Beclometasone (inhaled)
For additional information see Corticosteroids (inhaled)
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Also known as beclomethasone.
Mode of action
Mode of action from Corticosteroids
Reduce airway inflammation and bronchial hyper-reactivity.
Indications
Maintenance treatment of asthma
Accepted
Adjunct in maintenance treatment of COPD
Indications from Corticosteroids
Maintenance treatment of asthma and COPD
Precautions
Pregnancy
Safe to use.
Breastfeeding
Safe to use.
Precautions from Corticosteroids
COPD—inhaled corticosteroids may increase the risk of pneumonia.
Smoking—asthma patients who smoke may respond less well to inhaled corticosteroids than non-smokers and may require higher doses.
Pregnancy
Encourage pregnant women to continue using inhaled corticosteroids; beclometasone, budesonide or fluticasone propionate is preferred due to greater experience.
Adverse effects
Adverse effects from Corticosteroids
Common (>1%)
dysphonia, oropharyngeal candidiasis, bruising, facial skin irritation following nebulisation
Rare (<>
allergic reactions, including bronchospasm, rash, urticaria and angioedema
Systemic adverse effects
Occurrence depends on systemic absorption, which is influenced by dosage, duration of treatment and the delivery system. Reduce systemic absorption by:
using a spacer with a pMDI
rinsing mouth with water, gargling and spitting out after each dose.
Adrenal suppression can occur with high doses; when using high doses do not stop treatment suddenly and consider need for additional corticosteroids during periods of stress.
Bone density loss: clinical implications concerning risk of osteoporosis and fracture are still unknown. Consider screening adults on long-term high-dose inhaled corticosteroids for osteoporosis.
Glaucoma, cataract: risk may be increased.
Pneumonia: risk may be increased in COPD patients.
Skin thinning and bruising: increased risk with higher doses particularly in older patients.
Impaired growth: although inhaled corticosteroids may reduce growth initially, they appear to have only a small impact on final □□ height; poorly controlled asthma may also reduce growth. Effect on growth of other organs (eg brain and lung) is not well defined.
Dosage – Beclometasone
Asthma
See also Dosage in Corticosteroids
□□
pMDI, 50–200 micrograms twice daily; maximum 800 micrograms daily. Consider specialist referral for patients who require >400 micrograms daily.
Child
pMDI, 50–100 micrograms twice daily, up to 400 micrograms daily in severe persistent asthma. Consider specialist referral for children who require >400 micrograms daily (>200 micrograms daily if child <5>
COPD
□□, pMDI 200 micrograms twice daily.
Counselling
Use a spacer with Qvar?? (but not with Qvar Autohaler??).
Regularly clean the mouthpiece of your inhaler to prevent the nozzle blocking.
Counselling from Corticosteroids
Use a spacer with the metered dose inhaler.
Make sure that your doctor has given you an asthma action plan, and that you know what to do if you have acute symptoms or in an emergency (see www.nationalasthma.org.au/ asthma-first-aid).
Maintenance treatment: use this medicine every day even if you are feeling better; do not reduce dosage or stop this medicine unless your doctor tells you to. Rinse your mouth with water, gargle and spit out after use.
Practice points
in asthma, most of the therapeutic benefit occurs with a total daily dose of 200 micrograms
Practice points from Corticosteroids
check inhaler technique and compliance regularly
inhaled corticosteroids may be a useful add-on treatment for COPD inadequately controlled with long-acting beta2 agonists
Products
Search for Beclometasone on the PBS
pMDI, 50 mcg/dose, 200 doses, Qvar, PBS
pMDI, 50 mcg/dose (breath-activated), 200 doses, Qvar Autohaler, PBS??R1
pMDI, 100 mcg/dose, 200 doses, Qvar, PBS
pMDI, 100 mcg/dose (breath-activated), 200 doses, Qvar Autohaler, PBS??R1
1 patients unable to use Qvar??
Beclometasone combinations
Beclometasone with formoterol
Beclometasone with formoterol and glycopyrronium
Beclometasone with formoterol
Go to Beclometasone (inhaled) and Formoterol for information on individual components; limited detail below.
Indications
Maintenance treatment of asthma (including additional symptom relief)
Maintenance treatment of COPD
Dosage – Beclometasone with formoterol
For asthma, see also Dosage in Corticosteroids
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