The People's Perspective on Medicine

Beclomethasone

Overview

Vancenase AQ and its twin Beconase AQ have become very popular allergy treatments.

Corticosteroids (cortisone-like drugs such as prednisone) are very effective at easing inflammation and irritation in the upper respiratory tract (nose and lungs).

The problem with oral steroids, however, is that they come with a long list of side effects if they are used on a regular basis (cataracts, glaucoma, fluid retention, high blood pressure, muscle weakness, weakened bones, peptic ulcer, mood swings, etc.)

Ingredients in nasal sprays, however, are less likely to be absorbed into the body and cause such serious adverse reactions. Vancenase AQ and Beconase AQ are prescribed for allergic symptoms such as runny nose, stuffiness, and congestion.

Side Effects and Interactions

Nasal irritation may sometimes accompany the use of Vancenase AQ. This can precipitate a sneezing attack.

Other side effects may include nasal congestion, wheezing, nosebleeds, runny nose, or tearing eyes.

Lightheadedness, headache, and nausea have also been reported.

In rare cases patients have noted ulceration of the nasal tissues and perforation of the septum (the cartilage between the nostrils).

Cataracts and glaucoma are quite uncommon but may represent signs of systemic absorption.

Prolonged use at higher than recommended doses can increase the risk of such side effects. Report any symptoms to your physician promptly.

Special Precautions

Corticosteroid sprays are not supposed to be readily absorbed into the body.

Nevertheless, a study in the New England Journal of Medicine (July 3, 1997) revealed that when asthma patients inhaled beclomethasone (found in Vanceril and Beclovent) for long periods of time, they experienced a substantial increase in cataract formation.

An article in JAMA (March 5, 1997) noted that high doses of inhaled steroids (taken for more than three months) increased the risk for glaucoma. This suggests that at least for corticosteroid asthma inhalers there is absorption of the drug into the body.

Although Vancenase AQ and Beconase AQ are very effective for relieving nasal allergy symptoms, care must be taken not to overuse such sprays.

Exceeding the recommended dose could lead to systemic absorption and side effects such as fluid retention, acne, menstrual changes, enlarged face, and suppression of the body's natural cortisol production.

People exposed to chicken pox or measles should contact a physician immediately. If the immune system is impaired (through excess corticosteroid exposure) these infections could become very serious. Anyone with TB, herpes infection of the eye, or an untreated bacterial, fungal, or viral infection should probably not use any corticosteroid nasal spray unless specifically told to do so by a physician.

If someone uses corticosteroid nasal sprays for prolonged periods of time (more than several months) he should be seen by a physician so an examination of the nasal mucosa can be carried out. There have been rare cases of nasal septum perforation (a hole between the two nostrils) when such products are used for a long time.

Cases of yeast infections (Candida albicans) can occur with repeated use of any corticosteroid spray. If such an infection arises in the nose it will likely require suspension of Vancenase AQ and appropriate antifungal therapy.

If symptoms persist or someone experiences nasal irritation or breathing problems such as wheezing, a physician should be notified promptly.

In rare cases pressure within the eye has increased after exposure to nasal steroid sprays. This is unlikely with beclomethasone, but people with a risk of glaucoma should be periodically checked by an ophthalmologist.

A woman who may become pregnant should check with a physician before using any corticosteroid nasal spray.

Taking the Medicine

The usual dose of Vancenase AQ is one or two sprays in each nostril twice daily.

Steroid nasal sprays do not relive symptoms immediately. It may take one to two weeks of regular use to experience benefit.

If symptom relief is not noted within three weeks, discontinue the spray and notify your physician.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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