Qvar (beclomethasone dipropionate)

The commercially available 7.3-g regular- or double-strength oral inhalation aerosol with tetrafluoroethane (non-CFC) propellant (QVAR(R)) delivers about 40 or 80 mcg of beclomethasone dipropionate per metered spray and provides 100 metered sprays. Dosage of orally inhaled beclomethasone dipropionate must be carefully adjusted according to individual requirements and response.

The recommended dosage of orally inhaled beclomethasone dipropionate administered via metered-dose aerosol with tetrafluoroethane (non-CFC) propellant (QVAR(R) is lower than that with inhalation aerosols containing CFC propellant (e.g., Beclovent(R), Vanceril(R), Vanceril(R) Double Strength; all no longer commercially available in the US), although a definitive comparative therapeutic ratio between non-CFC and CFC-containing beclomethasone preparations has not been demonstrated. The usual initial dosage of beclomethasone dipropionate oral inhalation aerosol with tetrafluoroethane (non-CFC) propellant (QVAR(R)) for adults and children 12 years of age or older in whom previous asthma therapy consisted of bronchodilators alone is 40 or 80 mcg twice daily. The usual initial dosage of the drug for adults and children 12 years of age or older in whom previous asthma therapy consisted of inhaled corticosteroids is 40-160 mcg twice daily. In children 5-11 years of age in whom previous asthma therapy consisted of bronchodilators alone or inhaled corticosteroids, the usual initial dosage of the drug is 40 mcg twice daily. After a satisfactory response is obtained, dosage should be decreased gradually to the lowest dosage that maintains an adequate clinical response, particularly in children, since inhaled corticosteroids have the potential to affect growth. (See Cautions: Pediatric Precautions.) The manufacturer of QVAR(R) states that the safety and efficacy of dosages exceeding 320 mcg twice daily in adults and children 12 years of age or older or 80 mcg twice daily in children 5-11 years of age have not been established.

Patients who respond to beclomethasone dipropionate oral inhalation usually show improvement in pulmonary function within 1-4 weeks of continuous therapy.

Beclomethasone dipropionate is administered by oral inhalation using an oral aerosol inhaler. Patients should be carefully instructed in the use of the oral inhaler. To obtain optimum results, patients should also be given a copy of the patient instructions provided by the manufacturer. An adult should carefully supervise a child in the administration of beclomethasone dipropionate for oral inhalation. The manufacturer states that beclomethasone dipropionate oral inhaler should be used by oral inhalation only. The manufacturer states that the regular- (40 mcg/metered dose) and double-strength inhalation aerosols with tetrafluoroethane (non-CFC) propellant (QVAR(R)) should be tested by spraying twice into the air before using the device for the first time or whenever the aerosol has not been used for more than 10 days.

Because the commercially available beclomethasone dipropionate oral inhalation aerosol with tetrafluoroethane (non-CFC) propellant (QVAR(R)) is formulated as a solution, it is not necessary to shake the inhaler prior to use. After exhaling as fully as is comfortable, the mouthpiece of the inhaler should be placed well into the mouth and the lips closed firmly around it, keeping the tongue below the mouthpiece. The patient should then inhale slowly and deeply through the mouth while pressing the metal canister down with the forefinger. After holding the breath for as long as possible (about 5-10 seconds), the mouthpiece should be removed and the patient should exhale gently. If additional inhalations are required, the patient should repeat the procedure. Following each treatment, the patient should rinse the mouth thoroughly with water to remove drug deposited in the oropharyngeal area. The patient instructions provided by the manufacturer should be referred to for further information regarding use of beclomethasone dipropionate for oral inhalation.

Weekly cleansing of the mouthpiece of the beclomethasone dipropionate oral inhaler is recommended. The mouthpiece should be cleaned using a clean, dry tissue or cloth. The patient should be instructed not to wash or place any part of the inhaler canister in water.

According to the manufacturer of beclomethasone dipropionate inhalation aerosol with tetrafluoroethane (non-CFC) propellant (QVAR(R)), lung deposition does not differ when the drug is administered with or without a spacer device, and administration with a spacer device is not necessary. However, the manufacturer states that the QVAR(R) inhaler is compatible with the AeroChamber(R) spacer device, which may be used if preferred by the clinician or patient.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

No enhanced messaging available.

Orally inhaled beclomethasone dipropionate should be used during pregnancy only when the potential benefits justify the possible risks to the fetus.

Although there are no adequate and controlled studies to date in humans, 20 asthmatic patients who became pregnant and were receiving oral inhalation of beclomethasone dipropionate at usual dosages delivered healthy children. Other women with severe asthma who received orally inhaled beclomethasone dipropionate during pregnancy to reduce systemic corticosteroid dosage requirements also delivered healthy children; however, a cardiac malformation was reported in an infant whose mother had complications and was receiving other drugs. Several of these pregnancies resulted in premature deliveries and low birthweight infants, but evidence of neonatal adrenal insufficiency was not observed. Infants born to women who received substantial doses of corticosteroids during pregnancy should be carefully monitored for manifestations of hypoadrenalism. Subcutaneous beclomethasone dipropionate has been shown to be teratogenic and embryocidal in mice and rabbits at dosages about one-half the maximum recommended daily inhalation dose in adults on a mg/m2 basis. Teratogenic effects in these animals included fetal resorption, cleft palate, agnathia, microstomia, aglossia, delayed ossification, and agenesis of the thymus gland. Teratogenic or embryocidal effects were not observed following oral inhalation of beclomethasone dipropionate at 190 times the maximum recommended daily human dosage on a mg/m2 basis or following oral administration at 1000 times the usual human dosage in rats.

Since corticosteroids are distributed into milk and potentially may cause serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or the drug, taking into account the importance of the drug to the woman.

No enhanced messaging available.