Intranasal Corticosteroid Pregnancy: There is inadequate evidence of safety in human pregnancy; corticosteroids given to pregnant animals can cause abnormalities of foetal development, so there may be a very small risk in the human foetus, although intranasal delivery minimises systemic exposure. Use should be avoided during pregnancy unless thought essential by the doctor. In breast-feeding it is reasonable to assume beclometasone dipropionate is secreted in milk, but at intranasal doses there is low potential for significant levels; therapeutic benefit must be weighed against potential hazards to mother and baby.

Beclometasone Dipropionate Nasal Spray

Brand names: Beconase, Pollenase

Used in: COPD

Beclometasone dipropionate nasal spray is a topical intranasal corticosteroid used to prevent and treat the symptoms of seasonal and perennial allergic rhinitis.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Two sprays into each nostril twice daily (400 micrograms/day)

Route: Intranasal (administration by the intranasal route only)

Frequency: Twice daily (morning and evening)

Max: Total daily administration should not normally exceed eight sprays

Dose applies to adults and children over six years of age. Once control has been established it may be possible to maintain control with fewer sprays - a regimen of one spray into each nostril morning and evening has been shown to be efficacious in some patients; should symptoms recur, patients should revert to two sprays into each nostril morning and evening. The minimum dose at which effective control of symptoms is maintained should be used. Regular usage is essential for full therapeutic benefit, and it should be explained to the patient that maximum relief may not be obtained within the first few applications. For children under six years old there are insufficient clinical data to recommend use. Source product: Beconase Aqueous Nasal Spray (UK SPC).

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to beclometasone dipropionate or to any of the excipients

Side effects

Unpleasant taste and unpleasant smell (common)
Epistaxis, nasal dryness, nasal irritation, throat dryness and throat irritation (common)
Hypersensitivity reactions including rash, urticaria, pruritus and erythema; angioedema; dyspnoea and/or bronchospasm; anaphylactoid/anaphylactic reactions (all very rare)
Nasal septum perforation (very rare)
Glaucoma, raised intraocular pressure and cataract (very rare); blurred vision (frequency not known)

Interactions

Beclometasone is less dependent on CYP3A metabolism than some other corticosteroids and in general interactions are unlikely (SPC section 4.5 is truncated in the fetched source - clinician to review the full section 4.5 on the eMC)

Clinical monograph

How it works

Delivered locally to the nasal mucosa, it acts on glucocorticoid receptors to suppress inflammatory mediators and reduce mucosal inflammation, oedema and hypersecretion.

Prescribing in practice

Direct the spray slightly outward, away from the nasal septum, and review with prolonged use, as local irritation, crusting, epistaxis and rarely nasal septal perforation can occur.
Maximum benefit develops over days of regular use, so it should be taken continuously rather than as required.
Systemic absorption is low at recommended doses, but prolonged or high-dose intranasal corticosteroid use warrants attention to cumulative steroid burden, particularly in children where growth should be monitored.

Monitoring

Inspect the nasal mucosa periodically with prolonged use and monitor growth in children on long-term therapy.

Counselling the patient

Use it every day, as it works by preventing inflammation and takes a few days to reach full effect.
Aim the nozzle slightly towards the outer wall of the nostril, not the central wall, to reduce nosebleeds.
Report persistent nosebleeds, crusting or nasal discomfort to your team.

Evidence & guidelines

NICE and allergy guidelines recommend intranasal corticosteroids as the most effective single therapy for moderate-to-severe allergic rhinitis.

Reference: BSACI Rhinitis Guidelines 2017; NICE NG28 (Sinusitis); SIGN 134; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

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