Beclometasone

Beclometasone dipropionate is a corticosteroid prescribed as a preventer inhaler for the long-term management of asthma and as a nasal spray for allergic rhinitis.

It is also available as topical preparations for inflammatory skin conditions.

For asthma, beclometasone is taken daily to reduce airway inflammation, prevent symptoms, and decrease the frequency of exacerbations.

Inhaled beclometasone acts directly on the airway epithelium, suppressing the release of inflammatory mediators including cytokines, leukotrienes, and prostaglandins.

By reducing mucosal oedema, mucus hypersecretion, and bronchial hyperreactivity, it provides sustained symptom control when taken regularly.

It does not provide relief during an acute asthma attack; a short-acting bronchodilator such as salbutamol is needed for that purpose.

As a nasal spray, beclometasone relieves congestion, sneezing, nasal itching, and rhinorrhoea caused by seasonal or perennial allergic rhinitis.

When used on the skin, it is classified as a moderately potent topical corticosteroid suitable for eczema and dermatitis.

For the inhaler, shake it before use, breathe out gently, place the mouthpiece between your lips, press the canister and inhale slowly and deeply.

Hold your breath for about ten seconds, then breathe out slowly. Rinse your mouth with water after every use and spit it out to prevent oral thrush. Use a spacer device if your doctor recommends one.

For the nasal spray, blow your nose gently first, shake the bottle, insert the nozzle into the nostril while tilting your head slightly forward, and spray while breathing in gently. Do not sniff hard.

For skin preparations, apply a thin layer to the affected area once or twice daily and avoid using on the face for more than five days unless advised.

For asthma in adults, the usual dose is 200 to 400 micrograms twice daily, adjusted according to symptom control. Severe asthma may require up to 800 micrograms twice daily.

Children typically receive 100 to 200 micrograms twice daily. For the nasal spray, adults use two sprays in each nostril twice daily, reducing to one spray once symptoms are controlled.

Children aged six and over receive one spray in each nostril twice daily. Dose reduction for kidney or liver impairment is not required for inhaled or nasal routes.

Common side effects of the inhaler include oral thrush (candidiasis), hoarseness, sore throat, and cough after inhalation. Rinsing the mouth after use reduces the risk of thrush substantially.

Nasal spray side effects include nosebleeds, nasal dryness, and an unpleasant taste.

Skin preparations may cause thinning of the skin, stretch marks, and increased hair growth at the site with prolonged use.

Serious adverse effects are uncommon at standard doses.

High-dose inhaled beclometasone over prolonged periods may contribute to adrenal suppression, reduced bone mineral density, growth retardation in children, and posterior subcapsular cataracts.

Paradoxical bronchospasm may rarely occur immediately after inhalation. Severe allergic reactions are very rare but require immediate medical attention.

Do not rely on beclometasone during an acute asthma attack; always carry your reliever inhaler.

If you are switching from oral corticosteroids to inhaled beclometasone, the tablets must be reduced gradually under medical supervision to avoid adrenal crisis.

Children on long-term inhaled corticosteroids should have their height monitored regularly. Carry a steroid card if you are on high-dose inhaled treatment.

For skin preparations, do not use on infected areas unless concurrent antimicrobial treatment is given.

Beclometasone is contraindicated in patients with known hypersensitivity to beclometasone dipropionate or any excipient.

The inhaler should not be used in patients with active or quiescent pulmonary tuberculosis or untreated fungal, bacterial, or viral respiratory infections.

Skin preparations must not be applied to areas with active untreated infection, acne vulgaris, rosacea, or perioral dermatitis.