Adult Dosing
Asthma maintenance
- Prior bronchodilators alone
- Usual dose: 40-320 mcg INH bid
- Start 40-80 mcg INH bid
- Max: 640 mcg/day
Note: Titrate to lowest effective dose and rinse mouth after use
- Prior use of inhaled corticosteroids
- Usual dose: 40-320 mcg INH bid
- Start 40-160 mcg INH bid
- Max: 640 mcg/day
Note: Titrate to lowest effective dose and rinse mouth after use
- Prior oral steroid
- Usual dose: 40-320 mcg INH bid
- Max: 640 mcg/day
Note: Titrate to lowest effective dose and rinse mouth after use. Start varies based on oral steroid maintenance dose. Gradually taper oral steroids after >1wk
Bronchiectasis [Not FDA Approved]
Pediatric Dosing
Asthma maintenance
Prior bronchodilators alone
- 5-11 yrs
- Usual dose: 40-80 mcg INH bid
- Start 40 mcg INH bid
- Max: 160 mcg/day
- >12 yrs
- Usual dose: 40-320 mcg INH bid
- Start 40-80 mcg INH bid
- Max: 640 mcg/day
Note: Titrate to lowest effective dose and rinse mouth after use
Prior use of inhaled corticosteroids
- 5-11 yrs
- Usual dose: 40-80 mcg INH bid
- Start 40 mcg INH bid
- Max: 160 mcg/day
- >12 yrs
- Usual dose: 40-320 mcg INH bid
- Start 40-160 mcg INH bid
- Max: 640 mcg/day
Note: Titrate to lowest effective dose and rinse mouth after use
Prior oral steroid
- 5-11 yrs
- Usual dose: 40-80 mcg INH bid
- Max: 160 mcg/day
- >12 yrs
- Usual dose: 40-320 mcg INH bid
- Max: 640 mcg/day
Note: Titrate to lowest effective dose and rinse mouth after use. Start varies based on oral steroid maintenance dose. Gradually taper oral steroids after >1wk
[Outline]
See Supplemental Patient Information
- When shifting from systemic active corticosteroid to beclomethasone inhaler, closely monitor the patients, especially those who are suffering from asthma, as deaths due to adrenal insufficiency have occurred in these patients
- Instruct patients who have been withdrawn from systemic corticosteroids to resume oral corticosteroids (in large doses) immediately and to contact their physician during the period of stress or a severe asthmatic attack and also carry a warning card indicating that they may need supplementary systemic steroids in the periods of stress or a severe asthma attack
- Shifting from systemic steroid therapy to beclomethasone inhaler, can unmask allergic conditions like rhinitis, conjunctivitis, and eczema, previously suppressed by the systemic steroid therapy
- Use of corticosteroid can suppress the immune system and thus increase the susceptibility to infections like chickenpox and measles, hence particular care should be taken to avoid exposure in these patients
- If exposed to chickenpox, give prophylaxis with varicella zoster immune globulin (VZIG). If exposed to measles, give prophylaxis with pooled intramuscular immunoglobulin (IG) and consider antiviral treatment if chickenpox develops
- Beclomethasone inhaler is not indicated for rapid relief of bronchospasm, as it is not a bronchodilator
- Bronchospasm, with an immediate increase in wheezing can occur following dosing with beclomethasone inhaler. Immediately discontinue the therapy and treat with a short acting inhaled bronchodilator or oral corticosteroids
- Because of the possibility of systemic absorption of inhaled corticosteroids, HPA axis suppression can occur when recommended doses of beclomethasone inhaler are exceeded or in particularly sensitive individuals. Hence closely monitor the all the patients especially postoperatively or during periods of stress
- Hypercorticism and adrenal suppression occurs with systemic corticosteroid particularly at higher doses. If such changes occurs reduce beclomethasone inhaler slowly
- Reduction in growth velocity has been reported with beclomethasone inhaler when used in pediatric patients. Closely follow the growth of all pediatric patients taking corticosteroids by any route
- Use cautiously in all the patients with active or quiescent tuberculosis infections of the respiratory tract, untreated local or systemic fungal or bacterial infections, systemic viral or parasitic infections, or ocular herpes simplex
- Beclomethasone inhaler can cause cataracts, glaucoma, and increased intraocular pressure
Cautions: Use cautiously in
- Asthma
- Exposure to measles or chickenpox
- Pediatric patients
- Increased intraocular pressure
- Active or quiescent tuberculosis
- Untreated infection
- Ocular herpes simplex
- Cataracts
- Glaucoma
Supplemental Patient Information
- Instruct the patient to avoid exposure to chickenpox or measles
- Advice patient not to use for the treatment of asthma
- Advise patient not to abruptly withdraw the therapy, if there is need of discontinuation of therapy contact their physician
Pregnancy Category:C
Breastfeeding: The amounts of inhaled corticosteroids absorbed and excreted in breast milk are too small to affect a breastfed infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 19 April 2011). As per manufacturer data, Because of the potential for possible serious adverse reactions in nursing infants a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
US Trade Name(s)
US Availability
Qvar 40
Qvar 80
Canadian Trade Name(s)
Canadian Availability
Qvar 50
Qvar 100
UK Trade Name(s)
- Qvar 50
- Qvar 50 easi-breathe
- Qvar 50 autohaler
- Qvar 100
- Qvar 100 easi-breathe
- Qvar 100 autohaler
UK Availability
Qvar 50, Qvar 50 easi-breathe, Qvar 50 autohaler
Qvar 100, Qvar 100 easi-breathe, Qvar 100 autohaler
Australian Trade Name(s)
- Qvar
- Qvar autohaler inhaler
Australian Availability
Qvar, Qvar autohaler inhaler
- MDI: 50 mg/INH
- MDI: 100 mg/INH
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Qvar 40 MCG/ACT AERS [Inhaler] (IVAX PHARMACEUTICALS)
INC. act = $8.7
act = $26.1 - Qvar 80 MCG/ACT AERS [Inhaler] (IVAX PHARMACEUTICALS)
INC. act = $8.7
act = $26.1
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.