Beclomethasone Dipropionate

Class and Category
Pharmacologic class: Corticosteroid
Therapeutic class: Antiasthmatic, anti-inflammatory

Indications and Dosages
To maintain treatment of asthma as prophylactic therapy

Adults and adolescents who are not on an inhaled corticosteroid. 
  • Initial: 1 to 2 inhalations (40 to 80 mcg) twice daily, depending on the strength used, approximately 12 hr apart. Maximum: 4 to 8 inhalations (up to 320 mcg) twice daily approximately 12 hr apart, depending on strength used.
Adults and adolescents switching from another inhaled corticosteroid.
  • Initial: 1 to 4 inhalations (160 mcg) twice daily approximately 12 hr apart, depending on strength used previously. Maximum: 4 to 8 inhalations (up to 320 mcg) twice daily.
Children ages 4 to 11. 
  • 1 inhalation (40 mcg) twice daily, approximately 12 hr apart, increased after 2 wk to 2 inhalations (80 mcg) twice daily, approximately 12 hr apart, as needed. Maximum: 1 to 2 inhalations (80 mcg) twice daily.
  1. To relieve symptoms of seasonal or perennial allergic and nonallergic (vasomotor) rhinitis; to prevent recurrence of nasal polyps after surgical removal

Adults and children age 12 and over.
  • One or 2 inhalations (42 or 84 mcg) in each nostril twice daily for total dose of 168 or 336 mcg daily.

Children ages 6 to 12.
  • Initial: 1 inhalation (42 mcg) in each nostril twice daily, increased to 2 inhalations (84 mcg) in each nostril twice daily, as needed with further increases in strength but no more than 2 inhalations per nostril, as needed. Once control is achieved, dosage decreased to 1 spray (42 mcg) in each nostril twice daily. 
  • Maximum: 336 mcg (2 inhalations in each nostril) daily given in two divided doses 12 hr apart.

Mechanism of Action
May decrease number and activity of cells involved in the inflammatory response of allergies, asthma, and rhinitis, such as basophils, eosinophils, lymphocytes, macrophages, mast cells, and neutrophils. Also may inhibit production or secretion of chemical mediators, such as cytokines, eicosanoids, histamine, and leukotrienes. May produce direct smooth-muscle cell relaxation and decrease airway hyperresponsiveness.

Hypersensitivity to beclomethasone or its components, relief of acute bronchospasm or acute asthma, or status asthmaticus.


None reported

PEOPLE ALSO READ: What are Allergies?

Adverse Reactions
CNS: Aggression, depression, fatigue, fever, headache, insomnia, lightheadedness, mania, psychomotor hyperactivity, sleep disorders, suicidal ideation
CV: Chest pain, tachycardia
EENT: Blurred vision, burning sensation in nasal passages, cataracts, central serous chorioretinopathy, dry mouth, dysphonia, earache, elevated intraocular pressure, epistaxis, glaucoma, hoarseness, lacrimation, loss of smell and taste, nasal congestion or ulceration, nasal septal perforation, nose and throat dryness and irritation, nose and oral candidiasis, pharyngitis, rhinorrhea, sinusitis, sneezing, unpleasant smell and taste ENDO: Adrenal insufficiency, cushingoid symptoms
GI: Diarrhea, indigestion, nausea, rectal hemorrhage
GU: Dysmenorrhea, UTI

MS: Arthralgia, growth suppression in children (nasal aerosol)
RESP: Bronchitis, bronchospasm, chest congestion, cough, pulmonary infiltrates, upper respiratory tract infection, wheezing
SKIN: Acne, eczema, pruritus, rash, skin discoloration, urticaria
Other: Anaphylaxis, angioedema, flu-like symptoms, impaired wound healing, lymphadenopathy, weight gain

Childbearing Considerations
  • It is not known if drug can cause fetal harm.
  • Use with caution only if benefit to mother outweighs potential risk to fetus.

  • Drug is present in breast milk.
  • Patient should check with prescriber before breastfeeding.

Nursing Considerations
  • Be aware that beclomethasone should not be used with patients who have experienced recent nasal septal ulcers, nasal surgery, or nasal trauma because of corticosteroids’ adverse effects on wound healing.
  • Know that if patient also takes an oral corticosteroid, expect to taper dosage slowly (by decreasing daily dosage or taking drug every other day, as ordered) about 1 week after beclomethasone therapy begins.
WARNING: Be aware that when gradually switching patient from oral corticosteroid to inhaled beclomethasone, watch for signs of life threatening adrenal insufficiency, such as fatigue, hypotension, lassitude, nausea, vomiting, and weakness, during transition period and when exposed to infection, surgery, trauma, or other stressor. If signs occur, notify prescriber immediately.
  • Expect to resume oral corticosteroid during a stressful period or severe asthma attack. Watch for signs of adrenal insufficiency during periods of stress because beclomethasone may be absorbed systemically.

  • Be prepared, if patient has acute asthma attack or increased wheezing after receiving beclomethasone, to give a fast-acting bronchodilator, as prescribed. Expect to discontinue beclomethasone.
  • Assess for signs of candidiasis, such as thick white coating or plaques on tongue and sides of mouth.
  • Tell patient to rinse mouth with water without swallowing after inhalation; this may help to prevent oral candidiasis. If present, notify prescriber and expect to reduce dose or frequency or to stop beclomethasone. Also anticipate treatment with antifungal drug.
  • Assess nasal discharge regularly when patient is prescribed nasal spray. Look for color or consistency changes, which may indicate infection when patient is using beclomethasone nasal spray.
  • Monitor the growth of children receiving beclomethasone nasally.
  • Monitor patients with a change in vision or a history of blurred vision, cataracts, glaucoma, or intraocular pressure because use of intranasal and inhaled corticosteroids may cause eye abnormalities. If adverse eye symptoms develop, notify prescriber and expect patient to be referred to an ophthalmologist.
  • Monitor patient closely for altered thinking such as suicidal thoughts. If present, notify prescriber because drug will have to be discontinued.

  • Advise patient not to abruptly stop taking beclomethasone because adrenal insufficiency may occur.
  • Urge her to notify prescriber if she develops signs of adrenal insufficiency, such as anorexia, dizziness, dyspnea, fainting, fatigue, fever, hypotension, malaise, or nausea.
  • Instruct her to prime pump before using nasal spray for first time by placing her thumb on its base, and her index and middle fingers on its shoulder area (the canister should be on top, pointing down), and then pressing her thumb firmly and quickly against the bottle four times into the air away from eyes and face. If nasal spray has not been used for 7 consecutive days, remind patient that container needs to be primed by spraying two times prior to use. Before patient uses nasal inhalation canister for first time, instruct her to shake it and check that it’s working properly by spraying it once in the air while looking for fine mist.
  • Teach patient to inhale deeply after each nasal spray or inhalation, exhaling through mouth and tilting head back to let drug spread over the nasopharynx.
  • Teach patient how to properly use oral inhalation aerosol, shaking canister well before using. If patient has trouble using device and coordinating inhalation with it, suggest using a spacer device.
  • Advise patient prescribed two inhalations to wait a minute between them.
  • Tell patient prescribed an inhaled bronchodilator with beclomethasone oral inhalation to use bronchodilator first, wait for 5 minutes, and then use beclomethasone.
WARNING: Warn patient that beclomethasone isn’t intended to relieve acute bronchospasm. Urge patient to notify prescriber if asthma symptoms don’t respond.
  • Advise patient to wear medical identification that states need for supplemental oral corticosteroids during severe asthma attack or stress. Inform patient that prescriber may order high-dose oral corticosteroid therapy.
  • Warn patient and caretakers to report any abnormal thinking such as suicidal thoughts immediately to prescriber.
WARNING: Caution patient to avoid exposure to chickenpox and measles because drug may cause immunosuppression. If she’s exposed to these disorders, urge her to notify prescriber immediately.
  • Tell patient to report any changes in vision to prescriber.


Post a Comment

Previous Post Next Post