Dictionary of Allergies .. Beclomethasone nasal aerosol ρινικό αερονεφέλωμα μπεκλομεθαζόνης

This is an insoluble powder in suspension delivered by a freon propellant marketed as Vancenase, Schering Corp. Kenilworth, N.J., U.S.A. and Beconase, Glaxo Pharmaceutical  Research Triangle Park, N.C. (USA). With this nasal steroid aerosol it is possible to be expressed some systemic absorption. However, significant systemic effect has not been demonstrated even after topical  application of beclomethasone to the respiratory mucosa in doses much larger than those recommended for therapy. The onset of action of  beclomethasone is slow, with effects not demonstrable until 4 to 7 days or more after the beginning of the therapy. After the achievement  of the results the starting dose of one spray in each nostril, up to four times daily for an adult (and children age 12 and older), should be gradually decreased to the lowest maintenance level that will control symptoms, and continued throughout the period of expected severe allergen exposure. Potential local side effects are nasal bleeding, crusting etc. It is not recommended, this preparation to be continued on a long-term basis without periodic examination by a physician. Inhaled beclomethasone on patients with severe symptomatic rhinosinusitis and nasal polyposis, produces usually no improvement of the symptoms. Intranasal beclomethasone is not effective in chronic severe symptomatic rhinosinusitis [1].

Asthma and allergic rhinitis (AR) form a well-recognized comorbidity. Camargos PAet al (2004) assessed  the efficacy of nasally inhaled beclomethasone dipropionate (BDP) in their simultaneous treatment. A randomized controlled trial was conducted with 78 allergic rhinitis and asthma patients aged 5-17 years. Seventy-five individuals completed the study. During 8 weeks, 38 subjects received BDP-CFC aerosol (>or= 500 mcg/day) exclusively via nasal inhalation through a facemask attached to a plastic valved spacer.

The control group (37 patients) received 200 mcg/day of aqueous intranasal beclomethasone plus oral inhalation of BDP-CFC (>or= 500 mcg/day) through a mouthpiece connected to the same spacer. Primary outcomes analyzed in order to assess the response to treatment were clinical scoring for allergic rhinitis and measurements of nasal inspiratory peak flow (NIPF). AR clinical scoring and NIPF did not differ in the two groups at admission or at nearly all follow-up visits. Nasal inhalation of beclomethasone dipropionate provides AR symptom relief while maintaining control of asthma by delivering it to the lungs. Therefore, this therapeutic strategy might be considered for patients suffering from this comorbidity, especially in low-resource countries, since it is less expensive than the conventional treatment [2].  See:  Becotide, Beclovent, Beconase.

References

1. Krause, H.A. et al: Intranasal beclomethasone in severe rhinosinusitis and nasal polyps. Ann. Allergy 50:385 (1983).

2. Camargos PA, Rodrigues ME, Lasmar LM. Simultaneous treatment of asthma and allergic rhinitis. Pediatr Pulmonol.2004 Sep;38(3):186-92 .