Synopsis: Inhaled beclomethasone dipropionate1 is now well established in the management of asthma. Studies conducted over the last decade, and since the drug was previously reviewed in the Journal, have confirmed that inhaled beclomethasone dipropionate 400 to 800μg daily can reduce the need for oral maintenance corticosteroids in the majority of asthmatic patients requiring such therapy, and that increasing the dosage to 2000μg daily may provide additional clinical benefit in some patients unresponsive to usual therapeutic dosages. Follow-up over a period of several years has confirmed that the initial response to inhaled beclomethasone can be maintained in most patients. Recent studies indicate that beclomethasone dipropionate 400μg daily is equally effective when administered in 2 or 4 divided doses in patients with stable asthma, but it is likely that the lower frequency of administration will be less effective when the asthma is unstable.
Recent studies have established the usefulness and good tolerability of intranasal beclomethasone dipropionate in the treatment of perennial and seasonal rhinitis, where the drug has been shown to be more effective than intranasal sodium cromoglycate and similar in efficacy to flunisolide. Nasal polyps decrease in size during continuous treatment with intranasal beclomethasone dipropionate, but enlarge again during periods of respiratory infection.
After a decade of treatment with inhaled and intranasal beclomethasone dipropionate, there is no evidence that the drug damages the tracheobronchial lining or the nasal mucosa. Thus, the initial promise of beclomethasone dipropionate has been fulfilled. It has had an important role in asthma therapy over the past decade, which will continue into the future.
Pharmacodynamic Studies: Beclomethasone dipropionate has high topical activity but low systemic activity. In asthmatic patients, the inhaled drug has little immunosuppressive effect and causes minimal changes in circulating leucocytes and eosinophils. Although antigen-induced type I immediate asthmatic and nasal reactions are not inhibited by prechallenge administration of single doses of beclomethasone dipropionate, regular treatment for 1 week prior to antigen challenge inhibits such reactions in some patients.
Substitution of inhaled beclomethasone dipropionate for oral maintenance corticosteroids in patients with asthma generally results in an improvement in adrenal function when the oral steroids have been administered daily, but there is less evidence of improved adrenal function when inhaled beclomethasone dipropionate is substituted for alternate-day oral steroids. However, other systemic adverse effects associated with long term use of oral steroids rarely occur with inhaled beclomethasone dipropionate. Some recent studies have demonstrated that usual therapeutic doses of inhaled beclomethasone dipropionate may cause some adrenal suppression in children compared with that in asthmatic patients not receiving corticosteroid therapy, although the findings have not been consistent between studies. There was no evidence of adrenal suppression in patients with rhinitis who were treated with intranasal beclomethasone dipropionate.
Histological and electron microscope studies of the bronchial mucosa, and histological studies of the nasal mucosa, of patients treated for several years with topical beclomethasone dipropionate showed no evidence of mucosal damage due to administration of the drug.
Pharmacokinetic Studies: Beclomethasone dipropionate, although well absorbed by the oral route, possesses relatively low systemic activity after oral administration because of metabolic inactivation during its passage through the liver.
Therapeutic Trials: Studies published since inhaled beclomethasone dipropionate was first reviewed in the Journal have confirmed its efficacy in the treatment of asthma in steroid-dependent asthmatics and in patients with asthma not requiring maintenance oral corticosteroids. Long term controlled studies and open follow-up studies have demonstrated that the initial response achieved after several weeks of treament with inhaled beclomethasone dipropionate is maintained in most patients and that reinstitution of continuous maintenance systemic corticosteroids is seldom necessary in previously steroid-dependent patients once they have been replaced by the inhaled steroid.
In comparative trials, inhaled beclomethasone dipropionate 400μg daily in 4 divided doses was similar in efficacy to budesonide 200μg twice daily (when compared at a time when the asthma was stable), betamethasone valerate 400μg daily or dexamethasone isonicotinate 1000/μg daily. However, dexamethasone caused more adrenal suppression than beclomethasone dipropionate.
Although early studies generally failed to record any objective benefit from an increase in the dose of inhaled beclomethasone to 800μg daily or above, more recent trials have adequately demonstrated that some adult patients with severe chronic asthma whose disease is not satisfactorily controlled by beclomethasone dipropionate 400μg daily derive further clinical benefit from an increase in dosage of the inhaled steroid. The higher doses were in some instances associated with evidence of adrenal suppression, particularly in patients treated with beclomethasone dipropionate 2000μg daily, but this was often outweighed by the improvement in the control of their asthma.
Studies in patients with stable asthma have failed to show any objective benefit from administration of salbutamol before each dose of inhaled beclomethasone dipropionate or from concurrent administration of sodium cromoglycate. Similarly, dry-powder inhalation of beclomethasone dipropionate generally appeared to offer no advantages over the aerosol preparation in adults or children, including those patients with a mediocre or poor technique with the conventional aerosol, although some investigators considered the powder preparation to be more effective in some patients. Formal studies indicate that twice daily administration of inhaled beclomethasone dipropionate is similar in efficacy to the same dose administered 4 times daily in adults and children with stable asthma adequately controlled by beclomethasone dipropionate 400μg daily in addition to their usual bronchodilator therapy. However, there is evidence that it may not be assumed that twice daily doses of the drug are as effective as more frequent administration when the asthma is unstable.
The efficacy of intranasal beclomethasone dipropionate in the treatment of perennial and allergic seasonal rhinitis has been studied in numerous placebo-controlled trials and in comparisons with sodium cromoglycate, flunisolide and budesonide. On the basis of subjective changes in the severity of nasal symptoms, intranasal beclomethasone dipropionate has consistently been more effective than placebo or sodium cromoglycate, not significantly different from flunisolide and, in 1 study, less effective than an equal dose of budesonide. A decrease in the size of nasal polyps has been noted in patients treated for several months with intranasal beclomethasone dipropionate, but the drug was ineffective in relieving symptoms of severe rhinosinusitis or in diminishing persistent middlear effusion. There was no significant difference in the efficacy of intranasal beclomethasone dipropionate administered as a powder or an aerosol in nasal polyposis or when given once, twice or 4 times daily in patients with seasonal rhinitis. However, further studies are needed to determine the optimum frequency of administration in perennial rhinitis and in nasal polyposis.
Side Effects: The most frequent side effects associated with long term use of inhaled beclomethasone dipropionate have been oropharyngeal candidiasis, hoarseness and/or sore throat. Clinical thrush has seldom become a major problem as it has usually been readily controlled with topical antifungal drugs, and has only occasionally necessitated withdrawal of therapy. The incidence of hoarseness and sore throat, like that of oropharyngeal candidiasis, has varied considerably between studies, due in part to the different methods of eliciting side effect data.
In the first few years after the introduction of inhaled beclomethasone dipropionate, there was some concern that the drug may increase the incidence of respiratory infections. However, suitably designed studies have revealed no evidence of an increase in chest infections during long term treatment.
Symptoms indicative of systemic corticosteroid withdrawal and exacerbation of atopic conditions continue to occur when inhaled beclomethasone dipropionate is substituted for oral maintenance steroids, but atopic conditions can usually be controlled by appropriate topical therapy and seldom necessitate reinstitution of oral corticosteroids. The appearance of such side effects attests to the lack of systemic effect of usual therapeutic doses of inhaled beclomethasone dipropionate.
Experience with ‘high dose’ inhaled beclomethasone dipropionate indicates that long term treatment with doses higher than 1000μg daily may cause some adrenal suppression, but this is generally outweighed by the additional symptomatic benefit.
Intranasal beclomethasone dipropionate 400μg daily is well tolerated when used to treat perennial rhinitis, allergic seasonal rhinitis or nasal polyposis. The most commonly reported side effects of nasal irritation, sneezing, slight epistaxis and headache have generally occurred with similar frequency during treatment with either the active drug or its vehicle.
Dosage and Administration: The usual maintenance dose of inhaled beclomethasone dipropionate in the treatment of asthma is 10μg (2 inhalations) 2, 3 or 4 times daily in adults and 50 to 100μg 2, 3 or 4 times daily in children. In adults whose asthma is not adequately controlled with usual doses, daily doses of up to 2000μg have been used from an aerosol delivering 250μg per actuation.
In the treatment of perennial or seasonal rhinitis, the recommended dosage in children and adults is 50μg in each nostril 4 times daily, although 100μg twice daily is often used.
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Aaron. T.H. and Muttitt, E.L.C.: The treatment of nasal polyps with intranasal beclomethasone dipropionate. Abstract No. 212. Journal of Allergy and Clinical Immunology, March, p. 192 (1978).
Andcrsson. E.; Smidt, CM.; Sikjaer, B., Hinge, G. and Poynter, D.: Bronchial biopsies after beclomethasone dipropionate aerosol. British Journal of Diseases of the Chest 77:35 (1977).
Blair. H. and Butler, A.G.: The treatment of perennial rhinitis with intranasal beclomethasone dipropionate. Practitioner 218: 283–285 (1977).
Blaiss. M.S.: Herrod, H.G.; Crawford, L.V. and Lieberman, P.L. Beclomethasone dipropionate aerosol: Haematologic and immunologic effects. Annals of Allergy 48: 210–214 (1982).
Bjorkander. J.; Formgren, H.; Johansson, S.A. and Millquist, E.: Methodological aspects on clinical trials with inhaled corticosteroids. Results of two comparisons between two steroid aerosols in patients with asthma. European Journal of Respiratory Diseases 63(Suppl. 122): 108–177 (1982).
Breslin. A.B.X.; Pepys, J.: Davies, RJ. and Hendrick, D.J.: Effect of beclomethasone dipropionate on antigen bronchial challenge in asthmatic patients. Australian and New Zealand Journal of Medicine 3: 324 (1973).
BTTA (British Thoracic and Tuberculosis Association): Inhaled corticosteroids compared with oral prednisone in patients starting long-term corticosteroid therapy for asthma. Lancet 2: 7933 (1975).
BTTA (British Thoracic and Tuberculosis Association): A controlled trial of inhaled corticosteroids in patients receiving prednisone tablets for asthma. British Journal of Diseases of the Chest 70: 95 (1976).
Brogden. R.N.; Pinder, R.M.; Sawyer, P.R.; Speight, T.M. and Avery. G.S.: Beclomethasone dipropionate inhaler: A review of its pharmacology, therapeutic value and adverse effects. I: Asthma. Drugs 10: 166–210 (1975).
Brompton Hospital/Medical Research Council Collaborative Trial: Double-blind trial comparing two dosage schedules of beclomethasone dipropionate aerosol in the treatment of chronic bronchial asthma. Lancet 2: 303 (1974).
Brompton Hospital/Medical Research Council Collaborative Trial: Double-blind trial comparing two dosage schedules of beclomethasone dipropionate aerosol with a placebo in chronic bronchial asthma. British Journal of Diseases of the Chest 73: 121 (1979).
Brompton Hospital/Medical Research Council Collaborative Trial. Double-blind trial comparing two dosage schedules of beclomethasone dipropionate aerosol with a placebo in the treatment of perennial rhinitis for twelve months. Clinical Allergy 10: 239–251 (1980).
Brown, H.M.; Bhowmik, M.; Jackson, F.A. and Thantrey, N.: Beclomethasone dipropionate aerosols in the treatment of asthma in childhood. Practitioner 224: 847 (1980).
Brown. H.M.; Storey, G. and Jackson, F.A.: Beclomethasone dipropionate aerosol in long term treatment of perennial and seasonal asthma in children and adults: A report of five-and-half years’ experience in 600 asthmatic patients. British Journal of Clinical Pharmacology 4: 259S–267S (1977).
Bryant. D.H. and Pepys, J.: Bronchial reactions to aerosol inhalant vehicle. British Medical Journal 1: 1319–1320 (1976).
Bunnag. C.H.; Vipulakom, P. and Pacharee, P.: Intranasal inhalation of beclomethasone dipropionate in the treatment of perennial rhinitis in adults. Annals of Allergy 44: 100 (1980).
Burge. P.S.: The effects of corticosteroids on the immediate asthmatic reaction. European Journal of Respiratory Diseases 63: 163 (1982).
Campbell, I.A.; Finnegan, O.C.; Todd, J. and Smith, D.: A comparison of aerosol and powder inhalation of beclomethasone. British Journal of Diseases of the Chest 74: 419 (1980).
Carmichael, J.; Duncan, D. and Crompton, G.K.: Beclomethasone dipropionate dry-powder inhalation compared with conventional aerosol in chronic asthma. British Medical Journal 2: 657 (1978).
Chambers, W.B. and Malfitan, V.A.: Beclomethasone dipropionate aerosol in the treatment of asthma in steroid-independent children. Journal of International Medical Research 7: 415 (1979).
Charpin, D.; Beaupre, A. and Orehek, J.: Deep-inspiration induced bronchoconstriction: A mechanism for beclomethasone aerosol intolerance. European Journal of Respiratory’ Diseases 64: 494–497 (1983).
Chatterjee, S.S.: Experience with the use of corticosteroid aerosol. British Journal of Clinical Pharmacology 4: 255S (1977).
Chatterjee, S.S. and Butler, A.G.: Beclomethasone dipropionate in asthma: A comparison of two methods of administration. British Journal of Diseases of the Chest 74: 175 (1980).
Chiang, J.; Patterson, R.; McGillen, J.; Harris, K.; Phair, J.; Roberts, M. and Riesing, K.: The evaluation of selected parameters of immune function in asthmatics after long-term corticosteroid therapy. Clinical Allergy 9: 397–410 (1979).
Chiang, J.L.; Patterson, R.; McGillen, J.J.; Phair, J.P.; Roberts, M.: Harris, K.E. and Riesing, K.S.: Long term corticosteroid effect on and polymorphonuclear cell function in asthmatics. Journal of Allergy and Clinical Immunology 65: 263 (1980).
Clark, R.A. and Anderson, P.B.: Combined therapy with sulbutamol and beclomethasone inhalers in chronic asthma. Lancet 2: 70–72 (1978).
Clarke, P.S.: The effect of beclomethasone dipropionate on bronchial hyperreactivity. Journal of Asthma 19: 91–93 (1982).
Clark, T.J.H. (Ed.): Steroids in Asthma: A Reappraisal in the Light of Inhalation Therapy (ADIS Press, Auckland 1983).
Costello, J.F. and Clark, T.J.: Response of patients receiving high dose beclomethasone dipropionate. Thorax 29: 571–573 (1974).
Crompton, G.K.: Inhaled corticosteroids and allergic bronchopulmonary aspergillosis. British Journal of Diseases of the Chest 72: 253–254 (1978).
Crompton, G.K.: The use of inhaled steroids in the management of asthma; in Clark, T.J.H. (Ed.) Steroids in Asthma: A Reappraisal in the Light of Inhalation Therapy, pp. 166–192 (ADIS Press, Auckland 1983).
Dab, I. and Alexander, F.: Long term hospital treatment of asthmatic children with beclomethasone dipropionate aerosol. Pharmatherapeutica 2: 209–215 (1979).
De Cotiis, B.A. and Settipane, G.A.: The effect of inhaled beclomethasone on serum immunoglobulins. Abstract. Journal of Allergy and Clinical Immunology 65: 218 (1980).
Easton, J.G.: Effect of an inhaled corticosteroid on methacholine airway reactivity. Journal of Allergy and Clinical Immunology 67: 338 (1981).
Edmunds, A.T.; McKenzie, S.; Tooley, M. and Godfrey, S.: A clinical comparison of beclomethasone dipropionate delivered by pressurised aerosol and as a powder from a rotahaler. Archives of Disease in Children 54: 233 (1979).
Epstein, S.W. and Thompson, G.L.: A study of inhaled beclomethasone dipropionate therapy in asthma. Canadian Family Physician 22: 274 (1976).
Fein, B.T.: Geriatric asthma: Treatment with beclomethasone dipropionate aerosol. Southern Medical Journal 74: 1186–1193 (1981).
Finnegan, D.C.; Campbell, I.A.; Dennison, J. and Smith, D.: Management of asthma with beclomethasone dipropionate. A comparison of pressurised aerosol and rotahaler inhaler. British Journal of Diseases of the Chest 226: 158–159 (1982).
Francis, R.S.: Long-term beclomethasone dipropionate aerosol therapy in juvenile asthma. Thorax 31: 309 (1976).
Friedman, H.; Tworag, F.J.; Voss, H.E. and Coleman, M.: Eosinophilic pneumonia in association with the use of beclomethasone dipropionate aerosol. Abstract No. 72. Journal of Allergy and Clinical Immunology 61: 150 (1978).
Gaddie, J.; Petrie, G.R.; Reid, I.W.; Sinclair, D.J.M.; Skinner, C. and Palmer, K.N.F.: Aerosol beclomethasone dipropionate: A dose-response study in chronic bronchial asthma. Lancet 2: 280 (1973).
Gale, A.E.; Harding, P. and Solomon, E.: Flunisolide intranasal solution combined with intrabronchial steroids in adults with both asthma and perennial rhinitis. Annals of Allergy 46: 268–272 (1981).
Girard, J.P.; Cuevàs, M. and Heimlich, E.M.: A placebo controlled double-blind trial of beclomethasone dipropionate in the treatment of allergic rhinitis. Allergologica et Immunopathologica 6: 109–116 (1978).
Girard, J.P.; Vonlanthen, M.C. and Heimlich, E.M.: Therapeutic index of steroid aerosols in asthma. A single-blind comparative trial of beclomethasone dipropionate vs dexamethasone isonicotinate. Acta Allergologica 30: 363 (1975).
Godfrey, S.; Balfour-Lynn, L. and Tooley, M.: A three- to five-year follow-up of the use of the aerosol steroid, beclomethasone dipropionate, in childhood asthma. Journal of Allergy and Clinical Immunology 62: 335 (1978).
Godin, J. and Malo, J.L.: Acute bronchoconstriction caused by lsBeclovent’ and not ‘Vanceril’. Clinical Allergy 9: 585–589 (1979).
Goldstein, D.E. and König, P.: Effect of inhaled beclomethasone dipropionate on hypothalamic-pituitary-adrenal axis function in children with asthma. Pediatrics 72: 60–64 (1983).
Gregg, I.: The importance of patient education in the use of inhaled steroids; in Mygind, N. and Clark, T.J.H. (Eds) Topical Steroid Treatment for Asthma and Rhinitis, pp. 137–142 (Balliere Tindall, London 1980).
Greig, W.R.; Maxwell, J.D.; Boyle, J.A.; Lindsay, R.M. and Browning, G.M.C.K.: Criteria for distinguishing normal from subnormal adrenocortical function using the synacthen test. Postgraduate Medical Journal 45: 307 (1969).
Gwynn, CM. and Smith, J.M.: Long term results with beclomethasone dipropionate aerosol in children with bronchial asthma: Why does it sometimes fail? British Journal of Clinical Pharmacology 4: 269S–271S (1977).
Haahtela. T.: Comparisons among HC 20-511 (Ketotifen), clemastine. DSCG and bcclomethasone dipropionate in nasal challenge. Annals of Allergy 41: 345–347 (1978).
Harris. D.M.: Some properties of beclomethasone dipropionate and related steroids in man. Postgraduate Medical Journal 51 (Suppl. 4): 20 (1975).
Hendy. P. and Turner. A.S.: Pulmonary infiltrative eosinophilia and beclomethasone dipropionate. Correspondence. New Zealand Medical Journal 94: 394 (1981).
Hill. D.. Connolly, D. and Vorath, J.: Beclomethasone dipropionate aerosol in the treatment of children with severe perennial rhinitis. Medical Journal of Australia 2: 603–604 (1978).
Hillas. J.: Booth, R.J.: Somerfield, S.; Morton, R.; Avery, J. and Wilson. J.D.: A comparative trial of intranasal beclomethasone dipropionate and sodium cromoglycate in patients with chronic perennial rhinitis. Clinical Allergy 10: 253–258 (1980).
Hilton. A.M. and Chatterjee, S.S.: Bronchopulmonary aspergillosis-treatment with beclomethasone. Postgraduate Medical Journal 51 (Suppl. 4): 98 (1975).
Holopainen. E.: Grahne. B.; Malmberg, H.; Mäkinen, J. and Lindquist. N.: Budesonide in the treatment of nasal polyposis. European Journal of Respiratory Diseases 63 (Suppl. 122): 221–228 (1982a).
Holopainen. E.: Malmberg, H. and Binder, E.: Long term follow-up of intranasal beclomethasone treatment: A clinical and histological study. Acta Otolaryngologica 386 (Suppl.): 270–272 (1982b).
Holopainen. E.: Malmberg, H. and Tarkiainen, E.: Experiences of treating allergic rhinitis with intranasal beclomethasone dipropionate. Acta Allcrgologica 32: 263–277 (1977).
Imbeau. S.A. and Geller, M.: Aerosol beclomethasone treatment of chronic severe asthma. Journal of the American Medical Association 240: 1260 (1978).
Jalowayski. A.A.; Meltzer, E.O.: Orgel. A. and Kemp, J.P.: Nasal biopsy evaluation of the effect of topical corticosteroids on nasal mucosal cytology. Abstract. Journal of Allergy and Clinical Immunology 71(1, part 2): 90 (1983).
Johansson. S.-A.. Andersson, K.-E.; Brattsand, R.; Gruvstad, E. and Hedner, P.: Topical and systemic glucocorticoid potencies of budesonide and beclomethasone dipropionate in man. European Journal of Clinical Pharmacology 22: 523–529 (1982).
Jorde. W. and Werdermann, K.: Etude de la cytologie bronchique aprés traitement prolongé par le dipropionate de béclomethasone. Nouvelle Presse Médicale 6(15): 1281 (1977).
Kass. I.: Nair. S.V. and Patil, K.D.: Beclomethasone dipropionate aerosol in the treatment of steroid-dependent asthmatic patients. An assessment of 18 months of therapy. Chest 71: 703 (1977).
Kennedy. M.C.S; Haslock, M.R. and Thursby-Pelham, D.C.: Aerosol therapy for asthma: A 10-year follow-up treatment with beclomethasone dipropionate in 100 asthmatic patients. Pharmatherapeutica 2: 648 (1981).
Kershnar. J.: Klein, R.; Waldman, D.; Berger, W.; Rachelefsky, G.; Katz R. and Siegel, S.: Treatment of chronic childhood asthma with beclomethasone dipropionate aerosols. II. Effect on pituitary-adrenal function after substitution for oral corticosteroids. Pediatrics 62: 189 (1978).
Kewley. G.D.: Possible association between beclomethasone dipropionate aerosol and cataracts. Australian Paediatric Journal 16: 117–118 (1980).
Knight. A. and Kolin, A.: Long term efficacy and safety of beclomethasone dipropionate aerosol in perennial rhinitis. Annals of Allergy 50: 81–84 (1983).
Kriz. R.J.; Chmelik, F.; do Pico, G. and Reed CE.: A short-term double-blind trial of aerosol triamcinolone acetonide in steroid-dependent patients with severe asthma. Chest 69: 455–459 (1976).
Kriz. R.J.; Chmelik, F. and Reed, CE.: A short-term double-blind evaluation of triamcinolone acetonide aerosol in severe steroid-dependent asthma. Journal of Allergy and Clinical Immunology 55: 122 (1975).
Krouse. H.A.; Phung, N.D. and Klaustermeyer, W.B.: Intranasal beclomethasone in severe rhinosinusitis and nasal polyps. Annals of Allergy 50: 385–388 (1983).
Lahdensus. A. and Haahtela, T.: Efficacy of intranasal beclomethasone dipropionate in patients with perennial rhinitis and asthma. Clinical Allergy 7: 255–261 (1977).
Laitinen. L.A. and Haahtela, T.: The effect of two dosage schedules of beclomethasone dipropionate aerosol in the treatment of patients with moderately severe asthma. Current Therapeutic Research 24: 465–469 (1978).
Lal. S.: Further experiences with beclomethasone dipropionate. Postgraduate Medical Journal 51 (Suppl. 4): 105–108 (1975).
Lal. S.; Harris, D.M.; Bhalla, K.K.; Singhal, S.N. and Butler, A.G.: Comparison of beclomethasone dipropionate aerosol and prednisolone in reversible airways obstruction. British Medical Journal 3: 314 (1972).
Lal. S.: Malhotra, M.; Gribben, M.D. and Butler, A.G.: Beclomethasone dipropionate aerosol compared with dry powder in the treatment of asthma. Clinical Allergy 10: 259 (1980).
Lildholdt, T. and Kortholm, B.: Beclomethasone nasal spray in the treatment of middle-ear effusion — a double-blind study. International Journal of Pediatrie Otorhinolaryngology 4: 133–137 (1982).
Löfkvist. T. and Svensson, G.: Treatment of vasomotor rhinitis with intranasal beclomethasone dipropionate (Becotide). Acta Allergologica 31: 227–238 (1976).
Lundgren, R.: Scanning electron microscopic studies of bronchial mucosa before and during treatment with beclomethasone dipropionate inhalations. Scandinavian Journal of Respiratory Diseases (Suppl. 101): 179(1977).
Maberly, D.J.; Gibson, G.J. and Butler, A.G.: Recovery of adrenal function after substitution of beclomethasone dipropionate for oral corticosteroids. British Medical Journal 1: 778 (1973).
McAllen, M.K.; Kochanowski, S.J. and Shaw, K.M.: Steroid aerosols in asthma: An assessment of betamethasone valerate and a 12-month study of patients on maintenance. British Medical Journal 1: 171 (1974).
McAllen, M.K.; Portillo, P.R.; Parr, E.J.; Seaton, A. and Engler, C: Intranasal flunisolide, placebo and beclomethasone dipropionate in perennial rhinitis British Journal of Diseases of the Chest 74: 32–36 (1980).
MacKay, A.D. and Dyson, A.J.: How important is the sequence of administration of inhaled beclomethasone dipropionate and salbutamol in asthma. British Journal of Diseases of the Chest 75: 273–276 (1981).
Malm, L. and Wihl, J.-Å.: Intranasal beclomethasone dipropionate in vasomotor rhinitis. Acta Allergologica 31: 245–253 (1976).
Manicatide, M.A.; Nicholaescu, V.V.; Voiculescu, M.; Racoveanu, C.L. and Stroescu, V.: Long-term corticosteroid aerosol therapy in childhood asthma. Revue Roumaine de Médecine - Série Médecine Interne 16: 417 (1978).
Martin L.E.; Harrison, C. and Tanner, R.J.N.: Metabolism of beclomethasone dipropionate by animals and man. Postgraduate Medical Journal 51 (Suppl. 4): 11 (1975).
Martin, L.E.; Tanner, R.J.N.; Clark, T.J.H. and Cochrane, G.M.: Absorption and metabolism of orally administered beclomethasone dipropionate. Clinical Pharmacology and Therapeutics 15: 267–275 (1974).
Mccoy, R.J. and Laby, B.: Beclomethasone dipropionate in twice daily treatment of asthma. Australian Family Physician 9: 721–727 (1980).
Mellis, CM. and Phelan, P.D.: Asthma deaths in children — a continuing problem. Thorax 32: 29–34 (1977).
Meltzer, E.O.; Kemp, J.P.; Orgel, H.A. and Izu, A.E.: Flunisolide aerosol for treatment of severe, chronic asthma in steroid-dependent children. Pediatrics 69: 340 (1982).
Meltzer. E.O., Orgel, H.A.; Kemp, J.P.; Chubb, J.M. and Ward, J.F.: Effect of dosing schedule on efficacy and safety of beclomethasone dipropionate aerosol (BDP) in chronic asthma. Abstract 242. Journal of Allergy and Clinical Immunology 71 (1, part 2): 149 (1983).
Milne, L.J.R. and Crompton, G.K.: Beclomethasone dipropionate and oropharyngeal candidiasis. Brit. Med. J. 3: 397 (1974).
Mitchell, I.: Paterson, I.C.; Cameron, S.J. and Grant, I.W.B.: Treatment of childhood asthma with sodium cromoglycate and beclomethasone dipropionate aerosol singly and in combination. British Medical Journal 2: 457 (1976).
Mollura, J.L.; Bernstein, R.; Fine, S.R. and Vevaina, J.: Pulmonary eosinophilia in a patient receiving beclomethasone dipropionate aerosol. Annals of Allergy 42: 326–329 (1979).
Muers, M. and Dawkins, K.: Effect of a timed interval between inhalation of beta-agonist and corticosteroid aerosols on the control of chronic asthma. Thorax 38: 378–382 (1983).
Munch, E.; Gomez, G.; Harris, C; Lack, R.P.; Edwards, V.A.; O’Connor, P.; Snowden, D.V. and Mygind, V.: An open comparison of dosage frequencies of beclomethasone dipropionate in seasonal allergic rhinitis. Clinical Allergy 11: 303–309 (1981).
Munch, E.P.; Taudorf, E. and Weeke, B.: Dose frequency in the treatment of asthmatics with inhaled topical steroid. European Journal of Respiratory Diseases 63 (Suppl. 122): 143–153 (1982).
Mygind, N.; Pedersen, C.B.; Prytz, S. and Sorensen, H.: Treatment of nasal polyps with intranasal beclomethasone dipropionate aerosol. Clinical Allergy 5: 159–164 (1975).
Mygind, N.; Sørensen, H. and Pedersen, C.B.: The nasal mucosa during long term treatment with beclomethasone dipropionate aerosol. Acta Otolaryngologica 85: 437–442 (1978).
Nakhosteen, J.A.: Histologische Untersuchung von Bronchial-schleimhautbiopsien nach Inhajation von Beclomethasondi-propionat über 31 Monate. Praxis Pneumology 33: 172–176 (1979).
Nassif. E.; Weinberger, M.; Thompson, R. and Sherman, B.: Effects of continuous corticosteroid therapy on children with chronic asthma. J. Allergy Clin. Immunol. 65: 219 (1980).
Neuman, I. and Toshner, D.: Beclomethasone dipropionate in pediatric perennial extrinsic rhinitis. Annals of Allergy 40: 346–348 (1978).
Ng. S.H.; Dash, C.H. and Savage, S.J.: Betamethasone valerate compared with sodium cromoglycate in asthmatic children. Postgraduate Medical Journal 53: 315 (1977).
Oishi. T.; Deguchi, T. and Marumo, H.: Metabolic fate of beclomethasone 17,21-dipropionate in the rat. Pharmacometrics 22(5): 717–727 (1981).
Okuda, M. and Senba, O.: Effects of beclomethasone dipropionate nasal spray on subjective and objective findings in perennial allergic rhinitis. Clinical Otolaryngology and Allied Sciences 5: 315–321 (1980).
Paterson, I.C.; Cooke, N.J.; Murray, K.; Crompton, G.K. and Grant, I.W.: Pulmonary eosinophilia after substitution of aerosol for oral corticosteroid therapy. British Journal of Diseases of the Chest 57: 217–224 (1975).
Pedersen, C.B.; Mygind, N.; Sorensen, H. and Prytz, S.: Long term treatment of nasal polyps with beclomethasone dipropionate aerosol. Acta Otolaryngologica 82: 256–259 (1976).
Pelikan, Z.: The effects of disodium cromoglycate and beclomethasone dipropionate on the late nasal mucosa response to allergen challenge. Annals of Allergy 49: 200–212 (1982).
Pelikan. Z. and Pelikan-Filipek, M.: The effects of disodium cromoglycate and beclomethasone dipropionate on the immediate response of the nasal mucosa to allergen challenge. Annals of Allergy 49: 283–292 (1982).
Pepys. J.; Davies, R.J.; Breslin, A.B.X.; Hendrick, D.J. and Hutchcroft, B.J.: The effect of inhaled beclomethasone dipropionate (Becotide) and sodium cromoglycate on asthmatic reactions to provocation tests. Clinical Allergy 4: 13 (1974).
Pingleton, W.W.; Bone, R.C.; Kerby, G.R. and Ruth, W.E.: Oropharyngeal candidiasis in patients treated with triamcinolone acetonide aerosol. Journal of Allergy and Clinical Immunology 60: 254 (1977a).
Pingleton, W.W.; Hiller, F.C.; Bone, R.C.; Kerby, G.R. and Ruth, W.E.: Treatment of allergic aspergillosis with triancinolone acetonide aerosol. Chest 71: 782–784 (1977b).
Pipkorn, U. and Rundcrantz, H.: Budesonide and beclomethasone dipropionate in hay fever — a single blind comparison. European Journal of Respiratory Diseases 63 (Suppl. 122): 211–220 (1982).
Rao. M.: Steiner. P.; Maraya. R.; Victoria, M.S.; Jabar, H. and Hum. J.: Bcclomcthasonc dipropionate for chronic asthma in children: The Kings County Hospital experience. Journal of Asthma 19: 21 (1982).
Rimoldi. R. and Brunetta, F.: Clinical use of the beclomethasone dipropionate-salbutamol combination. International Journal of Tissue Reactions 1: 147–154 (1979).
Rosenhall. L: Lundqvist, G., Adelroth, E. and Glennow, C: Comparison between inhaled and oral corticosteroids in patients with chronic asthma. European Journal of Respiratory Diseases 63 (Suppl. 122): 154–162 (1982).
Rusnak. S.L.: Concurrent administration of flunisolide nasal solution with beclomethasone dipropionate bronchial aerosol in patients with both rhinitis and asthma. Annals of Allergy 47: 320–324 (1981).
Sahay. J.N.: Chatterjee. S.S. and Engler, C: A comparative trial of flunisolide and beclomethasone dipropionate in the treatment of perennial allergic rhinitis. Clinical Allergy 10: 65–70 (1980).
Sahay. J.N.: Chatterjee, S.S. and Stanbridge, T.N.: Inhaled corticostcroid aerosols and candidiasis. British Journal of Diseases of the Chest 73: 164–168 (1979).
Salorinne. Y. and Klemetti, L.: Dexamethasone-21-isonicotinate and beclomethasone dipropionate in the treatment of patients with asthma. IRCS Medical Science: Clinical Pharmacology and Therapeutics 7: 109 (1979).
Scherr. M.S.: Scherr. L.B. and Morton, J.L.: Use of inhaled beclomethasone dipropionate and optimized theophylline doses in asthmatic children at camp Bronco Junction, 1977–1978. Annals of Allergy 44: 82 (1980).
Schuylcr. M.R.: Bondarevsky, E.; Schmartz, H.J. and Schmitt, D.: Corticosteroid-sensitivie lymphocytes are normal in atopic asthma. Journal of Allergy and Clinical Immunology 68: 72 (1981).
Schwartz. R.H.: Otitis media with effusion: Results of treatment with a short course of oral prednisone of intranasal beclomethasone aerosol. Otolaryngology and Head and Neck Surgery 89: 386–391 (1981).
Schwartz. R.H.: Schwartz, D.M. and Grundfast, K.M.: Intranasal beclomethasone in the treatment of middle ear effusion: A pilot study. Annals of Allergy 45: 284–287 (1980).
Sidwcll. S.: A comparison of the efficacy and tolerance of an aqueous beclomethasone nasal spray with the conventional pressurized spray. Current Medical Research and Opinion 8: 659–664 (1983).
Sipila. P.; Sorri, M.; Ojala, K. and Palva, A.: Comparative trial of flunisolide and beclomethasone dipropionate nasal sprays in patients with seasonal allergic rhinitis. Allergy 38: 303–307 (1983).
Small. P.; Black, M. and Frenkiel, S.: Effects of treatment with beclomethasone dipropionate in subpopulations of perennial rhinitis patients. Journal of Allergy and Clinical Immunology 70: 178–182 (1982).
Smith. J.M.: Inhaled steroids in the management of childhood asthma: including data from a long term follow-up of a large personal scries; in Clark, T.J.H. (Ed.) Steroids in Asthma: A Reappraisal in the Light of Inhaled Therapy, pp. 193–209 (ADIS Press. Auckland 1983).
Smith. J.M. and Gwynn, CM.: A clinical comparison of aerosol and powder administration of beclomethasone dipropionate in asthma. Clinical Allergy 8: 479 (1978).
Smith. M.J. and Hodson, M.E.: High dose beclomethasone inhaler in the treatment of asthma. Lancet 1: 265–269 (1983a).
Smith. M.J. and Hodson, M.E.: Effects of long term inhaled high dose beclomethasone dipropionate on adrenal function. Thorax 38: 676–681 (1983b).
Stiksa. G.: Glennow, C. and Johannesson, N.: An open crossover trial with budesonide and beclomethasone dipropionate in patients with bronchial asthma. European Journal of Respiratory Diseases 63 (Suppl. 122): 266–267 (1982).
Svedmyr. N.: Löfdahl, C.-G. and Svedmyr, K.: The effect of powder aerosol compared to pressurized aerosol. European Journal of Respiratory Diseases 63 (Suppl. 119): 81–88 (1982).
Tandon. M.K. and Strahan, E.G.: Double-blind crossover trial comparing beclomethasone dipropionate and sodium cromoglycatc in perennial allergic rhinitis. Clinical Allergy 10: 459–462 (1980).
Toft. A.; Wihl, J.-A.; Toxman, J. and Mygind, N.: Double-blind comparison between beclomethasone dipropionate as aerosol and as powder in patients with nasal polyposis. Clinical Allergy 12: 391–401 (1982).
Toogood. J.H.: Steroids in Asthma. Correspondence. Lancet 2: 1185 (1979).
Toogood. J.H.: Concentrated aerosol formulations in asthma. Lancet 2: 790–791 (1983).
Toogood. J.H.; Baskerville, J.C.; Jennings, B.: Influence of dosing frequency on the response of chronic asthmatics to the aerosol steroid budesonide. Journal of Allergy and Clinical Immunology 70: 288–298 (1982b).
Toogood, J.H.; Baskerville, J.; Lefcoe, N. and Jennings, B.: Combined cromolyn (CS) beclomethasone aerosol (BA) therapy for chronic asthma. Abstract No. 65. Journal of Allergy and Clinical Immunology 65: 183 (1980a).
Toogood, J.H.; Jennings, B.; Baskerville, J. et al.: Clinical use of spacer systems for corticosteroid inhalation therapy: A preliminary analysis. European Journal of Respiratory Diseases 63 (Suppl. 122): 100–107 (1982c).
Toogood, J.H.; Jennings, B.; Crepea, S.B. and Johnson, J.D.: Efficacy and safety of concurrent use of intranasal flunisolide and oral beclomethasone aerosols in treatment of asthmatics with rhinitis. Clinical Allergy 12: 95–105 (1982a).
Toogood, J.H.; Jennings, B.; Greenway, R.W. and Chuang, L.: Candidiasis and dysphonia complicating beclomethasone treatment of asthma. Journal of Allergy and Clinical Immunology 65: 145–153 (1980b).
Toogood, J.H.; Lefcoe, N.M.; Haines, D.S.M.; Chuang, L; Jennings, B.; Errington, N.; Baksh, L. and Cauchi, M.: Minimum dose requirements of steroid-dependent asthmatic patients for aerosol beclomethasone and oral prednisone. Journal of Allergy and Clinical Immunology 61: 355 (1978).
Toogood, J.H.; Lefcoe, N.M.; Haines, D.S.M.; Jennings, B.; Errington, N.; Baksh, L. and Chuang, L: A graded-dose assessment of the efficacy of beclomethasone aerosol for severe chronic asthma. Journal of Allergy and Clinical Immunology 59: 298 (1977).
Vacca, M.; De Natale, G. and Preziosi, P.: A comparison between glucocorticoid systemic activity of betamethasone 17,21-dipropionate and beclomethasone 17,21-dipropionate. Current Therapeutic Research 30: 566–577 (1981).
Vaz, R.; Senior, B.; Morris, M. and Binkiewicz, A.: Adrenal effects of beclomethasone inhalation therapy in asthmatic children. Journal of Pediatrics 100: 660 (1982).
Vilsvik, J.S.; Jenssen, A.O. and Wahlstad, R.: The effect of beclomethasone dipropionate aerosol on allergen-induced nasal stenosis. Clinical Allergy 5: 292–295 (1975).
Webb, D.R.: Beclomethasone in steroid-dependent asthma. Effective therapy and recovery of hypothalamo-pituitary-adrenal function. Journal of the American Medical Association 238: 1508–1511 (1977).
Wheatley, D.: A corticosteroid nasal spray in hayfever. Current Therapeutic Research 19: 612–621 (1976).
Wihl, J.-Å.: Topical corticosteroids and nasal reactivity. European Journal of Respiratory Diseases 63 (Suppl. 122): 205–210 (1982).
Williams, A.J.; Baghat, M.S.; Stableforth, D.E.; Cayton, R.M.; Shenoi, P.M. and Skinner, C: Dysphonia caused by inhaled steroids: Recognition of a characteristic laryngeal abnormality. Thorax 38: 813–821 (1983a).
Williams, H.; Sibert, J.R.; Verrier Jones, E.R.; Can inhaled beclomethasone dipropionate be reduced to a twice daily dose frequency in the management of childhood asthma. Abstract of paper presented at the 49th Annual Scientific Assembly, Chicago 23–27 October (1983b).
Willey, R.F.; Godden, D.J.; Carmichael, J.; Preston, P.; Frame, M. and Crompton, G.K.: Comparison of twice daily administration of a new corticosteroid budesonide with beclomethasone dipropionate four times daily in the treatment of chronic asthma. British Journal of Diseases of the Chest 76: 61 (1982).
Willey, R.F.; Milne, L.J.R.; Crompton, G.K. and Grant, I.W.B.: Beclomethasone dipropionate aerosol and oropharyngeal candidiasis. British Journal of Diseases of the Chest 70: 32 (1976).
Wyatt, R.; Waschek, J.; Weinberger, M. and Sherman, B.: Adrenal suppression from alternate-day prednisone and inhaled beclomethasone. Abstract No. 76. Journal of Allergy and Clinical Immunology 61: 151 (1978b).
Wyatt, R.; Waschek, J.; Weinberger, M. and Sherman, B.: Effects of inhaled beclomethasone dipropionate and alternate-day prednisone on pituitary-adrenal function in children with chronic asthma. New England Journal of Medicine 299: 1387 (1978a).
Yernalt, J.-C: Leclercq, R.; Schandevyl, W.; Virasoro, E.; De Coster, A. and Copinschi, G.: The endocrinometabolic effects of beclomethasone dipropionate in asthmatic patients. Chest 71: 698–702 (1977).
Various sections of the manuscript reviewed by: G.K. Crompton, Respiratory Unit, Northern General Hospital, Edinburgh, Scotland; E. Holopainen, ENT Department, Laakso Hospital, Helsinki, Finland; M.C.S. Kennedy, Department of Respiratory Physiology, City General Hospital, Stoke-on-Trent, England; N. Mygind, University ENT Department, Rigshospitalet, Copenhagen, Denmark; M.C.F. Pain, Department of Thoracic Medicine, Royal Melbourne Hospital, Victoria, Australia; M.J. Smith, Department of Respiratory Physiology, Cardiothoracic Institute, Fulham Road, London, England; J.H. Toogood, Allergy Clinic, Victoria Hospital, London, Ontario, Canada; R.F. Willey, Lancaster Health Authority, Royal Lancaster Infirmary, Lancaster, England; M.H. Williams, Department of Medicine, Albert Einstein College of Medicine, Bronx Municipal Hospital Center, Bronx, New York, USA; J.D, Wilson, Department of Medicine, School of medicine, University of Auckland, New Zealand.
‘Becotide’ ‘Beconase’ (Allen and Hanburys; Glaxo); ‘Aldecin’, ‘Viarox’ (Schering Corporation); ‘Beclomet Nasal’ (Remeda, Finland).
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Brogden, R.N., Heel, R.C., Speight, T.M. et al. Beclomethasone Dipropionate. Drugs 28, 99–126 (1984). https://doi.org/10.2165/00003495-198428020-00002
- Nasal Polyposis
- Beclomethasone Dipropionate