Beclomethasone

What Does Beclomethasone Do?

Beclomethasone is a corticosteroid medication primarily utilised for treating inflammatory conditions in the lungs' airways. It is beneficial in managing conditions such as asthma, allergic rhinitis or hay fever, and nasal polyps by reducing inflammation, which aids in preventing asthma attacks, reducing sneezing, nose congestion, and shrinking nasal polyps. Additionally, it has off-label uses for conditions such as eczema, psoriasis, and contact dermatitis.

How Does Beclomethasone Work? (the complicated stuff)

Beclomethasone operates by binding to glucocorticoid receptors in cells, initiating various anti-inflammatory responses. It curbs the release of inflammatory cytokines, chemokines, and mediators, reducing the influx of immune cells to inflammation sites. Consequently, inflammation, swelling, and mucus production in airways and nasal passages are minimised. It is basically a steroid that reduces inflammation. 

Drug Type and Category of Beclomethasone

Beclomethasone is classified as a corticosteroid medication.

What dosage of Beclomethasone should you be taking?

According to the NICE guidelines ¹, the recommended dosage of beclomethasone dipropionate for the treatment of asthma is:

Adults and children 12 years and older:

• Initial dose: 40 to 80 micrograms (mcg) twice daily
• Maintenance dose: After 2 weeks, may increase dose for additional asthma control; after stability is achieved, titrate to the lowest effective dose to reduce side effects
• Maximum dose: 320 mcg twice daily

Children 4 to 11 years:

• Initial dose: 40 mcg twice daily
• Maintenance dose: After 2 weeks, may increase to 80 mcg twice daily for additional control; after stability, titrate to lowest effective dose
• Maximum dose: 80 mcg twice daily

The NICE guidelines also advise that the onset of symptom improvement is variable but may occur within 24 hours, with maximum benefit in 3-4 weeks. It is important to regularly assess lung function and oral cavity for candidiasis, and wean off oral corticosteroids slowly when starting inhaled beclomethasone.

What are the side-effects of Beclomethasone?

Beclomethasone can cause a range of side effects. These can be categorised into common, less common, and serious side effects.

Common Side Effects

• Oral Thrush: A fungal infection characterised by white patches in the mouth.
• Hoarseness: Changes in voice quality.
• Sore Throat: Dryness or irritation in the throat.
• Cough: Persistent coughing may occur.
• Nasal Irritation: Symptoms can include stuffy or runny nose and sneezing.
• Headache: A frequent complaint among users.

Less Common Side Effects

• Cramps: Abdominal discomfort or cramping.
• Skin Rash: Possible allergic reactions manifesting as rashes.
• Changes in Mood: Including depression or anxiety.
• Vision Changes: Such as blurred vision or eye pain.

Serious Side Effects

• Allergic Reactions: Symptoms may include hives, difficulty breathing, and swelling of the face or throat.
• Adrenal Insufficiency: Signs include extreme tiredness, weakness, and nausea.
• Increased Eye Pressure: Symptoms can include blurred vision or seeing halos around lights, potentially indicating glaucoma or cataracts.
• Severe Infections: Beclomethasone may mask signs of infection, and users are at a higher risk of infections.
• Behavioral Changes: Including severe mood swings or thoughts of self-harm.

Although inhaled rather than oral, if taken at high doses, long term issues include osteoporosis, weakened immune system, and adrenal suppression. 

Drug Interactions

Some known interactions of Beclomethasone includes :

1. Other corticosteroids: Using multiple corticosteroids simultaneously can increase the risk of side effects like weakened immune function, osteoporosis, and adrenal suppression.
2. Immunosuppressants: Beclomethasone may enhance the effects of immunosuppressants, increasing the risk of infections.
3. Live vaccines: Immunosuppression from beclomethasone can reduce the efficacy of live vaccines and increase the risk of vaccine-induced infections.
4. Antifungal agents (e.g., ketoconazole): These can increase the levels of beclomethasone in the blood, heightening the risk of systemic side effects.
5. HIV protease inhibitors (e.g., ritonavir): These can also increase beclomethasone levels, potentially leading to Cushing's syndrome and adrenal suppression.
6. Macrolide antibiotics (e.g., erythromycin): These can increase the concentration of beclomethasone in the bloodstream, potentially enhancing side effects.
7. Barbiturates and anticonvulsants (e.g., phenobarbital, phenytoin): These may decrease the effectiveness of beclomethasone by increasing its metabolism.

Natural Alternatives to Beclomethasone

There are several natural alternatives that may help manage asthma symptoms, but it's important to consult with a healthcare provider before making any changes to your treatment plan. Here are a few options that have shown some potential benefits:

Herbal Remedies

• Boswellia: Also known as Indian frankincense, boswellia contains anti-inflammatory compounds that may help reduce asthma symptoms.
• Ginger: Ginger has anti-inflammatory and antioxidant properties that may provide relief for some people with asthma.
• Butterbur: This herb contains compounds that may act as natural leukotriene inhibitors, similar to some prescription asthma medications.

Dietary Supplements ²

Vitamin D, omega-3 fatty acids, and magnesium are all nutrients that may play a role in asthma management. Some studies suggest that vitamin D supplements could help improve lung function and reduce the frequency of asthma exacerbations. Omega-3 fatty acids, commonly found in fish oil, have anti-inflammatory properties that might benefit people with asthma by reducing airway inflammation. 

Additionally, low levels of magnesium have been linked to more severe asthma symptoms, and supplementing with magnesium may offer a modest improvement in lung function. These nutrients, when included as part of a broader asthma management plan, could contribute to better respiratory health.

Lifestyle Changes ²

Breathing exercises can be beneficial for managing asthma symptoms. Techniques like the Buteyko method and pursed lip breathing are designed to help control breathing patterns, potentially reducing the frequency and severity of asthma attacks for some individuals.

Alongside these exercises, stress reduction is also crucial in managing asthma. Chronic stress has been shown to exacerbate asthma symptoms, making stress management practices such as yoga, meditation, and deep breathing valuable tools for those with asthma. These practices not only promote relaxation but also help in improving overall respiratory function, contributing to better asthma control.

Interesting facts about Beclomethasone

Beclomethasone dipropionate, the form used in inhalers, is a prodrug. This means it is converted into its active form, beclomethasone-17-monopropionate (17-BMP), in the lungs, where it exerts its effects.

Besides its inhaled form, beclomethasone is also available as a nasal spray for treating allergic rhinitis and as a cream or ointment for treating skin conditions like eczema

Disclaimer

This article is generated for informational purposes only. It was created in December 2024. Medications and medical guidance can change over time. Therefore, it is essential to consult with your general practitioner or healthcare provider before making any decisions regarding medications or treatment plans. Your GP can provide personalised advice based on your specific health needs and conditions.

References:

1. https://www.nice.org.uk/guidance/ng80/resources/inhaled-corticosteroid-doses-pdf-4731528781
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3245822/