provider know if you need to use your rescue inhaler more often than usual, as this may be a sign that your asthma is getting worse.
- Dulera contains a steroid and, as with all steroids, may suppress the immune system. Although this is more likely to occur with oral steroids, it is still possible with inhaled steroids such as Dulera. As a result, you may have a higher risk of infections when you take Dulera.
In addition, certain infections such as chickenpox or the measles may be more dangerous. Let your healthcare provider know right away if you have problems with your immune system, are exposed to chickenpox or the measles, or if you have not had chickenpox or the measles and have not been vaccinated against them.
- Like all steroids, Dulera may slow down the growth of children and teenagers. Usually, this slowing of growth is small, with children growing about a half a centimeter less per year. Contact your child's healthcare provider if you are concerned about slow growth in your child.
- Inhaled steroids, such as Dulera, may increase the risk of developing osteoporosis. If you already have osteoporosis or are at risk for osteoporosis, your healthcare provider may decide to take steps to protect you from fractures.
- Inhaled steroids, such as Dulera, can cause glaucoma or cataracts (conditions of the eyes). You may need to have your eyes examined more often if you take Dulera.
- Do not take Dulera more often than prescribed, as this may increase your risk of side effects.
- Before starting Dulera, make sure to tell your healthcare provider if you currently have any type of infection. Also, let him or her know if you have ever had tuberculosis or a herpes infection of the eye, as Dulera may weaken the immune system, allowing these infections to get worse.
- Dulera can interact with other medications (see Dulera Drug Interactions).
- Dulera is considered a pregnancy Category C medication. This means that it may not be safe to use during pregnancy. Talk with your healthcare provider about the risks and benefits of using Dulera during pregnancy (see Dulera and Pregnancy).
- It is not known if Dulera passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, talk to your healthcare provider about using Dulera (see Dulera and Breastfeeding).