BMA Concise Guide to Medicine & Drugs

Beclometasone

Brand names Asmabec, Beclazone, Becodisks, Beconase, Clenil Modulite, Clipper, Pulvinal, Qvar, and others

Used in the following combined preparation Fostair

QUICK REFERENCE

Drug group Corticosteroid and topical cortisosteroid

Overdose danger rating Low

Dependence rating Low

Prescription needed Yes (some preparations)

Available as generic Yes

GENERAL INFORMATION

Beclometasone is a corticosteroid drug prescribed to relieve the symptoms of allergic rhinitis (as a nasal spray) and to control asthma (as an inhalant). It controls nasal symptoms by reducing inflammation and mucus production in the nose. It also helps to reduce chest symptoms, such as wheezing and coughing. Asthma sufferers may take it regularly to reduce the severity and frequency of attacks. However, once an attack has started, the drug does not relieve symptoms.

Beclometasone is given primarily to people whose asthma has not responded to bronchodilators alone. Beclometasone is also used orally to help treat acute ulcerative colitis if there is an inadequate response to aminosalicylates such as mesalazine.

There are few serious adverse effects associated with beclometasone when it is given topically by nasal spray or inhaler. Fungal infections causing irritation of the mouth and throat are a possible side effect of inhaling beclometasone. These can be avoided to some degree by rinsing the mouth and gargling with water after each inhalation.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Inhaler, nasal spray, tablets.

Frequency and timing of doses 2–4 x daily.

Dosage range Adults 1–2 puffs 2–4 x daily according to preparation used (asthma); 1–2 sprays in each nostril 2–4 x daily (allergic rhinitis); 5mg daily orally for a maximum of 4 weeks. Children Reduced dose according to age and weight. Tablets not recommended.

Onset of effect Within 1 week (asthma); 1–3 days (allergic rhinitis). Full benefit may not be felt for up to 4 weeks (all conditions being treated).

Duration of action Several days after stopping the drug.

Diet advice None.

Storage Keep in original container at room temperature out of the reach of children. Protect from light.

Missed dose Take as soon as you remember. If your next dose is due within 2 hours, take a single dose now and skip the next.

Stopping the drug Do not stop the drug without consulting your doctor; symptoms may recur. Sometimes a gradual reduction in dosage is recommended.

Exceeding the dose An occasional unintentional extra dose is unlikely to cause problems. But if you notice any unusual symptoms, or if a large overdose has been taken, notify your doctor. Adverse effects may occur if the recommended dose is regularly exceeded over a prolonged period.

POSSIBLE ADVERSE EFFECTS

The occurrence and severity of side effects depend on the dose and duration of use. The main side effects are thrush of the throat and mouth with the inhaler, and irritation of the nose and throat with the nasal spray. Other possible adverse effects of the inhaler or spray include cough, hoarseness, and nosebleeds. Long-term use of oral beclometasone may produce more serious adverse effects (see Prolonged use).

INTERACTIONS

None.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have had tuberculosis or another nasal or respiratory infection.

· You have a skin infection (cream/ointment).

· You have had recent nasal ulcers or nasal surgery.

Pregnancy No evidence of risk.

Breast-feeding No evidence of risk.

Infants and children Reduced dose necessary.

Over 60 No known problems.

Driving and hazardous work No known problems.

Alcohol No known problems.

PROLONGED USE

Long-term use can lead to peptic ulcers, glaucoma, muscle weakness, osteoporosis, growth retardation in children, and, rarely, adrenal gland suppression. However, courses of oral beclometasone lasting more than 4 weeks are not generally recommended, which minimizes the risk of these side effects. Patients on long-term treatment should carry a steroid card or wear a MedicAlert bracelet.

Monitoring Periodic checks on adrenal gland function may be required if large doses are being taken. Children should have their height monitored.