Generic drug of the therapeutic class: Pneumology
active ingredients: Beclometasone
laboratory: IVAX PHARMACEUTICALS SAS
Solution for oral inhalation
Pressurized bottle of 200 doses
Continuous anti-inflammatory treatment of persistent asthma *:
* persistent asthma is defined as the presence of multi-weekly diurnal symptoms and / or nocturnal symptoms more than twice a month.
In mild, persistent childhood asthma, in the absence of definitive data on the effects on growth and bone metabolism of inhaled corticosteroids, it is desirable to initiate ongoing by a cromone before passing, in case of failure, an inhaled corticosteroid treatment.
Dosage BECLOMETASONE MERCK 50 μg / dose Solution for oral inhalation Pressurized bottle of 200 Doses
The dosage is strictly individual. The initial dose will be determined according to the severity of the disease before treatment and will then be adjusted according to the individual results. The minimum effective dosage should always be sought.
For information :
- in mild to moderate persistent asthma the recommended initial dose is between :
. in adults: 500 and 1000 μg per day,
. in children: 250 and 500 μg per day.
(Light persistent asthma is defined as the presence of daytime symptoms more than once a week and less than once a day and / or nocturnal symptoms more than twice a month, PEG or FEV1> 80% predicted values, variability of DEP * between 20 and 30%.
Moderate persistent asthma is defined as the presence of daily diurnal symptoms, seizures affecting activity and sleep, nocturnal asthma symptoms more than once a week, daily use of inhaled beta-2 mimetics. short-term action, PEF or FEV1 between 60 and 80% predicted values, variability of DEP * greater than 30%).
- in severe persistent asthma the recommended starting dose is up to :
. in adults: 2000 μg per day,
. in children: 1000 μg per day.
(Severe persistent asthma is defined as permanent symptoms, frequent seizures, frequent nocturnal asthma symptoms, physical activity limited by asthma symptoms, PEG or FEV1 less than 60% of predicted, variability of DEP * greater than 30%).
* The variability of the DEP is evaluated on the day: (evening DEP - morning DEP) / 1/2 (evening DEP + morning DEP), or over a week.
Note: this dosage is not suitable for moderate and severe asthma. More strongly dosed forms should be preferred.
Rhythm of administration:
- The daily dose can be divided into 2 doses per day.
- In case of unstable asthma, the dose and the number of doses should be increased until a dose of 3 to 4 doses per day depending on the patient's clinical condition.
Administration mode :
- Inhalation by dispenser with mouthpiece.
For correct use, it is desirable that the doctor ensures the proper use of the device.
If the patient is shown to have a poor hand / lung synchronization preventing the coordination of the inspiration / release movements of the apparatus, the use of an inhalation chamber is indicated.
- After shaking the device and removing the cap, the patient should:
. to exhale deeply,
. present the mouthpiece at the entrance of the mouth, the bottom of the metal cartridge directed upwards,
. start to inhale by pressing on the metal cartridge while continuing to inhale slowly and deeply,
. remove the mouthpiece and hold it for at least 10 seconds.
- The mouthpiece of the propulsion unit must, for hygienic reasons, be cleaned after use.
Intolerance to this medication (occurrence of cough or bronchospasm after inhalation of the product). In this case, this treatment should be discontinued and other therapies or other forms of administration prescribed.
Adverse effects Beclometasone Merck
- Local effects:
. Possibility of occurrence of oropharyngeal candidiasis. It usually gives way spontaneously or to appropriate treatment and it is exceptional that it requires the discontinuation of inhaled corticosteroid therapy. Its risk of appearance increases with the dose used and the number of shots. It can be prevented by rinsing the mouth with water after inhalation.
. Possibility of occurrence of pharyngeal discomfort, dysphonia, hoarseness of the voice can be prevented by rinsing the mouth after inhalation of the product.
. As with other inhaled products, possibility of coughing and, rarely, bronchospasm following inhalation. In this case, treatment should be discontinued and other therapies or other forms of administration prescribed.
- Systemic effects:
Above 1000 μg per day in adults and 500 μg in children, the risk of systemic effects related to inhaled corticosteroid therapy is minimal but can not be excluded. Inhalant corticosteroids have been described with observations of cutaneous thinning, subcutaneous hematomas, depression of adrenal biological functions (decrease in plasma cortisol and 24-hour cortisoluria) and bone scarcity. The clinical consequences of long-term administration, particularly on bone tissue and growth, are unclear.
The administration of large doses in the long term may therefore require monitoring, especially in children and the elderly.
In the current state of knowledge, although the search for the minimum effective dosage is always recommended, the risk to consider as a priority is that of insufficient control of asthma and should always be weighed against that of systemic impact.