Mometasone / formoterol inhaler (Dulera)

How Medicare covers it

Part D (inhaler used at home). Part A during a covered inpatient stay. No Part B clinician-administered form of the combination in the CMS Part B spending file.

What it treats

Mometasone/formoterol (Dulera) is a combination maintenance inhaler — the inhaled corticosteroid mometasone furoate plus the long-acting bronchodilator formoterol — for the treatment of asthma in patients 5 years of age and older. It is not indicated for the relief of acute bronchospasm.

What it is for, in depth

From the label's Indications section: Dulera is indicated for the treatment of asthma in patients 5 years of age and older, with the stated limitation that it is not for relief of acute bronchospasm. Who it is prescribed for and where it fits: asthma that needs a daily controller combination — an inhaled steroid to calm airway inflammation plus a LABA to keep airways open — rather than a rescue inhaler alone. The starting strength follows how severe the asthma is and what therapy the patient was already on, and control is reassessed over the first weeks. It is taken every day, twice a day, whether or not symptoms are present; it does not replace a short-acting rescue inhaler for sudden attacks. Forms in the formulary data behind this page: the Dulera metered-dose inhaler in 50 mcg/5 mcg, 100 mcg/5 mcg, and 200 mcg/5 mcg strengths (mometasone per actuation / formoterol per actuation), 60- and 120-inhalation canisters.

How it works

Dulera combines two medicines with different jobs. Mometasone furoate is a corticosteroid that reduces airway inflammation. Formoterol fumarate is a selective long-acting beta2-adrenergic bronchodilator (a LABA): it relaxes the muscles around the airways so they stay open for many hours. Together they control both the inflammation and the tightening that drive asthma symptoms.

How it is taken

A pressurized metered-dose inhaler, for oral inhalation only, with a dose counter. For patients 12 and older: 2 inhalations twice daily of the 100 mcg/5 mcg or 200 mcg/5 mcg strength, with the starting strength based on disease severity. For children 5 to under 12: 2 inhalations twice daily of the 50 mcg/5 mcg strength. After each dose, patients rinse their mouth with water and spit it out (without swallowing) to reduce thrush risk. It is a daily controller — not a rescue inhaler.

Common side effects

The label extract's adverse-reactions section describes the reaction types of the two components rather than a percentage table: serious asthma-related events linked to LABA use (hospitalizations, intubations, and death — see the warnings), cardiovascular and central nervous system effects of the beta-agonist, and the local and systemic corticosteroid effects — Candida (thrush) infection of the mouth and throat, immune suppression, too much corticosteroid effect (hypercorticism) and adrenal suppression, growth effects in children, and glaucoma and cataracts.

Serious warnings

This label has no boxed warning, but LABA medicines carry a serious class warning stated in the label: LABA monotherapy increases the risk of serious asthma-related events, and LABA use may result in serious asthma-related hospitalizations, intubations, and death — Dulera must not be started in acutely worsening asthma and is not for relief of acute bronchospasm or status asthmaticus (a contraindication). Other warnings: Candida (thrush) infection of the mouth and throat can occur; the steroid can worsen existing tuberculosis, fungal, bacterial, viral, or parasitic infections, and chickenpox or measles can be more serious or fatal in susceptible patients; patients switched from oral steroids must taper slowly because of adrenal-function risk; high doses can cause hypercorticism and adrenal suppression; paradoxical bronchospasm (sudden worsening right after a dose) requires stopping Dulera and using alternative therapy; bone mineral density can decrease; and glaucoma and cataracts can occur.

Who should be careful

People with cardiovascular disorders (the beta-agonist stimulates the heart and circulation — use with caution); people with active infections, including tuberculosis or ocular herpes simplex; people with major risk factors for decreased bone mineral content (bone density monitoring); children (growth is monitored); people transferring from oral corticosteroids (slow taper, adrenal risk); people with liver impairment (monitor for signs of increased drug exposure); and anyone with hypersensitivity to any Dulera ingredient (contraindicated).

Major interactions

The label states no formal drug interaction studies have been performed with Dulera, and the combination's interactions are expected to reflect those of its components. Two cautions are named in the warnings and interactions material: strong cytochrome P450 3A4 inhibitors (for example ritonavir) can increase systemic corticosteroid effects, so caution is advised; and Dulera must not be used with an additional long-acting beta2-agonist because of the risk of overdose. Short-acting rescue inhalers and intranasal corticosteroids were used alongside it in trials without an increased frequency of adverse reactions.

Cost and saving notes

Dulera is a brand-only combination inhaler, and in the CMS data behind this page fewer than half of Part D plans list it, most often on a higher non-preferred tier (see the tier section) — many readers will find their plan prefers a different steroid/LABA combination instead. If Dulera is the prescribed product and cost is high, a tier exception request and Extra Help are the factual routes.

Why it is in its tier

Mometasone / formoterol inhaler (Dulera) sits on Tier 4 in 68.94% of the plans that list it (1680 of 2437 listing plans). Tier 4 is the non-preferred tier — higher copays or coinsurance. The data-visible drivers: It is a brand-only product with no generic version in the formulary data, and the CMS dashboard puts its average Part D spending at about $1,532 per beneficiary for 2024 — a mid-cost drug, which matches where plans place it. Only 44.35% of Part D plans list it at all, so many readers will find their plan does not list it and covers a similar drug instead. The tier shown is the most common one; individual plans vary.

Sources

• DULERA (MOMETASONE FUROATE AND FORMOTEROL FUMARATE DIHYDRATE) AEROSOL [ORGANON LLC] — DailyMed
• MedlinePlus — Mometasone Oral Inhalation (first ingredient of mometasone-formoterol)

What official patient guides say

This combination inhaler (Dulera) has no separate MedlinePlus page; the facts below come from the MedlinePlus Mometasone Oral Inhalation page, for its first-named ingredient, using only the aerosol inhaler facts — the same kind of inhaler as this package. The aerosol is usually inhaled twice a day, at around the same times every day. Use it exactly as directed — do not inhale more, less, or use it more often than prescribed. If you use the inhaler for the first time, or have not used it in more than 5 days, prime it with 4 test sprays into the air, away from your face, and shake it before each inhalation. The dose counter tells you how many doses are left. After inhaling, rinse your mouth with water and spit it out; do not swallow it. Clean the inhaler once a week with a clean, dry tissue or cloth — do not wash it or put any part in water. This inhaler helps prevent asthma attacks but will not stop one that has already started; your doctor will prescribe a short-acting inhaler for attacks. It controls asthma but does not cure it, and it may take 1 to 2 weeks or longer to feel the full benefit. Continue even if you feel well, and do not stop without talking to your doctor. If you miss a dose, skip it and go back to your regular schedule; do not inhale a double dose. Store it out of reach of children, at room temperature, away from extra heat and moisture, and not in the bathroom. Keep it away from heat and open flames, protect it from freezing and direct sunlight, and do not puncture the container or throw it into a fire.

Source: MedlinePlus — Mometasone Oral Inhalation (first ingredient of mometasone-formoterol)

Part D formulary coverage

Source: CMS Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files — Monthly file 2026-10-15 (plan year 2027), file 2027_20261008.zip (data.cms.gov dataset ed1496ea-23e7-41f1-9292-172fa842ccfb): basic drugs formulary file + plan information file, both dated 20261031 inside the zip; downloaded and aggregated 2026-10-30. Medication RxCUI sets resolved through the NLM RxNav (RxNorm) API.

What you pay

Without insurance, the cash benchmark is 25.18114 per unit (DULERA 100 MCG-5 MCG INHALER) — about nan for 30 units. NADAC benchmark — the average price pharmacies pay (CMS, as of 2026-11-04). Pharmacy shelf prices vary.

A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.

Sources: CMS Plan Benefit Package + formulary data; CMS NADAC · Checked 2026-11-07

Coverage by plan and tier

Of the 5,495 Medicare drug plans we track for 2027, 2,437 list Mometasone / formoterol inhaler (Dulera) — 44.4% of plans. Most of those plans put it on Tier 4: 1,680 plans, 68.9% of the plans that list it. Other plans place it on Tier 3 (689 plans) or Tier 1 (68 plans). For example: Aetna Medicare Dual Extra (HMO D-SNP) puts it on Tier 4; Aetna Medicare Dual Extra Care (PPO D-SNP) puts it on Tier 4; Aetna Medicare Value Plus (PPO) puts it on Tier 4. You can compare these plans side by side on our Medicare Advantage hub. A tier is not a price. What you pay also depends on whether you have met your plan';s deductible, whether the drug costs a flat copay or a share of the price, and whether you get Extra Help or Medicaid.

Read next

• Part D in 2027: The $700 Deductible, the $2,400 Cap, and the $35 Insulin Rule
• Extra Help in 2027: Lower Drug Copays and Who Qualifies
• Checking Medicare Savings Programs and Extra Help

Part D spending averages (2024)

Source: CMS Medicare Part D Spending by Drug (Drug Spending Dashboard), release RY26 P04 V10, data through 2024 (DSD_PTD_RY26_P04_V10_DY24_BGM.csv), downloaded 2026-10-30

Companies covering this drug

Part D and Medicare Advantage plan sponsors that list this drug on a formulary, 50 at a time.