bë’ klō/mëth’ ə/zōn

Brand Names: QVAR®

Common Dosage Forms:

  • Inhalation Aerosol in a Metered Dose Inhaler (MDI):
    QVAR 40: Each actuation delivers 40 mcg from the actuator.
    QVAR 80: Each actuation delivers 80 mcg from the actuator.

FDA Indications/Dosages:

  • For the maintenance treatment of asthma as prophylactic therapy in patients 5 years of age and older and to reduce or eliminate the need for systemic corticosteroids in patients with asthma:
    Children ages 5-11: 40 to 80 mcg twice daily
    Adults: 40 to 160 mcg twice daily. Maximum dose is 320 mcg twice daily.

Monitor:

BMD, IOP, FEV

Pharmacology/Pharmacokinetics:

Adrenocorticoids bind to certain receptor proteins found in the cytoplasm of sensitive cells to form a steroid-receptor complex. This steroid-receptor complex enters the nucleus of the cell where it reacts with chromatin, or DNA. The steroid (or possibly the receptor) then uses stored information to stimulate, or in some cases inhibit, the transcription of m-RNA. The stimulation of m-RNA results in the synthesis of specific proteins and ultimately specific enzymes that carry out its antiallergy and anti-inflammatory actions. Inhaled beclomethasone dipropionate decreases airway inflammation and improves asthma symptoms. Beclomethasone dipropionate is rapidly hydrolyzed to beclomethasone 17 monopropionate which has a high binding affinity for the human glucocorticoid receptor.

Drug Interactions:

Additive effects occur with systemic corticosteroids.

Contraindications/Precautions:

Use is contraindicated in the primary treatment of status asthmaticus. Use caution in patients who are being transferred from systemic corticosteroids because deaths due to adrenal insufficiency have occurred during and after transfer to aerosolized steroids. Systemic steroids should be administered to these patients during periods of stress or during an acute asthmatic attack. Do not use as a bronchodilator and do not give for rapid relief of bronchospasm. Secondary fungal infections of the oral cavity may occur and may require antifungal treatment. Response of the hypothalamic-pituitary- adrenal (HPA) function is highly individualized. Patients on immunosuppressants are more susceptible to infections, especially chicken pox and measles. Use with caution during pregnancy

Adverse Effects:

The most common adverse effects are headache, upper respiratory tract infections and pharyngitis.

Patient Consultation:

  • Avoid contact with the eyes.
  • Contact a physician if the above side effects are severe or persistent.
  • If a dose is missed, skip it and return to normal dosing schedule.
  • QVAR is not intended to provide immediate relief of bronchospasm. To receive the full benefits of therapy, use on a regular basis. Although benefits can be seen within 24 hours of treatment, up to four weeks may be needed to observe benefits.
  • Use any prescribed bronchodilator a few minutes prior to using QVAR.
  • Prime the inhaler with two sprays initially and after 10 days of nonuse.
  • Store the inhaler upside down resting on the canister with the mouthpiece on top.
  • Follow enclosed instructions for inhalation technique for the HFA inhaler:
    (1) breathe out as fully as you comfortably can. Hold the inhaler upright, place mouthpiece in the mouth, close lips tightly around the mouthpiece,
    (2) while breathing in deeply and slowly, press down on the cartridge and hold your breath as long as you can while the inhaler is still in your mouth,
    (3) take your finger off the cartridge, remove the mouthpiece from your mouth, and breathe out gently. Wait one minute between puffs and repeat steps 2-4 if indicated,
    (4) rinse your mouth or gargle after the dose is complete,
    (5) clean the inhaler at least weekly by wiping the mouthpiece of the inhaler with a clean, dry tissue or cloth, and
    (6) discard the inhaler after the date calculated by your physician or pharmacist.for inhalation