1. Introduction
Beclometasone nasal spray, commonly marketed under brand names such as Beconase AQ, Qnasl, and Nasobec, is a corticosteroid used to manage allergic rhinitis, nasal polyps, and other inflammatory nasal conditions. It works by reducing inflammation and swelling in the nasal passages, relieving symptoms like congestion, sneezing, and runny nose.
2. Indications
- Approved Indications:
- Treatment of seasonal and perennial allergic rhinitis.
- Prevention and treatment of nasal polyps.
- Off-Label Uses:
- Non-allergic rhinitis with eosinophilia syndrome (NARES).
3. Dosage
- Adults and Children ≥12 years:
- 1–2 sprays in each nostril twice daily (total daily dose: 200–400 mcg).
- Children (6–12 years):
- 1 spray in each nostril twice daily (total daily dose: 200 mcg).
- Maximum dose should not exceed 400 mcg per day.
4. Administration
- Shake the bottle gently before each use.
- Prime the spray by releasing 5–10 sprays before first use or if unused for 7 days.
- Tilt the head slightly forward, insert the nozzle into the nostril, and spray while inhaling gently.
- Avoid spraying directly onto the nasal septum.
- Clean the nozzle regularly with a clean tissue or warm water.
5. Forms Available
- Nasal spray: 50 mcg per spray (200 sprays per bottle).
6. Side Effects
6.1. Common Side Effects
- Nasal irritation or dryness.
- Sneezing.
- Unpleasant taste or smell.
6.2. Less Common Side Effects
- Nosebleeds (epistaxis).
- Headache.
6.3. Rare but Serious Side Effects
- Nasal septum perforation (rare, with prolonged use).
- Hypersensitivity reactions, including rash and swelling.
- Glaucoma or cataracts with long-term use.
7. Warnings
- Do not use in the presence of untreated localised nasal infections, such as herpes simplex.
- Caution in patients with a history of nasal septum ulcers or surgery.
- Long-term use may increase the risk of systemic corticosteroid effects, including adrenal suppression.
8. Precautions
- Avoid use in patients with a known hypersensitivity to beclometasone or other corticosteroids.
- Use with caution in patients prone to recurrent nosebleeds.
- Regularly monitor intraocular pressure in patients with a history of glaucoma or cataracts.
9. Interactions
- Drug-Drug Interactions:
- Strong CYP3A4 inhibitors (e.g., ritonavir, ketoconazole) may increase the risk of systemic corticosteroid effects.
- Drug-Food Interactions:
- No significant interactions.
10. Monitoring Parameters
- Symptom improvement within 1–2 weeks of therapy.
- Signs of nasal infection or irritation.
- Regular monitoring for adverse effects with long-term use.
11. Use in Children
- Approved for children aged 6 years and above for allergic rhinitis.
- Monitor for potential growth suppression with prolonged use.
12. Use in Pregnancy
- Generally considered safe in pregnancy.
- Use only if the potential benefits outweigh the risks, especially in the first trimester.
- Uncontrolled allergic rhinitis poses greater risk to maternal and foetal health than the nasal spray.
13. Use in Elderly
- No specific dosage adjustments required.
- Monitor for long-term corticosteroid-related side effects, such as glaucoma or cataracts.
14. Use in Kidney Disease
- No dose adjustments required; systemic absorption is minimal.
15. Use in Liver Disease
- No dose adjustments required; systemic absorption is minimal.
16. Patient Counselling Points
- Explain how to use the spray correctly, including priming and cleaning.
- Advise patients to use the spray regularly for maximum benefit, even if symptoms improve.
- Highlight the importance of avoiding nasal irritants (e.g., smoke) during treatment.
- Inform patients about the possibility of mild nosebleeds and advise reporting persistent or severe symptoms.
- Store at room temperature and keep the bottle upright.
17. Table of Brand Names, Manufacturers, and Prices
Brand Name | Manufacturer | Price (USD) |
---|---|---|
Beconase AQ | GlaxoSmithKline | $35 (200 sprays) |
Qnasl | Teva Pharmaceuticals | $50 (120 sprays) |
Nasobec | Various | $25 (200 sprays) |
Generic Options | Various | $15–20 (200 sprays) |
18. FAQs (15 Questions)
- What is beclometasone nasal spray used for?
It is used to treat and prevent allergic rhinitis and manage nasal polyps. - How does beclometasone nasal spray work?
It reduces inflammation in the nasal passages, relieving symptoms like congestion and sneezing. - Can I use beclometasone nasal spray during an acute cold?
Yes, but it is more effective for chronic conditions like allergies than for acute nasal congestion. - What are the common side effects of beclometasone nasal spray?
Nasal irritation, sneezing, and an unpleasant taste. - Are there any serious side effects?
Rarely, nasal septum perforation and glaucoma can occur with prolonged use. - Can children use beclometasone nasal spray?
Yes, it is approved for children aged 6 and above with proper supervision. - Is beclometasone nasal spray safe during pregnancy?
Yes, it is generally considered safe when used at the lowest effective dose. - How should I store my nasal spray?
Store upright at room temperature, away from direct sunlight. - What happens if I miss a dose?
Use it as soon as you remember, but do not double the dose. - Can I use beclometasone nasal spray long-term?
Yes, but regular monitoring is advised to minimise risks like nasal irritation. - Does beclometasone nasal spray interact with other medicines?
Yes, strong CYP3A4 inhibitors can increase systemic absorption. - Can beclometasone nasal spray cause nosebleeds?
Yes, mild nosebleeds are a possible side effect, particularly with improper use. - How long does it take for beclometasone nasal spray to work?
Symptoms typically improve within a few days, with full benefits seen in 1–2 weeks. - Do I need a prescription for beclometasone nasal spray?
In many regions, it is available by prescription, though some forms may be over-the-counter. - Can I stop using the spray once my symptoms improve?
No, continue using it as prescribed to maintain symptom control.