Corticosteroid (inhaled, nasal, topical, rectal) Pregnancy: Inadequate evidence of safety in human pregnancy; avoid during pregnancy unless thought essential by the doctor. Corticosteroids can cause foetal abnormalities in animals at high systemic exposure. In breast-feeding, weigh therapeutic benefit against potential hazards.

Beclometasone dipropionate

Brand names: Clenil Modulite, Qvar, Fostair (with formoterol), Beconase (nasal), Clipper (rectal)

Beclometasone dipropionate is an inhaled corticosteroid used for the regular preventive treatment of asthma and as part of inhaled COPD therapy.

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

Frequency: Twice daily

Max: Total daily administration should not normally exceed eight sprays

Product: Beconase Aqueous Nasal Spray (intranasal route only). Adults and children over six years of age. Once control is established, may be possible to maintain with fewer sprays — one spray into each nostril morning and evening has been efficacious in some patients; revert to recommended dosage if symptoms recur. Use the minimum dose that maintains effective control. Regular usage is essential; maximum relief may not be obtained within the first few applications. For children under six years, insufficient clinical data to recommend use.

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 the active substance or any of the excipients

Side effects

Unpleasant taste, unpleasant smell (common)
Epistaxis, nasal dryness, nasal irritation, throat dryness, throat irritation (common)
Hypersensitivity reactions including rash, urticaria, pruritus, erythema (very rare)
Glaucoma, raised intraocular pressure, cataract (very rare)
Nasal septum perforation (very rare)

Interactions

Beclometasone is less dependent on CYP3A metabolism than some other corticosteroids; in general interactions are unlikely

Clinical monograph

How it works

It is a glucocorticoid that, after local activation, suppresses airway inflammation by modulating gene expression to reduce inflammatory mediator production and cellular infiltration.

Prescribing in practice

Different inhaler formulations are not interchangeable on a like-for-like basis, so prescribe and switch by brand to avoid dosing errors.
It is a preventer requiring regular use and provides no immediate relief of acute bronchospasm.
Oral candidiasis and dysphonia can occur, and high cumulative inhaled exposure carries systemic corticosteroid risks.

Monitoring

Monitor asthma control, inhaler technique, and in children growth, alongside vigilance for local oropharyngeal effects.

Counselling the patient

Use every day as a preventer even when you feel well.
Rinse your mouth after inhaling to reduce thrush and hoarseness.
Carry your reliever inhaler for acute symptoms.

Evidence & guidelines

Inhaled corticosteroids are a cornerstone of asthma maintenance therapy in NICE and national asthma guidance.

Reference: BTS/SIGN Asthma 158 (2019); NICE NG80; SmPC Clenil/Qvar/Fostair/Clipper; 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.

Calculators

Pathways