Therapeutic action
- Steroidal anti-inflammatory drug (inhaled corticosteroid)
Indications
- Long term treatment of chronic asthma (maintenance and symptomatic treatment), alone or in combination with a beta-2 agonist bronchodilator
Forms and strengths
- Solution or suspension for inhalation in pressurised metered dose inhalers, delivering 50, 100 or 250 micrograms of beclometasone dipropionate/puff
Dosage
Start at the step most appropriate to initial severity. Always try to administer the lowest effective dose.
|
Asthma severity |
6 to 11 years | 12 years and over and adult |
|---|---|---|
|
Intermittent asthma |
_ |
Only when symptomatic: 200 to 500 micrograms, in combination with salbutamol |
| Mild persistent asthma |
50 to 100 micrograms (low dose) 2 times daily |
100 to 250 micrograms (low dose) 2 times daily |
|
Moderate persistent asthma |
50 to 100 micrograms (low dose) 2 times daily, in combination with salmeterol
OR (if salmeterol is not available) 150 to 200 micrograms (medium dose) 2 times daily |
100 to 250 micrograms (low dose) 2 times daily, in combination with salmeterol
OR (if salmeterol is not available) 300 to 500 micrograms (medium dose) 2 times daily |
|
Severe persistent asthma |
150 to 200 micrograms (medium dose) 2 times daily, in combination with salmeterol |
300 to 500 micrograms (medium dose) 2 times daily, in combination with salmeterol
OR (if salmeterol is not available) > 500 micrograms (high dose) 2 times daily |
In all cases, do not exceed 2000 micrograms daily.
Duration
- As long as required. Re-evaluate after 2 to 3 months if doses are adequate or need to be increased or decreased.
Administration technique
- Shake the inhaler. Remove the mouthpiece cover.
- Breathe in and breathe out as completely as possible. Place the lips tightly around the mouthpiece. Inhale deeply while activating the inhaler. Hold breath 10 seconds before exhaling.
- If hand-breath co-ordination is difficult, use a spacer to facilitate administration and improve the efficacy of treatment.
Contra-indications, adverse effects, precautions
- Do not administer to patients with untreated respiratory infection.
- May cause:
- throat irritation, hoarseness and cough at the beginning of treatment; oro-pharyngeal candidiasis;
- adrenal suppression with high doses for prolonged periods.
- Pregnancy: no contra-indication
- Breast-feeding: no contra-indication
Remarks
- When beclometasone is given with salbutamol, preferably use combination inhaler. If not available, beclometasone should be inhaled right after salbutamol.
- Relief of symptoms may require several days or weeks of continuous therapy.
- Clean the mouthpiece before and after each use.
- Do not pierce or incinerate used aerosol containers (risk of explosion).
- Also comes in a combination metered dose inhaler with formoterol.