Beclometasone is one of the many agents used against bronchial asthma. It belongs to the younger generation of glucocorticoids, which have fewer side effects than other asthma medicines thanks to their localized action. Therefore, it can also be used in children.
What is beclometasone?
Beclometasone is one of the many agents used for bronchial asthma. Beclometasone is an active ingredient that belongs to the group of inhaled glucocorticoids. The synthetically produced substance has the molecular formulas C24H32O4 and C22H29ClO5 and is used exclusively in prescription and pharmacy medications. Beclometasone has anti-allergic, anti-inflammatory and immunosuppressive effects. In pharmaceuticals, it is in the form of beclometasone dipropionate. This is a white, almost insoluble crystalline powder. It is in solid state at room temperature. Its melting point is 212 °C. Beclometasone dipropionate is one of the most effective substances used in the treatment of asthma and is also used in allergic rhinitis. Its anti-inflammatory effect is due to the fact that the active substance attaches to intracellular glucocorticoid receptors. However, at very high doses, it can have negative effects on the body and psyche.
Pharmacologic effects
Beclometasone has vasoconstrictive, anti-inflammatory, anti-allergic, and immunosuppressive properties. It causes inflamed mucous membranes to decongest more quickly, clearing the airways. The active ingredient reduces the formation of bronchial mucus and at the same time liquefies it so that it can be coughed up better. It also has a spasmolytic effect on the bronchial muscles. In patients with allergic rhinitis, beclometasone reduces secretion formation in the nose and thus ensures unhindered nasal breathing. Since most of the active substance remains on the mucous membranes, the risk of side effects is reduced. In respiratory diseases, beclometasone is more effective than other glucocorticoids. It inhibits the production of prostaglandins in the body and restricts the formation of immune cells. This allows inflammatory processes to be combated quickly and immune system reactions to be suppressed. When used by inhalation, beclometasone is only slowly absorbed by the alveoli and therefore has a long-lasting effect. Beclometasone is used as a long-term treatment for allergic rhinitis, bronchial asthma, sinusitis, chronic bronchitis and chronic obstructive pulmonary disease such as COPD. As an acute agent, it can be used in smoke poisoning and toxic accidents, as it quickly relieves respiratory distress and prevents lung damage. Because the active ingredient has a highly limited local effect, little of it enters the blood. In the blood, about 87 percent of it binds to blood plasma proteins. In the liver, beclometasone-17,21-dipropionate is immediately metabolized to beclometasone-21-monopropionate and beclometasone (free alcohol). Its degradation in the body is carried out by certain enzymes (esterases). The metabolic breakdown products are excreted from the body through urine and stool.
Medical use and application
As a remedy for inhalation (in respiratory diseases), it is used 2 times a day. After taking it, the patient should be sure to eat a snack or rinse his oral pharynx thoroughly. Otherwise, it could lead to the formation of thrush (a fungal disease). The drug with beclometasone has a delayed effect and reaches its full effectiveness only after about 48 hours. It is used as a long-term therapeutic agent and is not suitable for acute asthma attacks. Because its systemic effects are very small, it can be prescribed to children as young as 4 years of age who have bronchial asthma. They take the beclometasone under adult supervision. In children, regular monitoring of the child’s growth should be done in parallel with the treatment. If growth disorders occur, the dose must be reduced immediately or another method of treatment must be used. The dosage is given according to the information on the package leaflet. The person suffering from respiratory diseases takes 1 to 2 strokes in the morning and in the evening. In order not to jeopardize the success of treatment, regular use is recommended. The daily dose for adults is 0.4 to 0.6 mg, for children it is correspondingly lower. For beclometasone nasal sprays, the guideline dose is 200 micrograms daily, with the dosage being individually adjusted to the patient.Beclometasone is available as a monotherapy and as a combination preparation and is sold, for example, under the trade names Qvar, Beclo Orion, Beconase, Bronchocort, Aerocortin, RatioAllerg, Rhinivict, Ventolair, Inuvair, and Formodual.
Risks and side effects
Side effects most commonly observed with beclometasone preparations include oral thrush, cough, irritation of the throat mucosa, hoarseness, infection, indigestion, paradoxical bronchospasm, glaucoma, cataract, headache, dry mouth, and inflammation of the mouth and throat. In children, it may cause the appearance of growth retardation. Therefore, it should be used in them only in the lowest therapeutically effective dosage. If paradoxical bronchospasm occurs, beclometasone use should be discontinued immediately. Less commonly, there are disturbances of the sense of smell and taste, nosebleeds, skin rashes, pruritus, urticaria, reduced stress resistance, reduction in bone density, and swelling and redness of the face, eyes, throat, and lips. Used in higher doses, it can have effects on the entire body and even lead to impaired kidney function, behavioral disturbances, and fat redistribution in the body. When other corticosteroids and sympathomimetics are given at the same time, the drug can increase their effects even more. Beclometasone should not be used in respiratory tract infections, eye infections, pulmonary tuberculosis, hypersensitivity to the active substance, pregnancy and lactation. Since it can damage adrenal function in the unborn child, the physician should prescribe the drug only after a thorough risk-benefit assessment. Like other glucocorticoids, it may pass into breast milk. Therefore, breastfeeding women who need to take the drug as long-term therapy or at higher doses should wean immediately.
