Beklospir
Beklospir: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Beclospir
ATX code: R03BA01
Active ingredient: beclometasone (Beclometasone)
Producer: JSC "Pharmaceutical Factory of St. Petersburg" (Russia)
Description and photo update: 2020-04-06
Beclospir is a topical preparation, glucocorticosteroid (GCS).
Release form and composition
The drug is released in the form of a metered dose inhalation aerosol, which is a suspension under pressure; when spraying on a glass slide, a white spot is formed [200 doses (50, 100 or 250 mcg per dose) in aluminum cans equipped with a metering valve and a nebulizer for anti-asthma drugs, 1 can in a cardboard box and instructions for use of Beclospir].
1 bottle (200 doses, or 14.02 g) contains:
- active substance: beclomethasone dipropionate - 0.012; 0.024 or 0.06 g (the content of beclomethasone dipropionate in one dose is 50, 100 or 250 mcg, respectively);
- auxiliary components: ethanol (absolute ethyl alcohol), hydrofluoroalkane (HFA-134a).
Pharmacological properties
Pharmacodynamics
Beklospir is a drug for topical use in the form of inhalation. Its active substance, beclomethasone dipropionate, has a weak tropism for glucocorticosteroid (GCS) receptors and is a prodrug. A pronounced local anti-inflammatory effect is exerted by its active metabolite - beclomethasone-17-monopropionate, which is formed under the action of esterases. The therapeutic effect is due to a decrease in the formation of the chemotaxis substance (effect on delayed-type allergic reactions). It inhibits the development of an immediate allergic reaction as a result of suppression of the production of metabolites of arachidonic acid and a decrease in the release of inflammatory mediators from mast cells. Helps to improve mucociliary transport, reduce the number of mast cells in the bronchial mucosa and epithelial edema, reduce bronchial hyperreactivity,marginal accumulation of neutrophils, mucus secretion by bronchial glands, inflammatory exudate and production of lymphokines. It inhibits the migration of macrophages, reduces the intensity of infiltration and granulation processes. Does not relieve bronchospasm. When administered by inhalation, it has almost no resorptive effect. The clinical effect is usually observed after 5-7 days of regular use of Beklospir.
Against the background of an increase in active beta-adrenergic receptors, the patient's response to bronchodilators is restored, which makes it possible to reduce the frequency of their use.
Pharmacokinetics
After inhalation, more than 25% of the dose of beclomethasone dipropionate is deposited in the respiratory tract, the rest remains in the mouth and pharynx, and also enters the gastrointestinal tract (GIT) as a result of ingestion.
Before the absorption of beclomethasone, dipropionate is extensively metabolized in the lungs to form the active metabolite, beclomethasone-17-monopropionate. Systemic absorption occurs in the lungs (36% - pulmonary fraction) and in the gastrointestinal tract (26% of the swallowed dose). The absolute bioavailability of unchanged beclomethasone dipropionate is about 2%, beclomethasone-17-monopropionate is 62% of the inhaled dose.
Beklospir is absorbed quickly. The maximum plasma concentration of beclomethasone dipropionate is reached within 0.3 hours, beclomethasone-17-monopropionate - 1 hour.
Plasma protein binding - 87%.
The volume of distribution in tissues is: beclomethasone dipropionate - 20 liters, beclomethasone-17-monopropionate - 424 liters. Plasma clearance of beclomethasone dipropionate and its active metabolite is 150 l / h and 120 l / h, respectively. The half-life of beclomethasone dipropionate is 0.5 hours, and that of beclomethasone-17-monopropionate is 2.7 hours.
Indications for use
The use of Beklospir is shown as a basic therapy for various forms of bronchial asthma in adults and children over 4 years old.
Contraindications
Absolute:
- children under 4 years of age;
- hypersensitivity to drug components.
Beklospir aerosol should be prescribed with caution to patients with liver cirrhosis, glaucoma, systemic infections (viral, fungal, parasitic, bacterial, including pulmonary tuberculosis), osteoporosis, hypothyroidism, during pregnancy and breastfeeding.
Beklospir, instructions for use: method and dosage
Beklospir aerosol is used by inhalation.
Before each use of the inhaler, make sure that the outlet tube is clean!
The procedure should take place without the slightest stress! Having removed the cap from the inhaler, the cartridge should be held in an upright position, placing the thumb on the bottom, and the index finger on its top. Vigorously shaking the can up and down, you need to make a deep exhalation through your nose and tightly clasp your lips around the tube of the can. Then inhaling slowly deeply, press the valve of the cartridge with your index finger and release a dose of spray, while continuing to inhale slowly. After removing the inhaler tube from your mouth, you should hold your breath for at least 10 seconds (s), then exhale slowly. With the simultaneous use of several doses, the interval between their administration should be at least 60 s. After the procedure, the inhaler is closed with a cap.
At the first stage of application, it is desirable to carry out inhalations in front of a mirror. If there is a release of "steam" from the top of the can or from the corners of the mouth, then the procedure should be repeated.
In the cold season, it is recommended to warm the spray can by hand, taking it out of the plastic case, since significant cooling of the spray can reduce its effectiveness.
The doctor selects the daily dose individually, taking into account the severity of bronchial asthma, it is divided into several doses.
The recommended initial daily doses of Beklospir for adults and children aged 12 years and older, taking into account the severity of bronchial asthma:
- mild degree [forced expiratory volume (FEV) or peak expiratory flow rate (PSV) - more than 80%, daily variation of PSV indices - less than 20%]: from 200 to 600 μg;
- average degree (FEV or PSV - 60–80%, daily range of PSV indicators - 20–30%): from 600 to 1000 μg;
- severe degree (FEV or PSV - 60%, daily range of indicators - more than 30%): from 1000 to 1200 mcg.
A stepwise approach to the treatment of bronchial asthma involves the use of Beklospir in a dose corresponding to the severity of the disease, starting from the second stage of therapy.
The following dosage is recommended:
- stage II, basic therapy: 100–400 mcg 2 times a day;
- stage III, basic therapy, combination of beclomethasone dipropionate with inhalation of long-acting beta 2 -adrenoreceptor agonists: 800-1600 mcg (in some cases up to 2000 mcg) per day;
- stages IV and V (severe bronchial asthma): 800-1600 mcg (in some cases up to 2000 mcg) per day.
The daily dose of Beklospir for children aged 4 to 12 years can be up to 400 mcg, it is divided into several doses throughout the day.
For elderly patients, as well as for patients with renal and / or hepatic insufficiency, dose adjustment is not required.
If you accidentally miss one inhalation, therapy should be continued in accordance with the treatment regimen with the next single dose at the appropriate time.
The inhaler requires regular maintenance, which consists in cleaning it at least once every 7 days. To do this, remove the metal can from the plastic case and rinse the case and cap with warm (not hot) water. After carefully drying them in natural conditions, the can is placed back into the case and closed with a cap. Do not dip a metal can in water.
Side effects
- from the respiratory system: irritation of the pharyngeal mucosa, candidiasis of the upper respiratory tract (the risk of occurrence increases with daily doses of more than 400 mcg), hoarseness (dysphonia), paradoxical bronchospasm;
- on the part of the digestive tract: unpleasant taste sensations, nausea, oral candidiasis (the risk of occurrence increases with daily doses of more than 400 μg);
- allergic reactions: hypersensitivity reactions (including redness and swelling of the lips, mucous membranes of the mouth and pharynx, eyes and face, itching, rash, urticaria);
- others: systemic effects (including headache, decreased function of the adrenal cortex, bruising or thinning of the skin, osteoporosis, cataracts, glaucoma, in children and adolescents - growth retardation).
Overdose
Symptoms: with an acute overdose of Beklospir, a temporary decrease in the function of the adrenal cortex can be observed, with chronic - persistent suppression of the function of the adrenal cortex.
Treatment: in case of an acute overdose, emergency therapy is not required, since within a few days the function of the adrenal cortex is restored, as evidenced by the level of cortisol in the plasma. In case of chronic overdose, it is necessary to monitor the reserve function of the adrenal cortex. The use of Beklospir can be continued in doses required to adequately maintain the therapeutic effect.
special instructions
When Beklospir is prescribed against the background of the use of GCS inside, its dose remains the same. The patient's condition should be relatively stable. After 7-14 days of combination therapy, a gradual decrease in the daily dose of oral corticosteroids should be started according to the scheme that the doctor prescribes taking into account the duration of previous treatment and the value of the initial dose of corticosteroids. In most cases, regular inhalation of corticosteroids allows you to cancel concomitant therapy with their oral forms. If patients took no more than 15 mg of prednisolone, then they can be completely transferred to inhalation therapy. However, after the transition, they need careful monitoring of the condition, including regular examination of indicators of the function of the adrenal cortex, during the period (first months) necessary for sufficient restoration of the pituitary-adrenal system,able to provide an adequate response to stressful situations such as infection, trauma or surgery. It should be borne in mind that the transfer of patients from systemic to inhaled GCS may increase the risk of developing allergic reactions (including allergic rhinitis, eczema), previously suppressed by systemic drugs. Patients with bronchial asthma with reduced function of the adrenal cortex who have used GCS only by inhalation should always have a supply of systemic GCS and a warning card indicating the need for additional systemic GCS in stressful situations. A sudden and progressive worsening of asthma symptoms requires an immediate increase in the GCS dose, since it poses a potential danger to the patient's life. An indirect indication of the ineffectiveness of therapy is the increase in the frequency of use of short-acting beta-adrenergic agonists.
If paradoxical bronchospasm occurs, the use of Beklospir should be stopped immediately and the attending physician should be consulted, who, after assessing the patient's condition and conducting an appropriate examination, will prescribe treatment with other drugs. For immediate relief of paradoxical bronchospasm, inhaled beta 2 -adrenomimetics of short action are used.
After achieving the desired therapeutic effect, the dose of inhaled corticosteroids is recommended to be reduced to the minimum effective dose to control the course of the disease. This will reduce the risk of developing systemic side effects. In most patients, the use of Beklospir at a daily dose of 1500 mcg is not accompanied by significant suppression of adrenal function.
When prescribing a drug, the doctor must instruct the patient about the rules for using inhaled GCS and make sure that their implementation ensures adequate penetration of the active substance into the lungs.
After each inhalation, the mouth and throat should be rinsed with water. The development of oral candidiasis most often occurs in patients with a high level of anti-candidiasis antibodies (evidence of previous candidiasis). For the treatment of candidiasis, the simultaneous use of local antifungal agents is indicated.
Beclospir is intended for regular daily use, and not for relieving attacks of bronchial asthma. For relief of seizures, salbutamol and other short-acting beta 2 -adrenomimetics should be used. In the absence of a sufficient therapeutic effect or severe exacerbation of bronchial asthma, the dose of inhaled beclomethasone dipropionate should be increased, if necessary, the appointment of systemic GCS is indicated. If an infection develops, an antibiotic should be given.
Long-term use of inhaled GCS for the treatment of children is recommended to be accompanied by regular monitoring of the dynamics of the child's growth.
Abrupt cessation of Beklospir use is contraindicated.
To prevent damage to the skin of the eyelids and nose, it is necessary to wash your face with water after each procedure. Do not allow the spray to get into the eyes.
The can (including empty) must not be thrown into fire or taken apart.
Influence on the ability to drive vehicles and complex mechanisms
There is no data on the effect of Beklospir on a person's ability to drive vehicles or complex mechanisms.
Application during pregnancy and lactation
With extreme caution and only in cases where the potential effect to the mother outweighs the possible risk to the fetus and child, the use of Beklospir is allowed during pregnancy and breastfeeding.
Pediatric use
The use of Beklospir aerosol in children under the age of 4 is contraindicated.
With impaired renal function
No dose adjustment is required for patients with renal impairment.
For violations of liver function
Beklospir should be prescribed with caution in patients with liver cirrhosis.
In hepatic impairment, dose adjustment is not required.
Use in the elderly
For elderly patients, dose adjustment of Beklospir is not required.
Drug interactions
There are no research results confirming the interaction of Beclospir with other drugs.
Analogs
Beclospir analogs are Beclomethasone, Beclomethasone DS, Beclomethasone Orion Pharma, Beclomethasone-aeronautical, Allergorus, Beklazon Eco, Beklazon Eco Light Respiration, Boson, Klenil, Klenil UDV, Nasobek, Rinocklenil.
Terms and conditions of storage
Keep out of the reach of children.
Store at temperatures up to 30 ° C, do not freeze.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews of Beklospir
Reviews of Beklospir are few, but they are positive. According to users, the drug is convenient and easy to use, does not cause discomfort when used in public places.
As disadvantages, the cost of the aerosol is mentioned, which is considered overestimated, as well as the lack of effect (in some patients, Beklospir therapy did not bring the expected results). In addition, patients complain that the drug has not been on sale recently.
Beklospir price in pharmacies
Currently, the drug is not supplied to the retail network, its supplies are carried out only to medical institutions. Prices for Beclospir registered in the VED list (Vital and Essential Medicines), for a package containing 1 aerosol canister, can be: 50 mcg in one dose - from 233 rubles, 100 mcg in one dose - from 276 rubles., 250 mcg per dose - from 362 rubles.
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
