Beclometasone
An inhaled corticosteroid prodrug used as a preventer in asthma and sometimes COPD; nasal and skin forms also exist.
Also called beclomethasone (US spelling) or BDP (abbreviation for beclometasone dipropionate).
Drug card
- How it works
- Activating glucocorticoid receptors to switch off airway inflammation
- Used for
- Maintenance treatment to prevent asthma
- COPD (sometimes, often with formoterol)
- Allergic rhinitis (nasal spray)
- Eczema (cream or ointment)
- Known for
- Oral thrush (candidiasis)
- Hoarse voice and sore throat
- Its name
- -metasone, -methasone means a corticosteroid (dexamethasone type)
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does beclometasone work?
Given as the dipropionate, a prodrug that is rapidly hydrolyzed to the active 17-monopropionate (17-BMP), which binds the glucocorticoid receptor about 13 times more strongly than dexamethasone. The activated receptor enters the nucleus and changes gene expression, cutting proinflammatory cytokine production in the airways.
Like other inhaled corticosteroids: Inhaled corticosteroids enter airway cells and bind the glucocorticoid receptor, which moves to the nucleus and changes gene expression: anti-inflammatory proteins rise and cytokines and other mediators fall, so fewer mast cells, eosinophils and lymphocytes inflame the airway. Benefit builds over days to weeks, not at once. Inhaled, they act strongly where they land with little whole-body effect.
Uses
What is beclometasone used for?
- Maintenance treatment to prevent asthma
- COPD (sometimes, often with formoterol)
- Allergic rhinitis (nasal spray)
- Eczema (cream or ointment)
Side effects
Side effects of beclometasone
- Oral thrush (candidiasis)Known for
- Hoarse voice and sore throatKnown for
- Headache
- Adrenal suppression at high dosesSerious
- Cushing-like features at high dosesSerious
- Slower growth in children
- Lower bone mineral density
- Glaucoma (raised eye pressure)Serious
- Cataracts
- Worse infections, severe chickenpox or measlesSerious
- Paradoxical bronchospasmSerious
- Allergic reactions: hives, angioedema, rashSerious
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- It is not for acute attacks or status asthmaticus; a reliever is needed for those.
- Moving from oral steroids needs a slow taper, as the adrenal glands may be suppressed.
- Tuberculosis, fungal, viral or eye herpes infections can worsen; chickenpox and measles can be severe.
- Some inhalers contain a little alcohol, which matters with disulfiram or metronidazole.
Good to know: A prodrug activated by hydrolysis; in one inhaler with formoterol it can serve as both preventer and reliever in asthma.
Remember it
A way to remember it
Steroid in the lungs, thrush on the tongue.
Some of each dose stays in the mouth and throat, so oral thrush and a hoarse voice are the classic local side effects; rinsing the mouth afterwards lowers the risk.
Written for biofideX
Its name
-metasone, -methasone means corticosteroid (dexamethasone type)
Dexamethasone, betamethasone, beclometasone and mometasone share it; WHO files it under pred. US names keep the h (beclomethasone). Fluticasone ends in -casone.
- Every drug name stem
Its class
Inhaled corticosteroids
Other inhaled corticosteroids with a card:
Easily mixed up with glucocorticoids, long-acting beta-2 agonists and leukotriene receptor antagonists.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
- Beclomethasone dipropionate HFA inhalation aerosol: label (DailyMed)
- Beclomethasone dipropionate (NCI Thesaurus)
- Beclometasone inhalers (NHS)
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Lungs and allergy
Beclometasone is one of 16 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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