Beclometasone

Inhalation/Respiratory
Asthma prophylaxis

Nasal
Treatment and prophylaxis of allergic and non-allergic rhinitis

Oral
Ulcerative colitis

Topical/Cutaneous
Corticosteroid-responsive dermatoses

As primary treatment of status asthmaticus or acute episodes of asthma requiring intensive measures (inhalation).

Patient w/ bacterial (e.g. active or quiescent pulmonary TB), fungal, parasitic, and viral (e.g. chickenpox, measles, ocular herpes simplex) infection, DM, gastro-duodenal ulcer, serious arterial HTN, myasthenia gravis, MI, osteoporosis, hypoadrenalism, glaucoma, cataract, seizure disorder, depression, previous steroid-related psychosis, recent nasal septal ulcers, trauma, and surgery. Renal and hepatic (e.g. cirrhosis) impairment. Childn. Pregnancy and lactation.

Oral candidiasis, hoarseness, cough, epistaxis, irritation and dryness of nose and throat, unpleasant taste and smell, nasopharyngitis, rhinitis, sneezing, paradoxical bronchospasm w/ wheezing, dyspnoea; hypersensitivity (e.g. rash, urticaria, pruritus, erythema, angioedema); impaired wound healing; headache, vertigo, tremor; adrenal suppression. Rarely, Cushing’s syndrome, decreased bone mineral density, psychomotor hyperactivity, aggression, irritability, anxiety, depression, sleep disorder, suicidal ideation.

Nasal: C

Rinse mouth thoroughly after inhalation.

Monitor growth annually during long term use in childn. Assess for ocular changes, signs and symptoms of adrenal insufficiency, and oral candidiasis.

Description:
Mechanism of Action: Beclometasone (as diproprionate) is a prodrug w/ potent glucocorticoid and weak mineralocorticoid activity. It controls the rate of protein synthesis, depresses the migration of polymorphonuclear leukocytes, reduces fibroblast activity, and reverses capillary permeability and lysosomal stabilisation at the cellular level to prevent or control inflammation.
Onset: W/in a few days up to 2 wk.
Pharmacokinetics:
Absorption: Readily absorbed from the resp and GI tract. Absolute bioavailability: 44% (nasal). Time to peak plasma concentration: 0.5 hr (inhalation).
Distribution: Rapidly distributed to all body tissues. Volume of distribution: 20 L. Plasma-protein binding: 87%.
Metabolism: Undergoes hydrolysis by pulmonary esterases to major active metabolite, beclometasone-17-monopropionate (17-BMP), during absorption; subsequently undergoes metabolism in the liver by CYP3A4 enzyme to less active metabolites, beclometasone-21-monopropionate (21-BMP) and beclometasone. Undergoes first-pass metabolism in the liver and/or GI tract (oral).
Excretion: Via faeces (60% mainly as metabolites) and urine (<10-12% as free and conjugated metabolites). Elimination half-life: 0.5 hr.

Source: National Center for Biotechnology Information. PubChem Database. Beclomethasone, CID=20469, https://pubchem.ncbi.nlm.nih.gov/compound/Beclomethasone (accessed on Jan. 21, 2020)

Store between 15-30°C. Nasal/inhalation aerosol: Do not puncture. Protect from heat or open flame.

Antiasthmatic & COPD Preparations / Corticosteroid Hormones / Nasal Decongestants & Other Nasal Preparations / Topical Corticosteroids

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McEvoy GK, Snow EK, Miller J et al (eds). Beclomethasone Dipropionate. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 06/09/2016.

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QNASL Aerosol, Metered (Teva Respiratory, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 06/09/2016.

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