Beclometasone (Beclomethasone) ๐
๐ 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).
โ๏ธ Mode of Action
- Corticosteroid that reduces airway inflammation by inhibiting cytokine production, reducing eosinophil recruitment, and upregulating ฮฒ2-adrenoceptor sensitivity.
- Does not provide immediate relief of symptoms โ preventer inhaler, not a reliever.
๐ฏ Indications & Typical Doses
- Asthma (standard inhaler): 200โ400 micrograms twice daily. Max 800 micrograms BD.
- Asthma (QVAR inhaler): 50โ200 micrograms BD inhaled (extra-fine particle โ roughly 2ร potency of standard).
๐ Dose Summary
| Preparation | Typical Dose | Frequency | Route |
| Beclometasone (standard) | 200โ400 micrograms | BD | Inhaled |
| Beclometasone (QVAR) | 50โ200 micrograms | BD | Inhaled |
Always confirm equivalence when switching between preparations (QVAR โ 2ร potency of standard beclometasone).
๐ Interactions
- See BNF for full list.
- Risk of adrenal suppression โ with concomitant CYP3A4 inhibitors (e.g. ritonavir).
โ ๏ธ Cautions
- Risk of systemic corticosteroid effects at high doses (adrenal suppression, osteoporosis, growth retardation in children).
- History of pulmonary TB.
๐ซ Contraindications
๐ฅ Side Effects
- Oral candidiasis (oral thrush) โ prevent by rinsing mouth after use.
- Hoarse voice (dysphonia).
- Paradoxical bronchospasm (rare).
- At high doses: systemic steroid effects (adrenal suppression, bruising, Cushingoid features).
๐ References