Beclomethasone - instructions for use, dose, side effects, contraindications

Has a retarding effect on the release of mediators of inflammation, enhances the production of lipomodulin inhibitor of phospholipase A, reduces the release of arachidonic acid, inhibits the synthesis of prostaglandins.

It prevents the accumulation of neutrophils, thereby reducing the formation of inflammatory exudates and the production of lymphokines. Beclethethasone inhibits the migration of macrophages, which leads to a slowing down of the processes of infiltration and granulation.

Beclomethasone reduces the number of mast cells in the bronchial mucosa, reduces the epithelial edema and the secretion of mucus by the bronchial glands. It causes relaxation of the smooth muscles of the bronchi, reduces their hyperreactivity and improves the function of external respiration.

The drug increases the number of active beta-adrenergic receptors, restores the patient's response to bronchodilators, thereby reducing the frequency of their use.

The drug does not have a mineralocorticoid effect.

As a rule, in therapeutic doses beclomethasone does not have side effects, characteristic of systemic glucocorticosteroids.

The therapeutic effect usually develops after 5-7 days of course use of beclomethasone.

With external and local application it has anti-edematous, anti-allergic and anti-inflammatory effects.

Pharmacokinetics:

When inhaled, the drug penetrates deep into the lungs. In the lungs of beclomethasone, dipropionate undergoes hydrolysis to beclomethasone monopropionate, which is then hydrolyzed to beclomethasone.

The active substance binds to plasma proteins by 87%.

The half-life of beclomethasone with intravenous administration is 30 minutes. Metabolites are excreted up to 64% with feces and up to 14% in urine for 96 hours.

Indications:

Infectious skin diseases - for topical use beclomethasone are used in combination with antimicrobial agents.

Treatment of bronchial asthma, bronchial asthma severe course.

Prevention and treatment of seasonal allergic rhinitis, including rhinitis in hay fever, vasomotor rhinitis.

ICD-10

VIII.H65-H75.H66 Purulent and unspecified otitis media

X.J30-J39.J30.0 Vasomotor rhinitis

X.J30-J39.J30.1 Allergic rhinitis caused by pollen of plants

X.J30-J39.J30.3 Other allergic rhinitis

X.J40-J47.J45 Asthma

XII.L20-L30.L30.3 Infectious dermatitis

Contraindications:

Tuberculosis, candidomycosis of the upper respiratory tract, pregnancy, hypersensitivity to beclomethasone.

Carefully:

Avoid contact with the eye.

With moderate and severe bronchial obstructive syndrome, it is recommended to use bronchodilators 15-20 minutes prior to inhalation.

It is used with caution in patients with signs of hypothalamic-pituitary-adrenal insufficiency. It is necessary to continue inhalations necessarily controlling the level of basal cortisol in the blood plasma. The same control is needed when using high doses of beclomethasone (1500 μg or more).

It should be inhaled before eating and rinse your mouth after each inhalation to reduce the likelihood of oropharyngeal candidiasis.

Pregnancy and lactation:

Strict contraindications in the first trimester of pregnancy.

Application in the II and III trimesters of pregnancy is possible only if it is assumedMay, the benefit to the mother exceeds the potential risk to the fetus.Newborns, whose mothers received beclomethasone during pregnancy, should be carefully examined about the insufficiency of adrenal function.

If you need to use during lactation with the doctor in charge, you should decide whether to stop breastfeeding.

Dosing and Administration:

For external and local administration, the dose depends on the indications and the drug dosage form used.

The average dose for adults with inhalation is 400 μg 2-4 times a day. If necessary, the dose may be increased to 1 g per day.

For children, a single higher dose for inhalation administration is 100 μg.

Side effects:

Allergic reactions: rashes, hives, itching;

Edema: eye, face, lips and throat.

From the respiratory system: hoarseness, irritation in the throat; rarely - cough, eosinophilic pneumonia, paradoxical bronchospasm, with intranasal application - perforation of the nasal septum.

With prolonged use, it is possible to develop candidiasis of the oral cavity and upper respiratory tract.

Effects due to systemic action: decreased function of the adrenal cortex, osteoporosis, cataract, glaucoma,stunted growth in children.

Overdose:

Symptoms: nausea, vomiting, sleep disorders, euphoria, agitation, depression.

Treatment: against the background of a gradual withdrawal of the drug - maintenance of vital functions, correction of electrolyte balance, antacids, phenothiazines, preparations of Li⁺; with the syndrome of Itenko-Cushing - aminoglutethimide.

With long-term treatment with high doses of the drug, it is possible to develop osteoporosis, increase blood pressure and other signs of hypercorticism (including Isenko-Cushing syndrome).

Interaction:

The use of beclomethasone together with other preparations of SCS suppresses the function of the adrenal cortex.

The use of beta-adrenostimulants can enhance the action of beclomethasone.

Special instructions:

Inhalants containing 1 dose of 250 μg beclomethasone are not suitable for children under 12 years of age.

The transfer of patients from internal SCS to inhalation forms can be performed only if the patient's condition is stable.

If there is a chance of developing a paradoxical bronchospasm: 10-15 minutes before the administration of beclomethasone, inhalation of bronchodilators (salbutamol).

With the development of candidiasis of the oral cavity and upper respiratory tract, local antifungal therapy is indicated without discontinuing beclomethasone treatment.

Instructions

Beclomethasone (Beclomethasonum)