beclomethasone dipropionate inhaler, Vanceril
GENERIC NAME: beclomethasone dipropionate inhaler
BRAND NAME: Vanceril
DRUG CLASS AND MECHANISM: Beclomethasone is a synthetic steroid of the glucocorticoid family. The naturally-occurring glucocorticoid (cortisol or hydrocortisone) is produced in the adrenal glands. Glucocorticoid steroids have potent anti-inflammatory actions. When used as an inhaler, the medication goes directly into the lungs, and very little finds its way into the rest of the body. Therefore, in comparison with glucocorticoids that are taken orally, beclomethasone has fewer side effects.
GENERIC AVAILABLE: Yes
PREPARATIONS: Inhaler 42 mcg/actuation; 84 mcg/actuation.
STORAGE: Beclomethasone should be kept at room temperature, 15-30°C (59-86°F).
PRESCRIBED FOR: Beclomethasone is used for the control of bronchial asthma in persons requiring continuous treatment. Such patients may include those with frequent asthmatic episodes that require medications to dilate the airways in the lung or those with asthmatic episodes at night.
DOSING: Beclomethasone is used to prevent attacks of asthma and not to treat active attacks of asthma. Doses vary widely. The medication requires continuous use to be effective. Some benefit may be noted as soon as three days after starting treatment, but optimal benefit usually is not seen until after two to three weeks.
DRUG INTERACTIONS: No drug interactions have been described with inhaled beclomethasone.
PREGNANCY: There does not appear to be an increased risk of malformation in children born to mothers exposed to beclomethasone during pregnancy. Additionally, there is no dependency on or withdrawal from the medication.
NURSING MOTHERS: It is not known if beclomethasone is secreted in breast milk. Other medications in this class of medications are secreted into breast milk, but is not known whether the small amounts that appear in milk have any effect on the infant.
SIDE EFFECTS: The most commonly noted side effects associated with inhaled beclomethasone are mild cough or wheezing due to chemical irritation; these effects may be minimized by using an inhaled bronchodilator (e.g., albuterol or Ventolin) prior to the beclomethasone. Oral candidiasis or thrush, a fungal infection of the mouth and throat, can occur in between 1 in 20 and 1 in 8 persons who use beclomethasone. The risk of thrush is greater with higher doses, but the risk in children is lower than in adults. Hoarseness may occur in as few as 1 in 20 or as many as 1 in 2 persons and is due to chemical irritation. A spacer device that can be attached to the inhaler and washing out the mouth with water following each use of beclomethasone reduces the amount of beclomethasone in the mouth and throat and reduces the risk of thrush and hoarseness.
Higher doses of inhaled beclomethasone (more than 1000 mcg/day) may result in more absorption into the body. This may decrease bone formation and increase bone breakdown (resorption), resulting in weak bones and a risk of fractures. Even higher doses (more than 1500 mcg/day in adults and 400 mcg/day in children) may suppress the adrenal glands and impair their ability to make natural glucocorticoid. People with such suppression (which can be identified by testing) need increased amounts of glucocorticoid orally or by the intravenous route during periods of high physical stress since higher amounts of glucocorticoids are needed by the body to fight physical stress. Patients receiving beclomethasone may develop easy bruising if enough beclomethasone is absorbed into the body from the lungs.
Reference: FDA Prescribing Information
Last Editorial Review: 12/31/1997
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