What are the common side effects of beclomethasone inhalers. How can you manage oral thrush caused by beclomethasone. What serious side effects should you watch out for when using beclomethasone inhalers. How do beclomethasone inhalers affect children and teenagers. When should you seek immediate medical attention while using beclomethasone inhalers.

Understanding Beclomethasone Inhalers: Benefits and Potential Side Effects

Beclomethasone inhalers are widely prescribed for managing asthma and chronic obstructive pulmonary disease (COPD). These inhalers contain a corticosteroid medication that helps reduce inflammation in the airways, making breathing easier for patients. While beclomethasone is generally considered safe and effective, it’s essential to be aware of potential side effects.

Are beclomethasone inhalers likely to cause systemic side effects? The good news is that when you use a beclomethasone inhaler, very little of the medication enters your bloodstream. This localized delivery method significantly reduces the risk of systemic side effects compared to oral or injectable corticosteroids.

The Importance of Proper Inhaler Technique

To maximize the benefits of beclomethasone inhalers while minimizing side effects, proper inhaler technique is crucial. Healthcare providers should demonstrate the correct usage and regularly assess patients’ technique. Using a spacer device can also help improve medication delivery and reduce the risk of side effects in the mouth and throat.

Common Side Effects of Beclomethasone Inhalers

While beclomethasone inhalers are generally well-tolerated, some users may experience common side effects. These side effects occur in more than 1 in 100 people and are usually mild to moderate in severity. Understanding these potential issues can help users manage them effectively.

Oral Thrush: A Common Concern

Oral thrush is one of the most frequently reported side effects of beclomethasone inhalers. This fungal infection can cause white patches, redness, and soreness in the mouth. How can you prevent or manage oral thrush while using a beclomethasone inhaler?

• Rinse your mouth with water after each use of the inhaler
• Brush your teeth immediately after using the inhaler
• Use a spacer device to reduce medication deposition in the mouth
• If thrush develops, consult a pharmacist for antifungal treatments

Can you continue using your beclomethasone inhaler if you develop oral thrush? Yes, it’s important to keep using your inhaler as prescribed while treating the thrush. Your healthcare provider may recommend temporarily adjusting your inhaler technique or prescribe an antifungal medication to address the issue.

Throat Irritation and Voice Changes

Some users of beclomethasone inhalers may experience a dry or sore throat, or notice changes in their voice, such as hoarseness. These side effects are usually temporary and can be managed with simple measures. How can you alleviate throat irritation caused by beclomethasone inhalers?

1. Drink water before and after using your inhaler
2. Use a spacer device to reduce medication impact on the throat
3. Practice good inhaler technique to minimize throat exposure
4. Suck on throat lozenges or hard candies to soothe irritation

If throat irritation or voice changes persist despite these measures, consult your healthcare provider for further guidance.

Serious Side Effects: When to Seek Medical Attention

While serious side effects from beclomethasone inhalers are rare, it’s crucial to be aware of potential warning signs. Prolonged use of high doses of beclomethasone may increase the risk of more severe side effects. What serious side effects should users watch out for?

• Signs of adrenal insufficiency (e.g., severe fatigue, dizziness, nausea)
• Symptoms of Cushing’s syndrome (e.g., “moon face,” weight gain in upper back or abdomen)
• Changes in vision (potential signs of glaucoma or cataracts)
• Indicators of severe infection (e.g., high fever, persistent cough with colored mucus)

If you experience any of these symptoms, contact your healthcare provider promptly for evaluation and guidance.

Beclomethasone and Adrenal Insufficiency: Understanding the Risk

Adrenal insufficiency is a potential concern for individuals using high doses of beclomethasone or those taking multiple steroid medications. This condition occurs when the adrenal glands don’t produce enough cortisol, a crucial hormone for various bodily functions.

How can you recognize the signs of adrenal insufficiency? Watch for symptoms such as:

• Extreme fatigue and weakness
• Dizziness or fainting
• Nausea and vomiting
• Loss of appetite and weight loss
• Mood changes or depression

If you’re on high doses of beclomethasone or using multiple steroid medications, your doctor may recommend carrying a steroid emergency card. This card provides crucial information to healthcare providers in case of an emergency.

Allergic Reactions to Beclomethasone Inhalers: Recognizing Anaphylaxis

Although rare, severe allergic reactions (anaphylaxis) can occur with beclomethasone inhalers. It’s vital to distinguish between an asthma attack and an allergic reaction, as the symptoms can be similar. What are the signs of a severe allergic reaction to beclomethasone?

• Sudden swelling of the lips, mouth, throat, or tongue
• Rapid breathing difficulties or wheezing
• Tightness in the throat or difficulty swallowing
• Skin color changes (pale, blue, or grey tint)
• Sudden confusion, drowsiness, or dizziness
• Loss of consciousness
• In children: limpness, unresponsiveness, or difficulty focusing

If you suspect a severe allergic reaction, seek immediate medical attention by calling emergency services or visiting the nearest emergency department.

Beclomethasone and Children: Growth Considerations

Parents and healthcare providers may have concerns about the potential impact of long-term beclomethasone use on children’s growth. While this is a valid consideration, it’s important to put the risk in perspective. How likely is it for beclomethasone to affect a child’s growth?

The risk of growth suppression in children using beclomethasone inhalers is very low, estimated at less than 1 in 10,000 cases. However, healthcare providers typically aim to prescribe the lowest effective dose to manage symptoms while minimizing potential side effects.

Monitoring Growth in Children Using Beclomethasone

To ensure optimal growth and development in children using beclomethasone inhalers, healthcare providers may implement the following strategies:

• Regular height and weight measurements
• Periodic assessment of bone density
• Adjustment of medication doses as needed
• Consideration of alternative treatments if growth concerns arise

Parents should discuss any growth-related concerns with their child’s healthcare provider to ensure the best possible management of asthma or COPD while supporting healthy development.

Balancing Benefits and Risks: The Importance of Beclomethasone in Asthma and COPD Management

While it’s crucial to be aware of potential side effects, it’s equally important to recognize the significant benefits of beclomethasone inhalers in managing asthma and COPD. How do the benefits of beclomethasone compare to the potential risks?

Beclomethasone inhalers are one of the most effective tools for controlling airway inflammation, reducing symptoms, and preventing exacerbations in asthma and COPD patients. The localized delivery of medication minimizes systemic exposure, making it a safer option compared to oral corticosteroids for long-term management.

Optimizing Beclomethasone Therapy

To maximize the benefits of beclomethasone while minimizing risks, consider the following strategies:

• Use the lowest effective dose to control symptoms
• Practice proper inhaler technique and use a spacer when recommended
• Attend regular follow-up appointments with your healthcare provider
• Report any concerning symptoms or side effects promptly
• Discuss alternative treatment options if side effects become problematic

By working closely with your healthcare provider and staying informed about potential side effects, you can ensure that beclomethasone therapy provides optimal benefits for managing your respiratory condition.

Conclusion: Empowering Patients Through Education

Understanding the potential side effects of beclomethasone inhalers empowers patients to make informed decisions about their respiratory health management. While side effects can occur, the benefits of beclomethasone in controlling asthma and COPD symptoms often outweigh the risks for most patients.

By staying vigilant for potential side effects, practicing proper inhaler technique, and maintaining open communication with healthcare providers, patients can optimize their treatment outcomes and quality of life. Remember that each individual’s response to medication can vary, so personalized management strategies are key to successful long-term respiratory health.

Side effects of beclometasone inhalers

Like all medicines, beclometasone can cause side effects, although not everyone gets them.

When you take beclometasone through an inhaler, very little medicine gets into the rest of your body, so it’s unlikely to give you side effects.

If you’re on high doses of beclometasone, or you’re also taking other steroid medicines or tablets for fungal infections or HIV, you may get underactive adrenal glands (adrenal insufficiency) as a side effect. Ask your doctor if you need to carry a steroid emergency card.

Your doctor or nurse will always aim to give you the lowest dose of steroid medicine to keep your symptoms controlled. You’ll only be given higher doses if you need extra help to deal with your symptoms.

It’s important to remember that inhaled steroid medicines are one of the best ways to treat asthma and COPD and reduce your risk of symptoms and asthma attacks.

Common side effects

These common side effects of beclometasone inhalers may happen in more than 1 in 100 people. There are things you can do to help cope with them:

Oral thrush

If you get oral thrush, a fungal infection that causes white patches, redness and soreness in your mouth, try rinsing your mouth with water or brushing your teeth after using your inhaler to stop this happening.

You can also ask a pharmacist to recommend a suitable treatment such as an antifungal mouth gel. They may suggest that you see your doctor to discuss the best treatment.

Keep using your beclomethasone inhaler while using any antifungal treatment.

Dry or sore throat, or hoarse voice

Try rinsing your mouth with water or brushing your teeth after using your inhaler to stop this happening.

Keep taking the medicine but talk to your doctor, nurse or a pharmacist if the advice on how to cope does not help and these side effects bother you or do not go away. They can check that you’re using your inhaler correctly.

Using a spacer with your beclometasone inhaler can also help to prevent side effects in your mouth.

Serious side effects

It’s unusual to have any serious side effects when using a beclometasone inhaler.

Side effects are more likely if you’re on a higher dose of beclometasone for a long time (more than a few months).

Speak to your GP if you get “moon face” (a puffy, rounded face), weight gain in the upper back or belly. This happens gradually and can be a sign of Cushing’s syndrome.

Call your doctor or call 111 now if you get:

• high temperature, chills, a very sore throat, ear or sinus pain, a cough, coughing up more mucus (phlegm), a change in colour of your mucus, pain when you pee, mouth sores or a wound that will not heal – these can be signs of an infection
• a very upset stomach or you’re being sick (vomiting), feeling very dizzy or passing out, muscle weakness, feeling very tired, mood changes, loss of appetite and weight loss – these can be signs of adrenal insufficiency
• changes in your eyesight, such as blurred vision or a cloudy lens in the eye – these can be signs of increased pressure in your eyes (glaucoma) or a cataract

Serious allergic reaction

In rare cases, beclometasone inhalers may cause a serious allergic reaction (anaphylaxis).

This is different to an asthma attack. If you or your child have asthma symptoms, such as wheezing or tightness in the chest or throat, use a reliever inhaler. If the symptoms do not improve or get worse, call 999 or go to A&E.

Immediate action required: Call 999 now if:

• your lips, mouth, throat or tongue suddenly become swollen
• you’re breathing very fast or struggling to breathe (you may become very wheezy or feel like you’re choking or gasping for air)
• your throat feels tight or you’re struggling to swallow
• your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• you suddenly become very confused, drowsy or dizzy
• someone faints and cannot be woken up
• a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

You or the person who’s unwell may also have a rash that’s swollen, raised, itchy, blistered or peeling.

These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

Children and teenagers

Using beclometasone inhalers at higher doses for a long time could possibly slow down the normal growth of children and teenagers. But the risk of this happening is very low, less than 1 in 10,000 people.

Talk to your doctor or asthma nurse if you’re worried. They’ll be able to explain the benefits and risks of giving your child beclometasone inhalers.

Your child’s doctor or asthma nurse will monitor their height and weight on an annual basis for as long as they’re taking this medicine. This will help them spot any slowing down of your child’s growth and change their treatment if needed.

Even if your child’s growth slows down, it does not seem to have much effect on their overall adult height.

Other side effects

These are not all the side effects of beclometasone inhalers. For a full list see the leaflet inside your medicines packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

Page last reviewed: 22 March 2023

Next review due: 22 March 2026

Beclomethasone Dipropionate Inhalation: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Read the Patient Information Leaflet and Instructions for Use provided by your pharmacist before you start using this medication and each time you get a refill. If you have any questions, ask your doctor, pharmacist, or respiratory therapist.

Inhale this medication by mouth as directed by your doctor, usually 2 times a day. The dosage is based on your medical condition and response to treatment.

Do not use a spacer device with this medication. You do not need to prime or shake this inhaler before use. If your prescribed dose is 2 puffs, wait at least one minute between them. If you are using other inhalers at the same time, wait at least 1 minute between the use of each medication, and use this drug (the corticosteroid) last.

To prevent dry mouth, hoarseness, and oral yeast infections from developing, gargle, rinse your mouth with water and spit out after each use. Do not swallow the rinse water.

Keep track of the number of inhalations used. Discard the canister after using the labeled number of inhalations on the package, even if it feels as though there is medication left in the canister. Follow the instructions for cleaning the inhaler. Do not wash the inhaler or put any part of it in water.

Use this medication regularly to get the most benefit from it. To help you remember, use it at the same times each day. This medication works best if used at evenly spaced times. Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.

Do not stop using this medication without consulting your doctor. Some conditions may become worse when the drug is suddenly stopped. Your dose may need to be gradually decreased.

Learn which of your inhalers you should use every day (controller drugs) and which you should use if your breathing suddenly worsens (quick-relief drugs). Ask your doctor ahead of time what you should do if you have new or worsening cough or shortness of breath, wheezing, increased sputum, worsening peak flow meter readings, waking up at night with trouble breathing, if you use your quick-relief inhaler more often (more than 2 days a week), or if your quick-relief inhaler does not seem to be working well. Learn when you can treat sudden breathing problems by yourself and when you must get medical help right away.

If you are regularly taking a different corticosteroid by mouth (such as prednisone), you should not stop taking it unless directed by your doctor. Some conditions (such as asthma, allergies) may become worse when the drug is suddenly stopped. If you suddenly stop taking the drug, you may also have withdrawal symptoms (such as weakness, weight loss, nausea, muscle pain, headache, tiredness, dizziness). To help prevent withdrawal, your doctor may slowly lower the dose of your old medication after you begin using beclomethasone. Tell your doctor or pharmacist right away if you have withdrawal. See also Precautions section.

You may start to feel this medication working within 24 hours, but it may take several weeks or longer to get the full benefit. Tell your doctor if you do not get better or if you get worse.

Active substance BECLOMETASONE (BECLOMETASONUM) | Compendium

Manufacturer:

CAS No: 4419-39-0 C ₂₂ H ₂₉ CIO ₅

MESH: pregna-1,4-diene-3,20-dione, 9-chloro-11,17,21-trihydroxy-16-methyl-, (11 β ,16 β )-.

M _m = 408. 93 Da. log P (octanol-water) = 2.03. Beclomethasone (in the form of dipropionate) is an odorless white or creamy white powder, very slightly soluble in water, well soluble in chloroform, acetone and alcohol.

Presentation: inhalation aerosol, metered dose inhalation aerosol, nasal spray, suspension.

• Pharmacological properties
• Indications BECLOMETASONE
• Application of BECLOMETASONE
• Contraindications
• Side effects
• Special instructions
• Interactions
• Diagnosis
• Recommended alternatives
• Trade names

Medicinal preparations containing the active substance BECLOMETASONE

Beclazon-Eco

inhalation aerosol 100 mcg/dose canister 200 doses with inhalation device, No. 1

Teva Ukraine

Pharmacy prices

Beclazon-Eco

9 0002 inhalation aerosol 250 mcg/dose can 200 doses with inhalation device, No. 1

Teva Ukraine

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Beclomethasone-Zdorovye

metered nasal spray, suspension 50 mcg/dose vial 180 doses, No. 1

Zdorovye

Pharmacy prices

Beclofort™ Evohaler™

inhalation aerosol metered dose 250 mcg/dose bottle 200 doses, No. 1

GlaxoSmithKline Export

Pharmacy prices 900 03

Baconase

nasal spray, suspension 50 mcg/dose vial 180 doses, № 1

Glaxo Wellcome

Prices in pharmacies

Local glucocorticosteroids are used as basic therapy for BA, have anti-inflammatory and anti-allergic effects. It inhibits the release of inflammatory mediators, increases the production of lipomodulin – an inhibitor of phospholipase A, reduces the formation of arachidonic acid and its metabolic products – cyclic endoperoxides, prostaglandins. Under the action of beclomethasone, the number of mast cells in the bronchial mucosa decreases, epithelial edema decreases, mucus secretion by bronchial glands, bronchial hyperreactivity, marginal accumulation of neutrophils, inflammatory exudate and production of lymphokines, macrophage migration is inhibited, the intensity of infiltration and granulation processes decreases, which ultimately improves indicators of the function of external respiration. Increases the number of active β-adrenergic receptors, restores the patient’s response to bronchodilators, and reduces the frequency of their use. Virtually no mineralocorticosteroid activity and resorptive action after inhalation. In therapeutic doses, it has an active local effect without the development of side effects characteristic of systemic corticosteroids. Does not stop bronchospasm, the therapeutic effect develops gradually, usually after 5-7 days of course use of beclomethasone dipropionate.

Absorption is low, with the inhalation route of administration at recommended doses, it does not have significant systemic activity. 10-20% of the dose enters the lungs, where beclomethasone dipropionate is hydrolyzed into its active metabolite, beclomethasone monopropionate. Most of the beclomethasone that enters the digestive tract is inactivated during the first passage through the liver. Communication with blood plasma proteins – 87%. The main part (35-76%) is excreted within 96 hours with feces, mainly in the form of polar metabolites, 10-15% – with urine.

as basic therapy for BA; seasonal and year-round allergic rhinitis, recurrent nasal polyposis, non-infectious inflammatory processes in the nasal cavity.

inhalation use. Adults (including elderly patients) and children over 12 years of age with mild BA (forced expiratory volume (FEV) or peak expiratory flow (PEF) – more than 80%, daily variation in PSV values ​​- less than 20%) – according to 200–600 mcg/day for 2 inhalations; with moderately severe BA (FEV or PSV – 60-80%, daily variation in PSV values ​​- 20-30%) – 600-1000 mcg / day for 2-4 inhalations; Severe BA (FEV or PSV – 60%, daily variation in PSV values ​​- 30%) – 1000-2000 mcg / day for 2-4 inhalations. The maximum daily dose of the drug in adults should not exceed 1 mg, in very severe cases – 1.5-2 mg / day for 3-4 doses. Children aged 6 to 12 years are prescribed at an initial dose of 50-100 mcg 2 times a day. If necessary, the dose can be increased to 400 mcg. The daily dose is divided into 2-4 doses. The maximum daily dose of the drug in children should not exceed 500 mcg. After each inhalation, it is recommended to rinse the mouth with water. Beclomethasone dipropionate containing 250 mcg per dose is not intended for pediatric use.

Intranasal application . The recommended dose for adults and children over the age of 12 is 200 micrograms (2 inhalations, with the first inhalation directed to the upper and the second to the lower part of the nasal passage) 2 times a day in each nasal passage or 100 micrograms in each nasal move 3-4 times a day; the maximum daily dose is 1000 mcg. Children aged 6-12 years – 42-50 mcg in each nasal passage 3-4 times a day. The total daily dose is 252–400 mcg, the maximum is 500 mcg.

hypersensitivity to beclomethasone.

dysphonia, throat irritation, cough, sneezing, paradoxical bronchospasm, eosinophilic pneumonia, allergic reactions, oral and upper respiratory tract candidiasis (with prolonged use and / or when used in high doses). With prolonged use in doses of more than 1.5 mg / day, systemic side effects of corticosteroids, headache, dizziness, cataracts, increased intraocular pressure, leukocytosis, lymphopenia, eosinopenia are possible. With a single inhalation of beclomethasone dipropionate in high doses (more than 1 mg), some decrease in the function of the hypothalamic-pituitary-adrenal system is possible, which does not require any emergency measures, and treatment should be continued. The function of the hypothalamic-pituitary-adrenal system is restored after 1-2 days.

is used with caution in liver cirrhosis, glaucoma, hypothyroidism, systemic infections, osteoporosis, during pregnancy and lactation.

methandrostenolone, estrogens, β ₂ -adrenergic agonists, theophylline and orally administered corticosteroids increase the effect of beclomethasone.

Beclospir

BEKLOSPIR®

Registration number: LSR-000189/09 dated 16.01.2009

Trade name of the drug: Beclospir®

International nonproprietary name: Beclomethasone

Dosage form: dosed inhalation aerosol

Composition per bottle: 200 doses

Active substance: Beclomethasone dipropionate 0. 012g, 0.024g and 0.060g

Excipients: ethanol (absoluted ethyl alcohol), hydrofluoroalkane (HFA134a) up to 14.02

Description

The contents of the aluminum aerosol can with metering valve is a pressurized suspension that forms a white spot when sprayed onto a glass slide.

ATC code: [R03BA01]

Pharmacotherapeutic group

Glucocorticosteroid for local use.

Pharmacodynamics

Beclomethasone dipropionate is a prodrug and has a weak affinity for glucocorticosteroid (GCS) receptors. Under the action of esterases, it turns into an active metabolite – beclomethasone-17-monopropionate, which has a pronounced local anti-inflammatory effect by reducing the formation of chemotaxis substance (influence on delayed-type allergic reactions). By suppressing the production of arachidonic acid metabolites and reducing the release of inflammatory mediators from mast cells, it inhibits the development of an immediate type of allergic reaction. Improves mucociliary transport, reduces the number of mast cells in the bronchial mucosa, reduces epithelial edema, mucus secretion by bronchial glands, bronchial hyperreactivity, marginal accumulation of neutrophils, inflammatory exudate and production of lymphokines, inhibits the migration of macrophages, reduces the intensity of infiltration processes and granulation. After inhalation, it practically does not have a resorptive effect. Does not stop bronchospasm. The therapeutic effect develops gradually, usually after 5-7 days of course use. By increasing active beta-adrenergic receptors, it restores the patient’s response to bronchodilators, making it possible to reduce the frequency of their use.

Pharmacokinetics

More than 25% of the inhaled dose is deposited in the respiratory tract, the remaining amount is in the mouth, pharynx and is swallowed. In the lungs, before absorption of beclomethasone, dipropionate is extensively metabolized to the active metabolite beclomethasone-17-monopropionate. Its systemic absorption occurs in the lungs (36% lung fraction), in the gastrointestinal tract (26% of the swallowed dose). The absolute bioavailability of unchanged beclomethasone dipropionate and beclomethasone-17-monopropionate is, respectively, about 2 and 62% of the inhaled dose. Beclomethasone dipropionate is absorbed rapidly (Tmax – 0. 3 h), beclomethasone-17-monopropionate is absorbed more slowly (Tmax – 1 h). Distribution in tissues for beclomethasone dipropionate is 20 liters and for beclomethasone-17-monopropionate – 424 liters. Communication with blood plasma proteins is relatively high – 87%. Beclomethasone dipropionate and beclomethasone-17-monopropionate have high plasma clearance (150 and 120 l/h, respectively). T1 / 2 is 0.5 and 2.7 hours, respectively.

Indications for use

Bronchial asthma of various forms in adults and children over 4 years of age (basic therapy).

Contraindications

Hypersensitivity to any component of the preparation.

Use with caution in glaucoma, systemic infections (bacterial, including pulmonary tuberculosis, viral, fungal, parasitic), osteoporosis, liver cirrhosis, hypothyroidism. Pregnancy and lactation

With extreme caution only if the potential benefit to the mother outweighs the possible risk to the fetus and child.

Dosage and administration

Inhalation.

The dose is selected individually (it can be increased until a clinical effect appears or reduced to the minimum effective dose). The initial dose is determined by the severity of bronchial asthma. The daily dose is divided into several doses.

Adults and children aged 12 and over.

Recommended initial doses of the drug: – mild bronchial asthma (forced expiratory volume (FEV) or peak expiratory flow rate (PSV) – more than 80%, daily variation in PSV values ​​- less than 20%) – 200-600 mcg / day;

– moderate bronchial asthma (FEV or PSV – 60-80%, daily variation in PSV – 20-30%) – 600-1000 mcg / day;

– severe bronchial asthma (FEV or PSV – 60%, daily variation of indicators – more than 30%) – 1000-1200 mcg / day.

The treatment of bronchial asthma is based on a stepwise approach – therapy is started according to the step corresponding to the severity of the disease. GCS inhalation is prescribed at the second stage of therapy.

Stage 2. Basic therapy: beclomethasone dipropionate – 100–400 mcg 2 times a day. Stage 3. Basic therapy: inhaled corticosteroids in a high or standard dose, but in combination with inhaled administration of long-acting beta2-adrenergic agonists. Beclomethasone dipropionate – in a high dose (800-1600, in some cases up to 2000 mcg / day).

Stage 4 (severe asthma). Beclomethasone dipropionate – 800–1600 mcg / day, in some cases – megadoses up to 2000 mcg / day.

Stage 5 (severe asthma). Beclomethasone dipropionate – in a high dose (see step 3.4).

Children 4 to 12 years of age: up to 400 micrograms daily in divided doses.

Special groups of patients: there is no need to adjust the dose in the elderly, in patients with renal and hepatic insufficiency. Skipping a single dose of the drug: in case of accidental skipping of inhalation, the next dose must be taken at the scheduled time in accordance with the treatment regimen.

Side effects

From the respiratory system: upper respiratory tract candidiasis (the likelihood of development increases at doses of more than 400 mcg / day), dysphonia (hoarseness), irritation of the pharyngeal mucosa (the use of a spacer reduces the likelihood of their development), paradoxical bronchospasm (immediately stop with a short-acting inhaled beta2-adrenergic agonist).

From the digestive tract: oral candidiasis (the likelihood of development increases with doses of more than 400 mcg / day), nausea, unpleasant taste sensations.

Allergic reactions: hypersensitivity reactions including rash, urticaria, itching, redness and swelling of the eyes, face, lips and mucous membranes of the mouth and throat.

Other: possible systemic effects, incl. headache, bruising or thinning of the skin, decreased function of the adrenal cortex, osteoporosis, growth retardation in children and adolescents, cataracts, glaucoma.

Interaction with other drugs

There are no confirmed data on the interaction of beclomethasone dipropionate with other drugs.

Overdose

Acute overdose may lead to a temporary decrease in the function of the adrenal cortex, which does not require emergency treatment, because. it recovers within a few days, as evidenced by plasma cortisol levels. In chronic overdose, there may be a persistent suppression of the function of the adrenal cortex. In this case, it is necessary to monitor the reserve function of the adrenal cortex. Treatment with the drug can be continued in doses sufficient to maintain the therapeutic effect.

Precautions

If the drug is prescribed against the background of oral corticosteroids, the dose of the latter remains the same. In this case, the patient must be in a relatively stable condition. After about 1-2 weeks, the daily dose of oral corticosteroids begins to be gradually reduced according to the scheme, depending on the duration of the previous therapy and on the initial dose of corticosteroids. Regular use of inhaled corticosteroids allows, in most cases, to cancel oral corticosteroids (patients who need to take no more than 15 mg of prednisolone can be completely transferred to inhaled therapy), while in the first months after the transition, the patient’s condition should be carefully monitored until his pituitary-adrenal the system will not recover sufficiently to provide an adequate response to stressful situations (for example: trauma, surgery or infection). When transferring patients from systemic corticosteroids to inhaled, allergic reactions are possible (for example: allergic rhinitis, eczema), which were previously suppressed by systemic drugs. Patients with reduced function of the adrenal cortex, transferred to inhalation therapy, should have a supply of corticosteroids and always carry a warning card with them indicating that in stressful situations they need additional systemic administration of corticosteroids (after eliminating the stressful situation, the dose of corticosteroids can again be reduced). A sudden and progressive worsening of asthma symptoms is a potentially dangerous condition, often life-threatening for the patient, and requires an increase in the dose of corticosteroids. An indirect indicator of therapy failure is the more frequent use of short-acting beta2-agonists than before. With the development of paradoxical bronchospasm, it is necessary to immediately stop using the drug, assess the patient’s condition, conduct an examination and prescribe therapy with other drugs. With prolonged use of any inhaled corticosteroids, especially at high doses, systemic effects may occur (see “Side Effects”), but the likelihood of their development is much lower than with the appointment of corticosteroids inside. Therefore, it is especially important that when a therapeutic effect is achieved, the dose of inhaled corticosteroids should be reduced to the minimum effective dose that controls the course of the disease. The drug at a dose of 1500 mcg / day does not cause significant suppression of adrenal function in most patients. In connection with the possible adrenal insufficiency, when transferring a patient taking GCS orally to inhalation therapy, special care must be taken and the indicators of the function of the adrenal cortex should be regularly monitored. Special care should be taken when treating patients with tuberculosis, both active and inactive, with inhaled corticosteroids. There are no data on the effect of the drug on the ability to drive a car / mechanisms.

Special instructions

Before prescribing inhalation drugs, it is necessary to instruct the patient about the rules for their use, ensuring the most complete entry of drugs into the lungs. The development of oral candidiasis is most likely in patients with a high level of precipitating anti-candidiasis antibodies (indicative of previous candidiasis). After inhalation, the mouth and throat should be rinsed with water. For the treatment of candidiasis while continuing therapy with the drug, topical antifungal agents can be used. The drug is not intended for stopping seizures, but for regular daily use. Short-acting beta2-adrenergic agonists (for example, salbutamol) are used to stop seizures. In case of severe exacerbation of bronchial asthma or insufficient effectiveness of the therapy, the dose of inhaled beclomethasone dipropionate should be increased and, if necessary, systemic corticosteroids and / or an antibiotic should be prescribed if an infection develops. It is recommended to regularly monitor the growth dynamics of children receiving inhaled corticosteroids for a long time. Abrupt discontinuation of the drug is not recommended. It is necessary to protect the eyes from getting the drug; for the prevention of damage to the skin of the eyelids, nose, washing after inhalation is recommended. The medicine can must not be pierced, disassembled or thrown into fire, even if it is empty. When cooling the can, it is recommended to remove it from the plastic case and warm it with your hands for several minutes (at low temperatures, the drug may be ineffective).

Instructions for the patient to use the inhaler

Check the operation of the inhaler before using it for the first time, and also if you have not used it for some time.

1. Remove the cap from the inhaler. Make sure the outlet tube is free of dust and dirt.

2. Hold the can upright with your thumb on the bottom and your index finger on the top of the can. Shake the can vigorously up and down.

3. Inhale as deeply as possible (without exertion). Close the outlet tube of the can tightly with your lips.

4. Inhaling slowly and deeply, press the valve of the can with your index finger to release the dose of medicine. Continue to inhale slowly.

5. Remove the inhaler tube from your mouth and hold your breath for 10 seconds or as long as you can without exertion. Exhale slowly.

6. If more than one dose is needed, wait about a minute and then repeat from step 2. Put the cap back on the inhaler.

Take your time when performing steps 3 and 4. At the time of release of the dose of the drug, it is important to inhale as slowly as possible. Practice in front of a mirror first. If you notice “steam” coming out of the top of the can or the corners of your mouth, start again from step 2.

Cleaning the inhaler

Clean the inhaler at least once a week. Remove the metal can from the plastic case and rinse the case and cap with warm water. Do not use hot water. Dry thoroughly without using heating devices. Place the can back into the case and put on the cap.