Beclomethasone

Beclomethasone (Vanceril, Beconase, Vancenase, Beconase AQ, Vancenase AQ, Vancenase AQ Double Strength)

Category:

Anti-inflammatory corticosteroid (synthetic)

Description:

Halogenated synthetic glucocorticoid

Indications:

INH for chronic asthma
NASAL for seasonal/perennial rhinitis; prevention of recurrence of nasal polyps; non-allergic (vasomotor) rhinitis

Contraindications:

Primary treatment of status asthmaticus, nonasthmatic bronchial disease
Bacterial, fungal, or viral infections of the mouth, throat, or lungs; children <3 years

Precautions:

Pregnancy category C; excretion in breast milk unknown, but considered to be compatible with breast feeding
Nasal disease/surgery, children <12 years, nasal ulcers, recurrent epistaxis
Systemic effects such as mental disturbances, increased bruising, weight gain, cushingoid features, and cataracts

Adverse Reactions (Side Effects):

CNS: headache, paresthesia
EENT: burning, candidal infection, dryness, earache, nasal irritation, perforation at nasal septum, nasal ulcers, secretions with blood, sneezing, sore throat
GI: dry mouth, dysphonia
METAB: adrenal suppression
RESP: bronchospasm

Dosage:

Administered by oral inhalation and nasally

Adult: INH 2-4 puffs 3-4 times daily, not to exceed 20 INH/day; NASAL 1-2 sprays in each nostril 2-4 times daily; double strength (DS) NASAL 1-2 sprays each nostril daily
Child 2-12 years: INH 1-2 puffs 3-4 times daily, not to exceed 10 INH/day
Child >12 years: NASAL 1-2 sprays each nostril 2-4 times daily

Special Considerations:

Rinse mouth with water following INH to decrease possibility of fungal infections, dysphonia
Response to nasal steroids seen in 3 days to 2 weeks; discontinue if no improvement in 3 weeks
For prophylactic use, no role in acute treatment of asthma/allergy

Source: Operational Medicine 2001, Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300