Dulera® (Zenhale) Inhalation Aerosol for Long-Term Asthma Control

What Dulera® Is and How It Works

Dulera, known as Zenhale in Canada, combines mometasone furoate (inhaled corticosteroid) and formoterol fumarate (long-acting beta2-agonist). It is a metered-dose inhaler used as maintenance therapy for asthma in adults and adolescents 12 years and older. It is not a rescue inhaler. Many patients buy Dulera online to access Canadian pricing and reduce the Dulera cost without insurance.

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Mometasone reduces airway inflammation, swelling, and mucus. Formoterol relaxes airway smooth muscle, improving airflow for about 12 hours. Formoterol has a relatively quick onset, and mometasone provides ongoing anti-inflammatory control. Taken as directed, the combination helps reduce symptoms like wheeze, cough, and chest tightness, and lowers the risk of exacerbations.

Dulera/Zenhale comes in multiple strengths. Most patients use two inhalations twice daily, about 12 hours apart. The dose selected depends on prior asthma control and current therapy. Your prescriber determines the strength and number of inhalations.

Dosage and Usage

• Use two inhalations twice daily, or as prescribed. Do not exceed the prescribed number of inhalations per day.
• Do not use Dulera/Zenhale to treat sudden breathing problems. Keep a short-acting rescue inhaler available for acute symptoms.
• Prime the inhaler before first use: shake well, then release four test sprays away from the face. Re-prime if not used for more than five days or if dropped.
• Before each dose, shake the inhaler well. Breathe out fully. Place the mouthpiece in the mouth and close lips.
• Press down on the canister as you breathe in slowly and deeply. Hold your breath for about 10 seconds, then breathe out gently.
• If taking a second inhalation, wait about 30 to 60 seconds and repeat.
• Rinse mouth with water after each dose and spit to help reduce the risk of oral thrush.
• Watch the dose counter. Do not use the inhaler once the counter reads 0. Do not try to alter the counter.
• If a dose is missed, skip it and resume the regular schedule. Do not take extra inhalations to make up for a missed dose.
• Use with a spacer device only if your healthcare provider recommends one for your technique.

• Store at 20–25°C (68–77°F); brief excursions 15–30°C (59–86°F) are acceptable. Do not freeze.
• Keep away from heat above 49°C (120°F), open flame, or direct sunlight. Do not puncture or incinerate the canister.
• Keep the mouthpiece dry. Do not wash or immerse the canister or actuator in water. Wipe the mouthpiece with a dry cloth if needed.
• Re-prime after more than five days of nonuse or if the inhaler is dropped.
• Travel with the inhaler in carry-on luggage. Avoid storing it in a hot car. Keep the cap on to protect the mouthpiece.
• Carry your prescription or a copy when traveling. Consider a backup inhaler if extended travel is planned.

Benefits and Savings

Dulera/Zenhale simplifies asthma maintenance by combining an inhaled steroid and a LABA in one device. Twice-daily dosing supports steady control and may reduce nighttime symptoms. Many patients report fewer exacerbations and improved lung function when the dose is optimized. Formoterol’s quick onset provides noticeable symptom relief while mometasone sustains anti-inflammatory action.

Ordering from Canadian pharmacies can provide meaningful savings. Typical customers see 60–80% lower prices versus common US retail. This can help patients managing Dulera without insurance or those watching their Dulera cash price month to month.

You can set reorder reminders so you do not run out mid-month. Multi-month supplies and Dulera bulk promotions, when available, may lower your average monthly cost. For extra value, see current Dulera coupon options on our promotions page.

Side Effects and Safety

• Thrush (oral candidiasis), hoarseness, or sore throat
• Headache, sinus irritation, or upper respiratory tract infections
• Cough or throat irritation after inhalation
• Tremor, nervousness, or palpitations
• Nausea, upset stomach, or altered taste
• Muscle cramps or joint discomfort

Serious risks are uncommon but can include paradoxical bronchospasm, hypersensitivity reactions, adrenal suppression, and effects on bone mineral density with long-term high-dose steroid exposure. Eye effects such as glaucoma or cataracts can occur. Use caution in patients with cardiovascular disease, arrhythmias, hypertension, seizures, hyperthyroidism, or diabetes. Not for status asthmaticus or for relief of acute bronchospasm. Ask your prescriber about use during pregnancy or breastfeeding.

Onset Time

Formoterol begins to open airways within minutes, so breathing may feel easier soon after dosing. Most people notice better day-to-day control within several days to two weeks as inflammation declines. Lung function and symptom scores typically continue to improve over 4–8 weeks with regular use. Consistent dosing is key to sustained benefit.

Compare With Alternatives

Some patients do well on an inhaled corticosteroid alone. Products such as Qvar® Aerosol Inhaler (beclomethasone) or Asmanex® (mometasone) provide anti-inflammatory control without a LABA. These options may suit milder asthma or a step-down plan when control is stable.

Other ICS/LABA combinations include budesonide/formoterol and fluticasone/salmeterol. Choice depends on prior response, dosing preference, and prescriber guidance. Some clinicians select a specific device based on inhalation technique and patient comfort.

Short courses of oral corticosteroids may be used to treat acute exacerbations when directed by a clinician. Once stabilized, patients usually return to their controller inhaler at the prescribed maintenance dose.

Combination Therapy

• Keep a short-acting beta2-agonist (rescue inhaler) available for acute symptoms.
• Some treatment plans pair Dulera/Zenhale with a leukotriene receptor antagonist at night.
• During flare-ups, a brief oral steroid course may be added, then tapered off as control returns.
• To limit side effects, prescribers may adjust doses when other asthma medicines are added or removed.
• Do not use two LABA-containing inhalers together.

Patient Suitability and Cost-Saving Tips

Dulera/Zenhale is intended for asthma patients 12 and older who need both anti-inflammatory and bronchodilator control. It should not be used to treat sudden breathing problems or as first-line therapy in rapidly worsening asthma. Those with severe allergy to any component should avoid this product.

Use caution if there is a history of glaucoma or cataracts, osteoporosis, tuberculosis, or untreated fungal, bacterial, or viral infections. Certain medicines can interact, including strong CYP3A4 inhibitors that increase steroid exposure. Review all medications with the prescriber and pharmacist.

For budgeting, consider a multi-month supply if prescribed. It can reduce per-month costs and cut shipping fees over time. Price-check Dulera and the Canadian brand name Zenhale; the Zenhale cost may differ by strength. If you are weighing the Zenhale price without insurance, compare strengths and pack sizes to find the best per-inhaler value.

You can set email reminders for refills so you do not miss a dose window. Some customers prefer to purchase Dulera on a schedule to align with seasonal triggers. If you are new to combination therapy, ask the prescriber about the right starting strength and how to step down once control is sustained.

Authoritative Sources

FDA Prescribing Information for Dulera (mometasone furoate/formoterol fumarate)

Health Canada Drug Product Database: Zenhale (mometasone/formoterol)

Official Dulera website (Merck)

Order Dulera® from YouDrugstore: add to cart, upload your prescription, and we ship with prompt, express shipping.

This page is for educational purposes only and does not replace advice from your healthcare professional.