Pharmacologic class: Corticosteroid
Therapeutic class: Anti-inflammatory agent
Pregnancy risk category C
Unclear. May decrease inflammation by stabilizing leukocytic lysosomal membrane, decreasing number and activity of inflammatory cells, inhibiting bronchoconstriction (leading to direct smooth muscle relaxation), and reducing airway hyperresponsiveness.
Inhalation aerosol: 40-mcg metered inhalation in 7.3-g canister; 80-mcg metered inhalation in 7.3-g canister
Inhalation capsules: 100 mcg, 200 mcg
Nasal spray: 0.042% (25-g bottle containing 180 metered inhalations)
Indications and dosages
➣ Maintenance treatment of asthma as prophylaxis; asthma patients who require systemic steroids for whom adding an inhaled steroid may reduce or eliminate the need for systemic steroids
Adults and children ages 12 and older: When previous therapy was bronchodilator alone, 40 to 80 mcg by oral inhalation (QVAR) b.i.d.; maximum of 320 mcg b.i.d. When previous therapy was inhaled steroid, 40 to 160 mcg by oral inhalation (QVAR) b.i.d.; maximum of 320 mcg b.i.d.
Children ages 5 to 11: When previous therapy was bronchodilator alone, 40 mcg by oral inhalation (QVAR) b.i.d.; maximum of 80 mcg b.i.d. When previous therapy was inhaled steroid, 40 mcg by oral inhalation (QVAR) b.i.d.; maximum of 80 mcg b.i.d.
➣ Seasonal or perennial rhinitis
Adults and children ages 12 and older: One or two inhalations (42 to 84 mcg Beconase AQ Nasal Spray) in each nostril b.i.d.
Children ages 6 to 12: One inhalation (42 mcg Beconase AQ Nasal Spray) in each nostril b.i.d.
• Hypersensitivity to drug
• Status asthmaticus
Use cautiously in:
• active untreated infections, diabetes mellitus, glaucoma, underlying immunosuppression
• patients receiving concurrent systemic corticosteroids
• pregnant or breastfeeding patients
• children younger than age 6.
• Use spacer device to ensure proper delivery of dose and to help prevent candidiasis and hoarseness.
• After inhalation, tell patient to hold his breath for a few seconds before exhaling.
• For greater efficacy, wait 1 minute between inhalations.
• If patient is also receiving a bronchodilator, administer it at least 15 minutes before beclomethasone.
• Discontinue drug after 3 weeks if symptoms don't improve markedly.
EENT: cataracts, nasal irritation or congestion, epistaxis, perforated nasal septum, nasopharyngeal or oropharyngeal fungal infections, hoarseness, throat irritation
GI: esophageal candidiasis
Metabolic: adrenal suppression Respiratory: cough, wheezing, bronchospasm
Skin: urticaria, angioedema
Other: anosmia, Churg-Strauss syndrome, hypersensitivity reactions
• Assess patient's mouth daily for signs of fungal infection.
• Observe patient for proper inhaler use.
• Instruct patient to hold inhaled drug in airway for several seconds before exhaling and to wait 1 minute between inhalations.
• Advise patient to rinse mouth after using inhaler and to wash and dry inhaler thoroughly to help prevent fungal infections and sore throat.
• Encourage patient to document use of drug and his response in a diary.
• If patient is also using a bronchodilator, teach him to use it at least 15 minutes before beclomethasone.
• As appropriate, review all other significant and life-threatening adverse reactions.