Beclomethasone Dipropionate BP
(50mcg and 100mcg per actuation) Aqueous Nasal
Spray
Presentation
Beconase Aqueous Nasal Spray is a
presentation of an aqueous suspension of microfine
beclomethasone dipropionate delivered by a metering, atomising
pump. Each 100mg spray delivered by the nasal applicator
contains 50mcg Beclomethasone Dipropionate BP.
Beconase 100 Aqueous Nasal Spray
is a presentation of an aqueous suspension of microfine
beclomethasone dipropionate delivered by a metering, atomising
pump. Each 100mg spray delivered by the nasal applicator
contains 100mcg Beclomethasone Dipropionate BP.
Indications
Prophylaxis and treatment of
perennial and seasonal allergic rhinitis including hayfever,
and vasomotor rhinitis.
Beconase and Beconase 100 Aqueous
Nasal Spray can significantly delay the recurrence of nasal
polyps in those patients who have undergone nasal polypectomy.
In those polyps that do recur, Beconase and Beconase 100
Aqueous Nasal Spray can suppress their increase in
size.
Mode of action
Beclomethasone Dipropionate BP
has a potent anti-inflammatory effect within the respiratory
tract at doses which are not systemically
active.
Dosage and Administration
Beconase is for administration by
the intranasal route only.
Adults and Children over 6 years
of age:-
The recommended dose is 100mcg
into each nostril twice daily. A dosage regimen of 50mcg into
each nostril three or four times daily may be preferred. Total
daily administration should not normally exceed
400mcg.
For full therapeutic benefit
regular usage is essential.
The co-operation of the patient
should be sought to comply with the regular dosage schedule
and it should be explained that maximum relief may not be
obtained within the first few applications.
Children under six years
old:-
There are insufficient clinical
data to recommend use.
Contra-indications
Beconase Aqueous Nasal Spray is
contra-indicated in patients with a history of
hypersensitivity to any of its components.
Precautions
Infections of the nasal passages
and paranasal sinuses should be appropriately treated but do
not constitute a specific contra-indication to treatment with
Beconase Aqueous Nasal Spray.
Care must be taken while
transferring patients from systemic steroid treatment to
Beconase Aqueous Nasal Spray if there is any reason to suppose
that their adrenal function is impaired.
If recommended doses of
intranasal beclomethasone are exceeded or if individuals are
particularly sensitive or predisposed by virtue of recent
systemic steroid therapies, systemic effects may occur
including reduction in growth velocity.
Although Beconase Aqueous Nasal
Spray will control seasonal allergic rhinitis in most cases,
an abnormally heavy challenge of summer allergens may in
certain instances necessitate appropriate additional therapy
particularly to control eye symptoms.
Pregnancy and lactation
Administration of medicines
during pregnancy should only be considered if the expected
benefit to the mother is greater than any possible risk to the
foetus.
There is inadequate evidence of
saftey of beclomethasone dipropionate in human pregnancy. In
animal reproduction studies adverse effects typical of potent
corticosteroids are only seen at high systemic exposure
levels; direct intranasal application ensures minimal systemic
exposure.
Lactation:
No specific studies examining the
transference of beclomethasone dipropionate into the milk of
lactating animals have been performed.
It is reasonable to assume that
beclomethasone dipropionate is secreted in milk but at the
dosages used for direct intranasal application, there is low
potential for significant levels in breast milk. The use of
beclomethasone dipropionate in mothers breast feeding their
babies requires that the therapeutic benefits of the medicine
be weighed against the potential hazards to the mother and
baby.
Side Effects
Extremely rare cases of nasal
septal perforation have been reported following the use of
intranasal corticosteroids.
As with other nasal sprays,
dryness and irritation of the nose and throat, unpleasant
taste and smell and epistaxis have been reported
rarely.
Rare cases of raised intraocular
pressure or glaucoma in association with intranasal
formulations of beclomethasone have been reported.
Hypersensitivity reactions
including rashes, urticaria, pruritis, erythema and oedema of
the eyes, face, lips and throat have been
reported.
Interactions
Nil.
Overdosage
The only harmful effect that
follows inhalation of larger amounts of the medicine over a
short time period is suppression of
hypothalamic-pituitary-adrenal (HPA) function. No special
emergency action need be taken. Treatment with Beconase
Aqueous Nasal Spray should be continued at the recommended
dose. HPA function recovers in a day or two.
Pharmacokinetics
Beclomethasone 17,21-dipropionate
(BDP) administered intravenously is cleared rapidly with a
half life of approximately 30 minutes.
Beclomethasone 17-monopropionate
(BMP) appears rapidly in the plasma after intravenous BDP and
is itself cleared with a half life again of about 30 minutes.
BDP is bound to plasma proteins to the extent of
87%.
Up to 14% of an intravenous dose
of BDP is excreted in the urine in 96 hours, mainly as polar
metabolites a proportion of which are conjugated. Up to 64% of
the dose is excreted in faeces in this time, again primarily
as free and conjugated metabolites.
After intranasal administration
of BDP an undefined fraction of the dose is absorbed by the
nasal mucosa. The remainder, after being cleared from the
nose, either by drainage or mucociliary clearance, is
swallowed and is available for absorption from the
gastrointestinal tract. An intranasal dose of 200mcg BDP did
not produce measurable concentrations of BDP in plasma (limit
of quantitation 100pg/mL).
There is rapid metabolic
inactivation of the majority of the swallowed portion of BDP
during its first passage through the liver.
An oral dose (4mg) of tritium
labelled BDP was absorbed slowly with peak levels of
radioactivity equivalent to 20ng BDP/mL plasma being reached 5
hours after dosing. Excretion was mainly in the faeces (35-76%
of the dose in 96 hours) and primarily as polar metabolites
although the presence of BDP and BMP in faeces suggested
incomplete absorption of the dose. Up to 14% of the dose was
excreted as polar metabolites in urine.
The nasal mucosa is not known to
contain any enzymes capable of metabolising BDP. The liver
metabolises BDP to BMP and further converts it to polar
metabolites.
Pharmaceutical Precautions
Shake before use.
Shelf life
24 months
Storage conditions
Store below 25°C. Do not
refrigerate.
Discard three months after first
using the spray.
Package quantities
Beconase and Beconase 100 Aqueous
Nasal Spray are supplied in amber glass bottles fitted with a
metering, atomising pump and nasal applicator. Each bottle
contains 22 grams of suspension.