QVAR

Qvar is a breath-actuated or pressurised metered-dose inhaler containing beclometasone dipropionate in an extra-fine particle formulation.

It is prescribed as a preventer treatment for asthma in adults and children, providing effective anti-inflammatory control of the airways with lower nominal doses than traditional beclometasone inhalers.

The extra-fine formulation in Qvar produces smaller aerosol particles (approximately 1 micron) compared with standard beclometasone inhalers.

These finer particles penetrate more deeply into the small airways, achieving greater lung deposition and improved local anti-inflammatory activity.

As a result, Qvar typically requires roughly half the microgram dose of conventional beclometasone preparations to achieve equivalent asthma control.

Beclometasone dipropionate is a prodrug that is converted to its active metabolite, beclometasone-17-monopropionate, within the lungs.

This metabolite suppresses the release of inflammatory mediators, reduces mucosal oedema, and decreases mucus hypersecretion, thereby preventing bronchoconstriction and improving airflow.

As with all inhaled corticosteroid preventers, Qvar must be used consistently every day to maintain its protective effect.

It is not a rescue inhaler and should not be used to treat an acute asthma episode.

Inhale Qvar twice daily at evenly spaced intervals, as prescribed by your doctor.

If using the breath-actuated Easi-Breathe device, simply open the cap, breathe in steadily through the mouthpiece, and the dose is released automatically.

For the standard press-and-breathe inhaler, coordinate pressing the canister with a slow, deep inhalation.

Rinse your mouth with water after each dose and spit it out to minimise the risk of oral thrush. Do not stop using Qvar without consulting your prescriber, even if your asthma feels well controlled.

If you miss a dose, take it as soon as you remember, then return to your usual schedule.

The recommended adult dose of Qvar is 100 to 400 micrograms daily, given in two divided doses.

Because of the extra-fine formulation, 100 micrograms of Qvar provides equivalent efficacy to approximately 200 micrograms of standard beclometasone preparations.

Children aged 5 to 12 years typically receive 50 to 100 micrograms twice daily. Dosing should be titrated to the lowest dose that maintains good symptom control.

Dose adjustments are usually reviewed at three-monthly intervals.

Oral candidiasis (thrush) and hoarseness occur in approximately 5 to 10 per cent of users but are largely preventable through mouth rinsing and spacer use.

Throat irritation and cough upon inhalation are also reported commonly.

Headache, mild nausea, and taste disturbance have been noted in clinical trials. Bruising susceptibility may increase slightly with prolonged use.

Systemic effects such as adrenal suppression, osteoporosis, growth retardation in children, and cataract formation are associated with high-dose, long-term therapy.

They are uncommon at standard preventer doses.

Paradoxical bronchospasm may occur very rarely. If breathing worsens immediately after inhalation, stop using the inhaler, use your reliever, and seek medical advice.

Qvar does not replace a short-acting bronchodilator for acute symptom relief.

If you are using your reliever inhaler more often than usual, your asthma control may be deteriorating and you should seek a medical review.

Patients being transferred from oral corticosteroids to Qvar must have their systemic steroid dose tapered gradually. Abrupt withdrawal of oral steroids can precipitate adrenal crisis.

Because Qvar delivers a higher proportion of drug to the lungs than conventional inhalers, patients switching from standard beclometasone products should have their dose recalculated by their prescriber to avoid inadvertent overdosing.

Qvar is contraindicated in individuals with known hypersensitivity to beclometasone dipropionate or any of the excipients.

It is not appropriate as sole therapy for acute bronchospasm or status asthmaticus.

Active or quiescent pulmonary tuberculosis requires medical assessment before initiating inhaled corticosteroids.

Untreated systemic fungal, bacterial, or viral infections should also be addressed before starting treatment.