Inhaled corticosteroids (ICS)
ATC code: R03BA01 (Beclomethasone)
Brand names
Qvar, Clenil Modulite
Prodrug converted to active beclomethasone 17-monopropionate with high glucocorticoid receptor affinity. Suppresses airway inflammation by inhibiting transcription of pro-inflammatory cytokines. Modern extra-fine formulations (Qvar, Clenil Modulite) provide small-airway deposition, important in asthma with distal obstruction. Systemic bioavailability after inhalation 1–2 %.
First line
Asthma controller per 2024. Starting dose 100–250 mcg twice daily, up to 500 mcg twice daily in severe asthma. Extra-fine HFA formulations (Qvar, Clenil) are considered equivalent to twice the dose of conventional CFC beclomethasone – important when converting and switching brands. Used as monotherapy or combined with formoterol.
Sources
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Beclomethasone is an inhaled or nasal corticosteroid. It is prescribed for asthma (inhaled) and allergic rhinitis (nasal). In Russia and the CIS, beclomethasone is regularly nebulized to adults and children for acute respiratory infections outside an asthma indication. No clinical studies of nebulization use for colds exist. The drug causes oropharyngeal candidiasis, hoarseness, and with systemic absorption at high doses adrenal suppression. If beclomethasone was prescribed via nebulizer for a cold, consider seeking a second opinion.
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FDA categories were retired in 2015. Do not withdraw ICS in pregnant asthma patients. Pregnancy data for beclomethasone are smaller than for budesonide — budesonide is preferred in ICS-naive patients.
Compatible with breastfeeding.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Beclomethasone dipropionate is evaluated for the following indications with varying evidence strength: Asthma (evidence tier A), Immune support and respiratory infection care (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Beclomethasone dipropionate (≥ 1 in 100): Oral candidiasis, Dysphonia, Throat irritation. See the Safety section for uncommon and serious reactions.
FDA category C. FDA categories were retired in 2015. Do not withdraw ICS in pregnant asthma patients. Pregnancy data for beclomethasone are smaller than for budesonide — budesonide is preferred in ICS-naive patients.
Compatible with breastfeeding.
Beclomethasone dipropionate is contraindicated in: Hypersensitivity; Active pulmonary tuberculosis; Systemic fungal infections. Full list in the Safety section.