Beclometasone Dipropionate Nasal Spray

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.