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beclomethasone dipropionate

AeroBec (UK), Apo-Beclomethasone (CA), Asmabec (UK), Beclodisk (CA) (UK), Becloforte (CA) (UK), Beconase AQ Nasal Spray, Filair (UK), Hayfever Relief (UK), Nasobec (UK), Pollenase Nasal (UK), QVAR, Rivanase (CA)

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.

Adverse reactions

CNS: headache

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


None significant

Patient monitoring

• Assess patient's mouth daily for signs of fungal infection.

• Observe patient for proper inhaler use.

Patient teaching

• 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.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved


(be-kloe-meth-a-sone) ,


(trade name)


Therapeutic: anti inflammatories steroidal
Pharmacologic: corticosteroids
Pregnancy Category: C


Maintenance treatment of asthma as prophylactic therapy. May decrease requirement for or eliminate use of systemic corticosteroids in patients with asthma.


Potent, locally acting anti-inflammatory and immune modifier.

Therapeutic effects

Decreases frequency and severity of asthma attacks.
Improves asthma symptoms.


Absorption: 20%. Action is primarily local following inhalation.
Distribution: Crosses the placenta and enters breast milk in small amounts.
Metabolism and Excretion: Following inhalation, beclomethasone dipropionate is primarily converted to beclomethasone 17–monopropionate (active metabolite); primarily excreted in feces (<10% excreted in urine).
Half-life: 2.8 hr.

Time/action profile (improvement in symptoms)

Inhalationwithin 24 hr1–4 wk*unknown
*Improvement in pulmonary function; decreased airway responsiveness may take longer


Contraindicated in: Hypersensitivity (product contains alcohol); Acute attack of asthma/status asthmaticus.
Use Cautiously in: Active untreated infections; Diabetes or glaucoma; Underlying immunosuppression (due to disease or concurrent therapy); Systemic corticosteroid therapy (should not be abruptly discontinued when inhalable therapy is started; additional corticosteroids needed in stress or trauma); Obstetric / Lactation: Safety not established; Pediatric: Safety not established in children <5 yr; prolonged or high-dose therapy may lead to complications.

Adverse Reactions/Side Effects

Central nervous system

  • headache (most frequent)

Ear, Eye, Nose, Throat

  • cataracts
  • dysphonia
  • oropharyngeal fungal infections
  • pharyngitis
  • rhinitis
  • sinusitis


  • bronchospasm
  • cough
  • wheezing


  • adrenal suppression (increased dose, long-term therapy only)
  • decreased growth (children)


  • back pain


Drug-Drug interaction

None known.


Inhalation (Adults and Children ≥12 yr) Previously on bronchodilators alone—40–80 mcg twice daily (not to exceed 320 mcg twice daily). Previously on inhaled corticosteroids—40–160 mcg twice daily (not to exceed 320 mcg twice daily).
Inhalation (Children 5–11 yr) Previously on bronchodilators alone—40 mcg twice daily (not to exceed 80 mcg twice daily).Previously on inhaled corticosteroids—40 mcg twice daily (not to exceed 80 mcg twice daily).


Inhalation aerosol: 40 mcg/metered inhalation in 7.3–g canister (delivers 100 metered inhlations), 80 mcg/metered inhlation in 7.3–g canister (delivers 100 metered inhalations)

Nursing implications

Nursing assessment

  • Monitor respiratory status and lung sounds. Pulmonary function tests may be assessed periodically during and for several months following a transfer from systemic to inhalation corticosteroids.
  • Assess patients changing from systemic corticosteroids to inhalation corticosteroids for signs of adrenal insufficiency (anorexia, nausea, weakness, fatigue, hypotension, hypoglycemia) during initial therapy and periods of stress. If these signs appear, notify physician or other health care professional immediately; condition may be life-threatening.
  • Monitor for withdrawal symptoms (joint or muscular pain, lassitude, depression) during withdrawal from oral corticosteroids.
  • Monitor growth rate in children receiving chronic therapy; use lowest possible dose.
  • Lab Test Considerations: Periodic adrenal function tests may be ordered to assess degree of hypothalamic-pituitary-adrenal (HPA) axis suppression in chronic therapy. Children and patients using higher than recommended doses are at greatest risk for HPA suppression.
    • May cause increased serum and urine glucose concentrations if significant absorption occurs.

Potential Nursing Diagnoses

Ineffective airway clearance (Indications)
Risk for infection (Side Effects)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)


  • After the desired clinical effect has been obtained, attempts should be made to decrease dose to lowest amount required to control symptoms. Gradually decrease dose every 2–4 wk as long as desired effect is maintained. If symptoms return, dose may briefly return to starting dose.
  • Inhalation: Allow at least 1 min between inhalations of aerosol medication.

Patient/Family Teaching

  • Advise patient to take medication exactly as directed. If a dose is missed, take as soon as remembered unless almost time for next dose. Advise patient not to discontinue medication without consulting health care professional; gradual decrease is required.
  • Advise patients using inhalation corticosteroids and bronchodilator to use bronchodilator first and to allow 5 min to elapse before administering the corticosteroid, unless otherwise directed by health care professional.
  • Advise patient that inhalation corticosteroids should not be used to treat an acute asthma attack but should be continued even if other inhalation agents are used.
  • Patients using inhalation corticosteroids to control asthma may require systemic corticosteroids for acute attacks. Advise patient to use regular peak flow monitoring to determine respiratory status.
  • Caution patient to avoid smoking, known allergens, and other respiratory irritants.
  • Advise patient to notify physician if sore throat or mouth occurs.
  • Instruct patient whose systemic corticosteroids have recently been reduced or withdrawn to carry a warning card indicating the need for supplemental systemic corticosteroids in the event of stress or severe asthma attack unresponsive to bronchodilators.
  • Metered-Dose Inhaler: Instruct patient in the proper use of the metered-dose inhaler. Canister must be primed prior to first use. Do this by releasing 2 actuations into air away from face. Canister will remain primed for 10 days. If not used for more than 10 days, reprime with 2 actuations. Shake inhaler well. Exhale completely and then close lips firmly around mouthpiece. While breathing in deeply and slowly, press down on canister. Hold breath for as long as possible to ensure deep instillation of medication. Remover inhaler from mouth and breathe out gently. Allow 1–2 min between inhalations. Rinse mouth with water or mouthwash after each use to minimize fungal infections, dry mouth, and hoarseness. Clean only the mouthpiece weekly with clean dry tissue or cloth. Do not place in water (see ).

Evaluation/Desired Outcomes

  • Management of the symptoms of chronic asthma.
  • Improvement in asthma symptoms.
Drug Guide, © 2015 Farlex and Partners


Pulmonology An inhaled corticosteroid–beclomethasone dipropionate–administered by a metered dose inhaler to control asthma. See Asthma.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.
References in periodicals archive ?
QVAR RediHaler is a breath-actuated aerosol inhaled corticosteroid for the maintenance treatment of asthma as a prophylactic therapy in patients four years of age and older.
Israel-based Teva Pharmaceutical Industries has introduced QVAR RediHaler (beclomethasone dipropionate HFA) Inhalation Aerosol in both 40mcg and 80mcg strengths in the United States, it was reported yesterday.
In addition to the simple Granger causality test, the quantile vector autoregressive model (QVAR) [25] can measure the causal relationships.
In addition to quality variability (Qvar), other explanatory variables that seem relevant include geography/costs of network deployment (UrbanR), demand intensity (UseR), regulatory and policy institutions (TGRI), and platform competition (non-DSL).
They were on one of three ICSs: large-particle fluticasone, large-particle beclomethasone with a now-banned chlorofluorocarbon propellant, or ultrafine-particle beclomethasone in a solution aerosol--that is, QVAR.
Only a few inhaled corticosteroid (ICS) products possess the requisite median particle diameter (less than 2 mcm) needed to reach alveolar tissue in the distal tracheobronchial tree, including beclomethasone dipropionate HFA (QVAR), flunisolide HFA (Aerospan), and ciclesonide (Sepracor).
The second investigation was undertaken with a formulation containing 8% ethanol that produces evaporating particles (Qvar; 100 [micro]g/actuation beclomethasone dipropionate [BDP]).
Beclomethasone dipropionate (QVAR) has been known by several names such as Vanceril and Beclovent; however, with the transition from chlorofluorocarbon (CFC)-propelled MDI formulations, beclomethasone dipropionate has been reformulated with an HFA propellant, in a 40-and 80-microgram MDI strength as QVAR.
A novel method for analyzing electromechanical properties (e.g., aerodynamic diameter, electrostatic charge, polarity) of asthma medicinal drug aerosols produced by four different commercially available pressurized metered dose inhalers (pMDIs), including Albuterol?, Atrovent?, Qvar?, and, Ventolin?
AeroBid Prescription (flunisolide), Azmacort (triamcinolone), Flovent (fluticasone propionate), Pulmicort Turbohaler or Respules, (budesonide), Qvar (beclomethasone) Vanceril, Vanceril DS (beclomethasone), Asthmanex (mometasone) Oral corticosteroids.
Currently in the United States, only Ventolin (albuterol sulfate), manufactured by GlaxoSmithKline, and QVAR (beclomethasone dipropionate), manufactured by IVAX Laboratories Inc., are available with HFA propellant.
Drug Dosage Cost/Day fluticasone 88-264 $1.64 (Flovent) [micro]/day (176 [micro]g/day) (*) beclomethasone up to 504 Beclovent: $1.84; (Beclovent, [micro]g/day Vanceril: $1.76 Vanceril) (336 [micro]g/day) (*) beclomethasone 80-160 $1.04 (Qvar) [micro]g/day (160 [micro]g) (*) budesonide 200-400 $1.24 (Pulmicort) [micro]g/day (400 [micro]g) (*) flunisolide 500-1,000 $2.68 (Aerobid) [micro]g/day (1 mg) (*) fluticasone and 100 pg $2.88 (**) salmeterol fluticasone (Advair) b.i.d., 50 [micro]g salmeterol b.i.d.