Home Drug Guide Beclomethasone Dipropionate

Drug Guide

Generic Name

Beclomethasone Dipropionate

Brand Names Vanceril, Beclovent, Vancenase, Beconase, Vanceril Double Strength, Qvar 80, Qvar 40, Qnasl, Qvar Redihaler

Classification

Therapeutic: Anti-inflammatory corticosteroid

Pharmacological: Glucocorticoid receptor agonist

FDA Approved Indications

Asthma maintenance therapy
Allergic rhinitis (nasal spray)

Mechanism of Action

Beclomethasone Dipropionate is a corticosteroid that reduces inflammation by suppressing the immune response and inhibiting multiple cell types and mediator substances involved in allergic and inflammatory processes.

Dosage and Administration

Adult: Inhalation: typically 40-320 mcg twice daily, adjusted based on severity.

Pediatric: Start with 40-80 mcg twice daily, titrate to effect.

Geriatric: Use with caution, adjust doses based on response and tolerability.

Renal Impairment: No specific adjustment needed.

Hepatic Impairment: Use with caution; monitor for increased systemic effects.

Pharmacokinetics

Absorption: Minimal systemic absorption when inhaled, but some absorption occurs.

Distribution: Widely distributed in tissues, extensively bound to plasma proteins.

Metabolism: Metabolized in the liver via cytochrome P450 enzymes, mainly CYP3A4.

Excretion: Metabolites excreted primarily in urine.

Half Life: Approximately 2-3 hours for plasma; systemic effects depend on dose and formulation.

Contraindications

Hypersensitivity to beclomethasone or other corticosteroids.
Active systemic fungal infections.

Precautions

Use with caution in patients with active or dormant tuberculosis, herpes simplex infections, and during acute bronchospasm. Monitor for potential adrenal suppression with long-term high doses.

Adverse Reactions - Common

Mild throat irritation, cough (Common)
Oral candidiasis (thrush) (Occasional)

Adverse Reactions - Serious

Adrenal suppression (Rare)
Oropharyngeal candidiasis (Uncommon)
Respiratory infections (Uncommon)
Behavioral changes in children (e.g., hyperactivity) (Rare)

Drug-Drug Interactions

Cytochrome P450 3A4 inhibitors (e.g., ketoconazole) may increase systemic corticosteroid levels.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor lung function, symptom control, and for signs of adverse effects like oral thrush or changes in behavior in children.

Diagnoses:

Impaired gas exchange
Risk for infection
Ineffective airway clearance

Implementation: Administer via inhaler or nasal spray as prescribed, rinse mouth after inhalation, educate on proper inhaler technique.

Evaluation: Assess symptom improvement, monitor for side effects, and ensure proper inhaler use.

Patient/Family Teaching

Use regularly as prescribed for best results.
Rinse mouth and spit out after inhalation to prevent thrush.
Report any oral sores, hoarseness, or side effects.
Do not stop abruptly without consulting healthcare provider.

Special Considerations

Black Box Warnings:

Systemic corticosteroids may cause adrenal suppression, hyperglycemia, and other systemic effects, especially with high doses or prolonged use.

Genetic Factors: Pharmacogenetic variations affecting metabolism via CYP3A4 may alter drug levels.

Lab Test Interference: May alter growth in children; may affect cortisol levels.

Overdose Management

Signs/Symptoms: Symptoms of systemic corticosteroid excess, such as weight gain, fluid retention, hypertension.

Treatment: Discontinue use, provide symptomatic treatment, and support as needed. Seek emergency care if overdose is severe.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable until expiration date on the package.