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Beclometasone (Beclomethasone)
📖 About Beclometasone
- Always check the BNF entry for up-to-date prescribing advice.
- Inhaled corticosteroid (ICS) used in asthma and sometimes in COPD as part of triple therapy.
- Forms part of the stepwise asthma management ladder (NICE/BTS/SIGN).
⚙️ Mode of Action
- Corticosteroid that reduces airway inflammation by inhibiting cytokine production, reducing eosinophil recruitment, and upregulating β2-adrenoceptor sensitivity.
- Does not provide immediate relief of symptoms → preventer inhaler, not a reliever.
🎯 Indications & Typical Doses
- Asthma (standard inhaler): 200–400 micrograms twice daily. Max 800 micrograms BD.
- Asthma (QVAR inhaler): 50–200 micrograms BD inhaled (extra-fine particle → roughly 2× potency of standard).
💊 Dose Summary
| Preparation | Typical Dose | Frequency | Route |
|---|---|---|---|
| Beclometasone (standard) | 200–400 micrograms | BD | Inhaled |
| Beclometasone (QVAR) | 50–200 micrograms | BD | Inhaled |
Always confirm equivalence when switching between preparations (QVAR ≈ 2× potency of standard beclometasone).
🔀 Interactions
- See BNF for full list.
- Risk of adrenal suppression ↑ with concomitant CYP3A4 inhibitors (e.g. ritonavir).
⚠️ Cautions
- Risk of systemic corticosteroid effects at high doses (adrenal suppression, osteoporosis, growth retardation in children).
- History of pulmonary TB.
🚫 Contraindications
- Untreated active TB.
💥 Side Effects
- Oral candidiasis (oral thrush) → prevent by rinsing mouth after use.
- Hoarse voice (dysphonia).
- Paradoxical bronchospasm (rare).
- At high doses: systemic steroid effects (adrenal suppression, bruising, Cushingoid features).
📚 References
- BNF – Beclometasone
- NICE Asthma Guidelines
- BTS/SIGN Asthma Guideline
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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