Beclometasone Explained

Verifiedfields:changed
Verifiedrevid:459526640
Width:240
Width2:250
Usan:beclomethasone
Tradename:Qvar, Beconase AQ, others
Dailymedid:Beclomethasone
Pregnancy Au:B3
Routes Of Administration:Inhalation, nasal, topical
Legal Au:S2
Legal Uk:POM
Legal Uk Comment:but some nasal sprays are General sales list (GSL, OTC)
Legal Us:Rx-only
Bioavailability:Converted to beclometasone-17-monopropionate (17-BMP) during absorption
Protein Bound:87% of 17-BMP to albumin and transcortin
Metabolism:By esterase enzymes found in most tissues
Elimination Half-Life:2.8 hours
Excretion:Biliary (60%), renal (12%)
Iuphar Ligand:5894
Cas Number:5534-09-8
Atc Prefix:A07
Atc Suffix:EA07
Atc Supplemental:,,
Pubchem:21700
Drugbank:DB00394
Kegg:D00689
Chemspiderid:20396
Unii:5B307S63B2
Chebi:3002
Chembl:1200500
Synonyms:Beclometasone dipropionate; beclomethasone dipropionate
Iupac Name:(8S,9R,10S,11S,13S,14S,16S,17R)-9-Chloro-11-hydroxy-10,13,16-trimethyl-3-oxo-17-[2-(propionyloxy)acetyl]-6,7,8,9,10,11,12,13,14,15,16,17-dodecahydro-3H-cyclopenta[''a'']phenanthren-17-yl propionate
C:28
H:37
Cl:1
O:7
Smiles:O=C(OCC(=O)[C@]3(OC(=O)CC)[C@]2(C[C@H](O)[C@]4(Cl)[C@@]/1(\C(=C/C(=O)\C=C\1)CC[C@H]4[C@@H]2C[C@@H]3C)C)C)CC
Stdinchi:1S/C28H37ClO7/c1-6-23(33)35-15-22(32)28(36-24(34)7-2)16(3)12-20-19-9-8-17-13-18(30)10-11-25(17,4)27(19,29)21(31)14-26(20,28)5/h10-11,13,16,19-21,31H,6-9,12,14-15H2,1-5H3/t16-,19-,20-,21-,25-,26-,27-,28-/m0/s1
Stdinchikey:KUVIULQEHSCUHY-XYWKZLDCSA-N
Melting Point:117
Melting High:120
Melting Notes:(dec.)

Beclometasone or beclomethasone, also known as beclomethasone dipropionate, and sold under the brand name Qvar among others, is a steroid medication.[1] It is available as an inhaler, cream, pills, and nasal spray.[2] The inhaled form is used in the long-term management of asthma.[1] The cream may be used for dermatitis and psoriasis.[3] The pills have been used to treat ulcerative colitis.[4] The nasal spray is used to treat allergic rhinitis and nasal polyps.[5]

Common side effects with the inhaled form include respiratory infections, headaches, and throat inflammation.[1] Serious side effects include an increased risk of infection, cataracts, Cushing's syndrome, and severe allergic reactions.[1] Long-term use of the pill form may cause adrenal insufficiency.[4] The pills may also cause mood or personality changes.[4] The inhaled form is generally regarded as safe in pregnancy.[6] Beclometasone is mainly a glucocorticoid.[1]

Beclomethasone dipropionate was first patented in 1962 and used medically in 1972.[7] It was approved for medical use in the United States in 1976.[1] It is on the World Health Organization's List of Essential Medicines.[8] In 2021, it was the 268th most commonly prescribed medication in the United States, with more than 1million prescriptions.[9] [10]

Side effects

Common side effects with the inhaled form include respiratory infections, headaches, and throat inflammation.[1] Serious side effects include an increased risk of infection, cataracts, Cushing's syndrome, and severe allergic reactions.[1] Long-term use of the pill form may cause adrenal insufficiency.[4] The pills may also cause mood or personality changes.[4] The inhaled form is generally regarded as safe in pregnancy.[6]

Occasionally, it may cause a cough upon inhalation. Deposition on the tongue and throat may promote oral candidiasis, which appears as a white coating, possibly with irritation.[11] [12] [13] This may usually be prevented by rinsing the mouth with water after using the inhaler. Other adverse drug reaction side effects may rarely include: a smell similar to burning plastic, unpleasant taste, hoarseness or nasal congestion, pain or headache, and visual changes. Allergic reactions may occur, but rarely.

Nasal corticosteroids may be associated with central serous retinopathy.[14]

Pharmacology

Beclometasone is mainly a glucocorticoid.[1] Glucocorticoids are corticosteroids that bind to the glucocorticoid receptor[15] that is present in almost every vertebrate animal cell. The activated glucocorticoid receptor-glucocorticoid complex up-regulates the expression of anti-inflammatory proteins in the nucleus (a process known as transactivation) and represses the expression of proinflammatory proteins in the cytosol by preventing the translocation of other transcription factors from the cytosol into the nucleus (transrepression).[16]

Glucocorticoids are part of the feedback mechanism in the immune system which reduces certain aspects of immune function, such as inflammation.

Names

Beclometasone dipropionate is the INN modified and beclomethasone dipropionate is the USAN and former BAN. It is a prodrug of the free form, beclometasone (INN). The prodrug beclometasone is marketed in Norway and Russia.[17] [18] [19] [20] [21]

Clenil, Qvar, Cortis are brandnames for the inhalers; Beconase, Alanase, Vancenase, Qnasl for the nasal spray or aerosol.

Notes and References

  1. Web site: Beclomethasone Dipropionate. The American Society of Health-System Pharmacists. 2 December 2015. live. https://web.archive.org/web/20151208145637/http://www.drugs.com/monograph/beclomethasone-dipropionate.html. 8 December 2015.
  2. Web site: List of products: Beclometasone dipropionate . MHRA. 6 December 2015. live. https://web.archive.org/web/20151208113019/http://www.mhra.gov.uk/spc-pil/?subsName=BECLOMETASONE%20DIPROPIONATE&pageID=SecondLevel. 8 December 2015.
  3. Web site: Beclometasone dipropionate 0.25 mg/g Cream. MHRA. 6 December 2015. dead. https://web.archive.org/web/20151208111605/http://www.mhra.gov.uk/home/groups/spcpil/documents/spcpil/con1444971110586.pdf. 8 December 2015.
  4. Web site: Clipper. MHRA. 6 December 2015. dead. https://web.archive.org/web/20151208154434/http://www.mhra.gov.uk/home/groups/spcpil/documents/spcpil/con1353302219931.pdf. 8 December 2015.
  5. Web site: Beclomethasone Dipropionate eent. The American Society of Health-System Pharmacists. 2 December 2015. live. https://web.archive.org/web/20151208200147/http://www.drugs.com/monograph/beclomethasone-dipropionate-eent.html. 8 December 2015.
  6. Book: Hamilton R . Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. 2015. Jones & Bartlett Learning. 9781284057560. 349.
  7. Book: McPherson EM . Beclomethasone dipropionate . Pharmaceutical Manufacturing Encyclopedia. . 2007 . Elsevier . Burlington . 9780815518563. 539. 3rd. https://books.google.com/books?id=_J2ti4EkYpkC&pg=PA539. live. https://web.archive.org/web/20151208065619/https://books.google.ca/books?id=_J2ti4EkYpkC&pg=PA539. 8 December 2015.
  8. Book: ((World Health Organization)) . World Health Organization model list of essential medicines: 21st list 2019 . 2019 . 10665/325771 . World Health Organization . World Health Organization . Geneva . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO . free .
  9. Web site: The Top 300 of 2021 . ClinCalc . 14 January 2024 . 15 January 2024 . https://web.archive.org/web/20240115223848/https://clincalc.com/DrugStats/Top300Drugs.aspx . live .
  10. Web site: Beclomethasone - Drug Usage Statistics . ClinCalc . 14 January 2024.
  11. Willey RF, Milne LJ, Crompton GK, Grant IW . Beclomethasone dipropionate aerosol and oropharyngeal candidiasis . British Journal of Diseases of the Chest . 70 . 1 . 32–38 . January 1976 . 1259918 . 10.1016/0007-0971(76)90004-8 .
  12. Salzman GA, Pyszczynski DR . Oropharyngeal candidiasis in patients treated with beclomethasone dipropionate delivered by metered-dose inhaler alone and with Aerochamber . The Journal of Allergy and Clinical Immunology . 81 . 2 . 424–428 . February 1988 . 3339197 . 10.1016/0091-6749(88)90911-6 . free .
  13. Fukushima C, Matsuse H, Tomari S, Obase Y, Miyazaki Y, Shimoda T, Kohno S . Oral candidiasis associated with inhaled corticosteroid use: comparison of fluticasone and beclomethasone . Annals of Allergy, Asthma & Immunology . 90 . 6 . 646–651 . June 2003 . 12839324 . 10.1016/S1081-1206(10)61870-4 .
  14. Haimovici R, Gragoudas ES, Duker JS, Sjaarda RN, Eliott D . Central serous chorioretinopathy associated with inhaled or intranasal corticosteroids . Ophthalmology . 104 . 10 . 1653–1660 . October 1997 . 9331207 . 10.1016/s0161-6420(97)30082-7 . free .
  15. Book: Pelt AC . Glucocorticoids: effects, action mechanisms, and therapeutic uses . 2011 . Nova Science . Hauppauge, N.Y. . 978-1617287589 .
  16. Rhen T, Cidlowski JA . Antiinflammatory action of glucocorticoids--new mechanisms for old drugs . The New England Journal of Medicine . 353 . 16 . 1711–1723 . October 2005 . 16236742 . 10.1056/NEJMra050541 . 5744727 .
  17. Book: Elks J . The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies. 14 November 2014. Springer. 978-1-4757-2085-3. 123–.
  18. Book: Index Nominum 2000: International Drug Directory. 2000. Taylor & Francis. 978-3-88763-075-1. 95–.
  19. Book: Morton IK, Hall JM . Concise Dictionary of Pharmacological Agents: Properties and Synonyms. 6 December 2012. Springer Science & Business Media. 978-94-011-4439-1. 46–. 17 March 2019. 12 January 2023. https://web.archive.org/web/20230112040416/https://books.google.com/books?id=tsjrCAAAQBAJ&pg=PA46. live.
  20. Book: Muller NF, Dessing RP. European Drug Index: European Drug Registrations . Fourth . 19 June 1998. CRC Press. 978-3-7692-2114-5. 141–. 17 March 2019. 12 January 2023. https://web.archive.org/web/20230112040422/https://books.google.com/books?id=2HBPHmclMWIC&pg=PA141. live.
  21. Web site: Beclometasone . drugs.com . 17 March 2019 . 18 January 2018 . https://web.archive.org/web/20180118064657/https://www.drugs.com/international/beclometasone.html . live .