beclomethasone dipropionate
Beclodisk†, Becloforte Inhaler‡, Beclovent, Beclovent Rotacaps†, Vanceril
Pregnancy Risk Category C
How supplied
Oral inhalation aerosol: 42 mcg/metered spray, 50 mcg/metered spray‡
Action
Unknown. May decrease inflammation by decreasing the number and activity of inflammatory cells, inhibiting bronchoconstrictor mechanisms producing direct smooth-muscle relaxation, and decreasing airway hyperresponsiveness.
Indications & dosage
Chronic asthma--
Adults and children ages 12 and older: 2 inhalations t.i.d. or q.i.d.; or 4 inhalations b.i.d. Maximum dose is 20 inhalations daily (840 mcg).
Children ages 6 to 12: 1 to 2 inhalations t.i.d. or q.i.d.; or 2 to 4 inhalations b.i.d. Maximum dose is 10 inhalations daily (420 mcg).
Adverse reactions
EENT: hoarseness, fungal infection of throat, throat irritation.
GI: dry mouth, fungal infection of mouth.
Respiratory: bronchospasm, wheezing, cough.
Other: angioedema, hypersensitivity reactions, suppression of hypothalamic-pituitary-adrenal function, adrenal insufficiency, facial edema.
Interactions
None significant.
Effects on diagnostic tests
None reported.
Contraindications
Contraindicated in patients with hypersensitivity to drug or its ingredients (fluorocarbons, oleic acid) and in those with status asthmaticus.
Nursing considerations
- Use with extreme caution, if at all, in patients with tuberculosis, fungal or bacterial infections, ocular herpes simplex, or systemic viral infections.
- Don't use drug in patients with asthma controlled by bronchodilators or other noncorticosteroids alone or for those with nonasthmatic bronchial diseases.
- Use with caution in patients receiving systemic corticosteroid therapy.
- A spacer device may help ensure delivery of the proper dose and decrease local (oral) adverse effects.
- Check mucous membranes frequently for signs of fungal infection.
- During times of stress (trauma, surgery, or infection), systemic corticosteroids may be needed to prevent adrenal insufficiency in previously steroid-dependent patients.
- Periodic measurement of growth and development may be needed during high-dose or prolonged therapy in children.
- Alert:
Taper oral glucocorticoid therapy slowly, as ordered. Acute adrenal insufficiency and death have occurred in asthmatics who changed abruptly from oral corticosteroids to beclomethasone.
- Alert:
Don't confuse Vanceril with Vansil.
Patient teaching
- Inform patient that drug doesn't provide relief for acute asthma attacks.
- Tell patient requiring a bronchodilator to use it several minutes before beclomethasone.
- Instruct patient to carry a medical identification card indicating his need for supplemental systemic glucocorticoids during stress.
- If using a metered-dose inhaler, instruct patient to shake canister well before use.
- Advise patient to allow 1 minute to elapse before taking subsequent puffs of drug and to hold his breath for a few seconds to enhance action of drug.
- Instruct patient to contact his doctor if response to therapy decreases or if symptoms don't improve within 3 weeks; dosage may need to be adjusted. Tell him not to exceed recommended dosage on his own.
- Tell patient to keep inhaler clean and unobstructed. He should wash it with warm water and dry it thoroughly.
- Advise patient to prevent oral fungal infections by gargling or rinsing mouth with water after each use, but not to swallow the water.
- Tell patient to report symptoms associated with corticosteroid withdrawal, including fatigue, weakness, arthralgia, orthostatic hypotension, and dyspnea.
- Instruct patient to store drug between 59° and 86° F (15° and 30° C). Advise patient to ensure delivery of proper dose by gently warming canister to room temperature before using.
*Liquid contains alcohol. **May contain tartrazine. †Canada ‡Australia §U.K. OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING