Beclomethasone inhaled

Beclomethasone inhaled is a prescription medicine used to prevent the symptoms of chronic asthma.

• Beclomethasone inhaled is available under the following different brand names: Qvar, RediHaler

Adult and pediatric dosage

Oral inhalation aerosol

• 40mcg/actuation
• 80mcg/actuation
• Available as a breath-actuated inhaler (Qvar RediHaler)
• Note: Qvar RediHaler replaced the Qvar metered-dose inhaler in February 2018

Chronic Asthma

• Adult dosage
• No prior history of inhaled corticosteroid use: 40-80 mcg inhaled orally every 12 hours initially; may increase the dose if needed; not to exceed 320 mcg twice a day
• Prior history of inhaled corticosteroid use: 40-160 mcg inhaled orally every 12 hours based on previous inhaled corticosteroid product and disease severity; not to exceed 320 mcg twice a day
• Pediatric dosage
• Children below 4 years: Safety and efficacy not established
• Children between 4 to 11 years: 40 mcg inhaled orally twice a day for patients with/without prior history of inhaled corticosteroid use; may increase the dose for an adequate response after more than or equal to 2 weeks of therapy; not to exceed 80 mcg inhaled twice a day
• Children above 12 years: 
  • No prior history of inhaled corticosteroid use: 40-80 mcg inhaled orally every 12 hours initially; may increase the dose for an adequate response after more than or equal to 2 weeks of therapy; not to exceed 320 mcg twice a day
  • Prior history of inhaled corticosteroid use: 40-160 mcg inhaled orally every 12 hours based on the previous corticosteroid inhaled product and disease severity; may increase the dose for an adequate response after more than or equal to 2 weeks of therapy; not to exceed 320 mcg twice a day.

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Tramadol/Acetaminophen include:

• yeast infection in the mouth,
• headache,
• sore throat,
• runny nose,
• sinus pain, and
• irritation in the nose.

Serious side effects of Beclomethasone inhaled include:

• wheezing,
• choking,
• other breathing problems after using the medicine,
• worsening asthma symptoms,
• white patches or sores inside the mouth or on lips,
• blurred vision,
• tunnel vision,
• eye pain,
• seeing halos around lights,
• fever,
• chills,
• body aches,
• signs of low adrenal gland hormones: worsening tiredness, lack of energy, weakness, lightheadedness, nausea, vomiting, and
• increased adrenal gland hormones--hunger, weight gain, swelling, skin discoloration, slow wound healing, sweating, acne, increased body hair, tiredness, mood changes, muscle weakness, missed menstrual periods, and sexual changes.

Rare side effects of Beclomethasone inhaled include:

• none 

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first

• Beclomethasone inhaled has severe interactions with no other drugs.
• Beclomethasone inhaled has serious interactions with the following drugs:
  • aldesleukin
  • BCG intravesical live
  • BCG vaccine live
  • echinacea
  • hyaluronidase
  • leflunomide
  • macimorelin
  • natalizumab
  • pimecrolimus
  • tacrolimus ointment
• Beclomethasone inhaled has moderate interactions with the following drugs:
  • amphotericin B deoxycholate
  • bumetanide
  • chlorothiazide
  • chlorthalidone
  • corticorelin
  • deferasirox
  • denosumab
  • ethacrynic acid
  • furosemide
  • hydrochlorothiazide
  • sipuleucel-T
  • torsemide
  • trastuzumab
  • trastuzumab deruxtecan
• Beclomethasone inhaled has minor interactions with no other drugs. 

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity
• Primary treatment of status asthmaticus, acute bronchospasm

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Beclomethasone inhaled?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Beclomethasone inhaled?”

Cautions

• Immediate hypersensitivity reactions may occur; discontinue the beclomethasone inhaler if such reactions occur
• May decrease growth velocity in children; titrate dose to the lowest effective dose to relieve signs/symptoms
• Kaposi sarcoma is associated with prolonged corticosteroid treatment; if observed, consider discontinuing therapy
• Psychiatric disturbances reported with corticosteroid use; psychiatric conditions, including depression, euphoria, personality changes, insomnia, and mood swings may be exacerbated by corticosteroid use
• Following initiation of inhaled corticosteroids, rare cases of vasculitis or eosinophilic conditions may occur after the decrease and/or withdrawal of oral corticosteroid therapy
• Use caution in patients with heart failure (long-term use associated with fluid retention), diabetes mellitus (may lead to hyperglycemia), gastrointestinal disease (diverticulitis, peptic ulcer, ulcerative colitis due to perforation risk), myasthenia gravis (exacerbation may occur), myocardial infarct (exacerbation of symptoms reported), myocardial infarct (corticosteroids associated with myocardial rupture), ocular disease (routine eye exam recommended), history of seizure disorder (seizures reported with adrenal crisis)
• Dosage adjustments may be necessary with changes in thyroid status; metabolic clearance of corticosteroids may increase in hyperthyroid patients and decrease in hypothyroid ones

Long term corticosteroid use

• Decreases in bone mineral density (BMD) have been observed; monitor
• Eye disorders
  • Cataracts, glaucoma, increased IOP, and blurred vision reported after long term corticosteroid use; closely monitor for patients with changes in vision or with a history of increased intraocular pressure, blurred vision, glaucoma, and/or cataracts

Immunosuppression

• Risk for the more serious or fatal course of chickenpox or measles in susceptible patients (eg, unvaccinated or immunologically unexposed individuals); care must be taken to avoid exposure
• Immunocompromised patients

Localized effects

• Risk of localized infections of nose, mouth, and pharynx, including Candida albicans; must rinse mouth after inhalation to reduce risk
• If oropharyngeal candidiasis develops, it should be treated with appropriate local or systemic antifungal therapy; certain cases may require temporary interruption of therapy under close supervision

Deterioration of asthma and acute episodes

• Risk of bronchospasm with an immediate increase in wheezing after administration; if this occurs, discontinue therapy and administer SABA immediately
• Not a bronchodilator; should not be administered for rapid relief of acute bronchospasm
• Acute symptoms (eg, shortness of breath) should be relieved with a short-acting beta2-agonist; patients with acute episodes may require oral corticosteroids

Transferring patients from systemic corticosteroid therapy

• Excessive use may suppress HPA function (eg, adrenal insufficiency when exposed to trauma, surgery, or infections (particularly gastroenteritis); monitor closely, especially postoperatively or during periods of stress
• During periods of stress or severe status asthmaticus, may require supplementary systemic corticosteroids immediately; the patient should carry a warning card indicating a possible need for supplementary systemic steroids in such emergencies Switching from systemic steroids to therapy may unmask allergic conditions (eg, conjunctivitis, eczema, rhinitis)
• Deaths have occurred due to adrenal insufficiency following abrupt withdrawal of oral steroids; taper withdrawal gradually

Pregnancy and Lactation

• There are no adequate and well-controlled in pregnant women; there are clinical considerations with the use of inhaled corticosteroids (ICS), including beclomethasone dipropionate, in pregnant women; available human data do not establish the presence or absence of drug-associated risk to the fetus; in animal reproduction studies, beclomethasone dipropionate resulted in adverse developmental effects in mice and rabbits at subcutaneous doses equal to or greater than approximately 0.75 times maximum recommended human daily inhalation dose (MRHDID) in adults (0.64 mg/day); in rats exposed to beclomethasone dipropionate by inhalation, dose-related gross injury to fetal adrenal glands was observed at doses greater than 180 times the MRHDID, but there was no evidence of external or skeletal malformations or embryo lethality at inhalation doses up to 440 times the MRHDID
• The risk of complications to the mother and developing fetus from inadequate control of asthma must be balanced against risks from exposure to beclomethasone dipropionate

Labor and delivery

• There are no specific human data regarding any adverse effects of inhaled beclomethasone dipropionate on labor and delivery

Fertility

• Impairment of fertility was observed in rats and dogs at oral doses corresponding to 250 and 25 times the MRHDID for adults on an mg/ m² basis, respectively

Lactation

• There are no data available on the presence in human milk, effects on the breastfed child, or milk production; however, other inhaled corticosteroids have been detected in human milk
• The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on the breastfed child from beclomethasone dipropionate or underlying maternal condition