IN THE UK THE ADULT DOSAGE OF THE CONVENTIONAL AEROSOL AND SOME DRY POWDER INHALERS IS USUALLY 400 MICROGRAMS DAILY, INHALED IN 2 TO 4 DIVIDED DOSES FOR MAINTENANCE TREATMENT; IF NECESSARY, 600 TO 800 MICROGRAMS MAY BE INHALED DAILY INITIALLY, SUBSEQUENTLY ADJUSTED ACCORDING TO THE PATIENT'S RESPONSE. IN PATIENTS WITH SEVERE ASTHMA OR IN THOSE SHOWING ONLY A PARTIAL RESPONSE TO STANDARD INHALATION DOSES, HIGH-DOSE INHALATION THERAPY MAY BE CONSIDERED; DOSES OF 1 MG DAILY (250 MICROGRAMS FOUR TIMES DAILY OR 500 MICROGRAMS TWICE DAILY) MAY BE USED AND MAY BE INCREASED TO 1.5 TO 2 MG DAILY (500 MICROGRAMS THREE OR FOUR TIMES DAILY) IF NECESSARY; A MAXIMUM OF 2 MG DAILY SHOULD NOT BE EXCEEDED. IN CHILDREN, 50 OR 100 MICROGRAMS MAY BE INHALED 2 TO 4 TIMES DAILY ACCORDING TO THE RESPONSE OR ALTERNATIVELY, 100 OR 200 MICROGRAMS MAY BE INHALED TWICE DAILY.
ALTHOUGH BECLOMETASONE DIPROPIONATE IS GENERALLY INHALED IN AEROSOL FORM, INHALATION CAPSULES OR DISCS CONTAINING POWDER FOR INHALATION ARE AVAILABLE FOR PATIENTS WHO EXPERIENCE DIFFICULTY IN USING THE AEROSOL. OWING TO DIFFERENCES IN THE RELATIVE BIOAVAILABILITY TO THE LUNGS A 100-MICROGRAM DOSE FROM AN INHALATION CAPSULE OR DISC IS APPROXIMATELY EQUIVALENT IN ACTIVITY TO A 50-MICROGRAM DOSE FROM A CONVENTIONAL AEROSOL. RECOMMENDED MAINTENANCE DOSES OF BECLOMETASONE DIPROPIONATE FROM INHALATION CAPSULES OR DISCS ARE THEREFORE HIGHER: 200 MICROGRAMS INHALED 3 OR 4 TIMES DAILY OR 400 MICROGRAMS INHALED TWICE DAILY FOR ADULTS, AND 100 MICROGRAMS INHALED 2 TO 4 TIMES DAILY OR 200 MICROGRAMS INHALED TWICE DAILY FOR CHILDREN. UP TO 800 MICROGRAMS TWICE DAILY MAY BE INHALED IF NECESSARY IN ADULTS REQUIRING HIGH-DOSE THERAPY.
IN SOME COUNTRIES BECLOMETASONE DIPROPIONATE IS NOW AVAILABLE AS A CFC-FREE AEROSOL. BECAUSE OF CHANGES IN PARTICLE SIZE THE DOSE REQUIRED FROM SOME SUCH INHALERS MAY BE LOWER THAN THAT FROM A CONVENTIONAL AEROSOL: TYPICAL UK DOSES FOR ONE PRODUCT (QVAR) RANGE FROM 100 TO 200 MICROGRAMS DAILY IN MILD ASTHMA TO 400 TO 800 MICROGRAMS DAILY IN SEVERE ASTHMA, GIVEN AS 2 DIVIDED DOSES.
INHALATION OF NEBULISED BECLOMETASONE DIPROPIONATE HAS ALSO BEEN USED IN THE MANAGEMENT OF ASTHMA IN CHILDREN.
BECLOMETASONE DIPROPIONATE IS ALSO USED AS A NASAL SPRAY IN THE PROPHYLAXIS AND TREATMENT OF ALLERGIC AND NON-ALLERGIC RHINITIS. USUAL DOSES ARE 100 MICROGRAMS IN EACH NOSTRIL TWICE DAILY OR 50 MICROGRAMS IN EACH NOSTRIL 3 OR 4 TIMES DAILY; A TOTAL OF 400 MICROGRAMS DAILY SHOULD NOT GENERALLY BE EXCEEDED. A DOSE OF 50 MICROGRAMS IN EACH NOSTRIL TWICE DAILY MAY BE SUFFICIENT FOR PROPHYLAXIS. THE NASAL SPRAY IS ALSO USED TO PREVENT RECURRENCE OF NASAL POLYPS AFTER SURGICAL REMOVAL.
BECLOMETASONE DIPROPIONATE IS ALSO USED TOPICALLY IN THE TREATMENT OF VARIOUS SKIN DISORDERS. IT IS GENERALLY APPLIED AS A CREAM OR OINTMENT CONTAINING 0.025%. BECLOMETASONE SALICYLATE HAS ALSO BEEN USED TOPICALLY. FOR RECOMMENDATIONS CONCERNING THE CORRECT USE OF CORTICOSTEROIDS ON THE SKIN, AND A ROUGH GUIDE TO THE CLINICAL POTENCIES OF TOPICAL CORTICOSTEROIDS.
SEVERE ASTHMA :- 12 TO 16 INHALATION A DAY. MAXIMUM 20 INHALATION.