beclomethasone, intranasal (Rx)Brand and Other Names:Beconase AQ, QNASL

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

metered-dose nasal spray suspension

  • 42mcg/actuation (Beconase AQ)

metered-dose nasal spray solution

  • 80mcg/actuation (QNASL)

Allergic Rhinitis

Indicated for the relief of the symptoms of seasonal or perennial allergic and nonallergic (vasomotor) rhinitis

Beconase AQ: 1-2 sprays/nostril twice daily (total daily dose: 168-336 mcg/day)

QNASL: 2 sprays/nostril qDay (total daily dose: 320 mcg/day)

Nasal Polyps (Postsurgical Prophylaxis)/ Vasomotor Rhinitis

Beconase AQ: 1-2 sprays/nostril twice daily (total daily dose: 168-336 mcg/day)

Administration

Beconase AQ

  • Shake well before each use
  • Before first use, prime pump by 6 actuations into air
  • If not used for 7 days, reprime pump until fine spray appears

QNASL

  • Before first use, prime pump by spraying into air away from eyes 4 times (dosage counter on canister should read 120 after priming)
  • To prime, hold device upright between thumb and index finger (the canister should be on top, pointing down)
  • If not used for 7 days, reprime pump with 2 sprays before use

Dosage Forms & Strengths

metered-dose nasal spray suspension

  • 42mcg/actuation (Beconase AQ)

metered-dose nasal spray solution

  • 40mcg/actuation (QNASL)
  • 80mcg/actuation (QNASL)

Rhinitis

Indicated for the relief of the symptoms of seasonal or perennial allergic, and nonallergic (vasomotor) rhinitis

Beconase AQ

  • <6 years: Safety and efficacy not established
  • 6-11 years: 1 spray/nostril twice daily (168 mcg/day); may increase to 2 sprays/nostril (336 mcg/day) in patients not adequately responding or those with more severe symptoms; decrease dose to 1 spray/nostril twice daily once adequate control achieved
  • 12 years: As in adults; 1-2 sprays/nostril twice daily (total dose: 168-336 mcg/day)

QNASL

  • <4 years: Safety and efficacy not established
  • 4-11 years: 1 spray (40 mcg/actuation) each nostril qDay (total dose: 80 mcg/day)
  • ≥12 years: As in adults; 2 sprays (80 mcg/actuation) each nostril qDay (total dose: 320 mcg/day)

Administration

Beconase AQ

  • Shake well before each use
  • Before first use, prime pump by 6 actuations into air
  • If not used for 7 days, reprime pump until fine spray appears

QNASL

  • Before first use, prime pump by spraying into air away from eyes 4 times (dosage counter on canister should read 120 after priming)
  • To prime, hold device upright between thumb and index finger (the canister should be on top, pointing down)
  • If not used for 7 days, reprime pump with 2 sprays before use
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Adverse Effects

>10%

Nasopharyngeal irritation (24%)

1-10%

Headache (<5%)

Nausea (<5%)

Lightheadedness (<5%)

Sneezing attacks after administration (4%)

Nasal congestion (<3%)

Nose bleeds (<3%)

Rhinorrhea (<3%)

Increased lacrimation (<3%)

Epistaxis (<3%)

Frequency Not Defined

Nasal mucosa ulceration

Nasal septum perforation

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Warnings

Contraindications

Hypersensitivity

Used as primary treatment of status asthmaticus or acute episodes of asthma where intensive measures are required

Cautions

Monitor for vision change, or with history of increased IOP, glaucoma, or cataracts

Recent nasal surgery, nasal trauma, nasal septum ulcers (until healing has occurred)

Potential worsening of existing tuberculosis, fungal, bacterial, viral, or parasitic infections, or ocular herpes simplex

More serious or fatal course of chickenpox or measles in susceptible patients

Risk for hypercorticism and adrenal suppression with higher than normal doses

Potential reduction of growth velocity in children

Prolonged corticosteroid use may result in elevated IOP, glaucoma, and/or cataracts

Nasal septal perforation and localized Candida albicans infections of the nose and/or pharynx may occur

Nasal discomfort, epistaxis, and nasal ulceration reported

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Pregnancy & Lactation

Pregnancy Category: C

Lactation: Unknown whether distributed in breast milk; use caution

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

more...
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Pharmacology

Mechanism of Action

Corticosteroid with potent anti-inflammatory properties; elicits effects on various cells, including mast cells and eosinophils; also elicits effects on inflammatory mediators (eg, histamine, eicosanoids, leukotrienes, cytokines)

Absorption

Bioavailability: 44% (43% from swallowing portion of intranasal dose; 1% from nasal absorption)

Peak Plasma Concentration: Undetectable (<50 pg/mL)

Distribution

Protein Bound: 87%

Vd: 20 L; 424 L for B-17-MP metabolite

Metabolism

Metabolites: B-17-MP active metabolite

Metabolized by: Esterase enzymes found in most tissues

Elimination

Half-life: 0.3 hr

Excretion: feces (60%), urine (12%); after oral administration

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Images

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Formulary

FormularyPatient Discounts

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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