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Adult Dosing .
Dosage forms: SPRAY: 80 mcg per actuation
allergic rhinitis
- [2 actuations (80 mcg per actuation) in each nostril qd]
- Max: 4 actuations/day
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: SPRAY: 40 mcg per actuation, 80 mcg per actuation
allergic rhinitis
- [4-11 yo]
- Dose: 1 actuation (40 mcg per actuation) in each nostril qd; Max: 2 actuations/day
- [12 yo and older]
- Dose: 2 actuations (80 mcg per actuation) in each nostril qd; Max: 4 actuations/day
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- nasal septal ulcer, unhealed
- nasal wound, unhealed
- caution: long-term systemic corticosteroid use, recent
- caution: local infection, untreated
- caution: systemic infection, untreated
- caution: TB infection
- caution: ocular HSV infection
- caution: measles exposure
- caution: varicella exposure
- caution: IOP incr.
- caution: glaucoma
- caution: cataract
- caution: peds pts (long-term use)
Drug Interactions .
Overview
beclomethasone nasal
corticosteroid nasal
- immunosuppressive effects
- interferes w/ ACTH analog test
Avoid/Use Alternative
- beclomethasone nasal
- budesonide nasal
- cladribine oral
- flunisolide nasal
- mometasone nasal
- natalizumab
- pimecrolimus topical
Monitor/Modify Tx
- carfilzomib
- cosyntropin
- everolimus
- temsirolimus
Caution Advised
- abatacept
- abemaciclib
- abrocitinib
- acalabrutinib
- adalimumab
- aldesleukin
- alemtuzumab
- anakinra
- anifrolumab
- anti-thymocyte globulin
- atidarsagene autotemcel
- avacopan
- axicabtagene ciloleucel
- azacitidine
- azathioprine
- baricitinib
- basiliximab
- beclomethasone inhaled
- belatacept
- belimumab
- belinostat
- bendamustine
- betamethasone
- bimekizumab
- blinatumomab
- bortezomib
- brentuximab vedotin
- brexucabtagene autoleucel
- brodalumab
- budesonide
- budesonide inhaled
- budesonide rectal
- busulfan
- cabazitaxel
- canakinumab
- carboplatin
- carmustine
- certolizumab pegol
- chlorambucil
- ciltacabtagene autoleucel
- cisplatin
- cladribine injection
- clofarabine
- copanlisib
- corticotropin
- cortisone
- cyclophosphamide
- cyclosporine
- cytarabine
- dacarbazine
- dactinomycin
- danicopan
- daratumumab
- dasatinib
- daunorubicin
- decitabine
- deflazacort
- deucravacitinib
- dexamethasone
- dexamethasone ophthalmic
- difluprednate ophthalmic
- dimethyl fumarate
- dinutuximab
- diroximel fumarate
- docetaxel
- doxorubicin
- dupilumab
- duvelisib
- eculizumab
- efgartigimod alfa
- elivaldogene autotemcel
- elotuzumab
- elranatamab
- emapalumab
- epcoritamab
- epirubicin
- eribulin
- etanercept
- etoposide
- etrasimod
- fingolimod
- floxuridine
- fludarabine
- fludrocortisone
- fluocinolone intravitreal
- fluorometholone ophthalmic
- fluorouracil
- fluticasone furoate
- fluticasone propionate
- fruquintinib
- gemcitabine
- gemtuzumab ozogamicin
- glofitamab
- golimumab
- guselkumab
- hydrocortisone
- hydrocortisone ophthalmic
- hydroxyurea
- ibritumomab tiuxetan
- ibrutinib
- idarubicin
- idecabtagene vicleucel
- idelalisib
- ifosfamide
- inebilizumab
- infliximab
- inotuzumab ozogamicin
- iptacopan
- irinotecan
- isatuximab
- ixabepilone
- ixekizumab
- leflunomide
- lenalidomide
- lisocabtagene maraleucel
- lomustine
- loncastuximab tesirine
- loteprednol ophthalmic
- lymphocyte immune globulin, anti-thymocyte globulin
- melphalan
- mercaptopurine
- methotrexate
- methylprednisolone
- mirikizumab
- mitomycin
- mitoxantrone
- mogamulizumab
- momelotinib
- mometasone implant
- mometasone inhaled
- monomethyl fumarate
- mosunetuzumab
- mycophenolate mofetil
- mycophenolic acid
- nelarabine
- obinutuzumab
- ocrelizumab
- ofatumumab
- omacetaxine mepesuccinate
- oxaliplatin
- ozanimod
- paclitaxel
- panobinostat
- pegcetacoplan
- pentostatin
- pirtobrutinib
- polatuzumab vedotin
- pomalidomide
- ponatinib
- ponesimod
- pozelimab
- pralatrexate
- prednisolone
- prednisolone ophthalmic
- prednisone
- procarbazine
- quizartinib
- ravulizumab
- regorafenib
- rilonacept
- risankizumab
- ritlecitinib
- rituximab
- romidepsin
- ropeginterferon alfa-2b
- rozanolixizumab
- ruxolitinib
- ruxolitinib topical
- sarilumab
- satralizumab
- secukinumab
- selinexor
- siltuximab
- siponimod
- sirolimus
- sirolimus albumin-bound
- spesolimab
- sulfasalazine
- sutimlimab
- tacrolimus
- tafasitamab
- talquetamab
- teclistamab
- temozolomide
- teplizumab
- teriflunomide
- thioguanine
- thiotepa
- tildrakizumab
- tisagenlecleucel
- tocilizumab
- tofacitinib
- topotecan
- tralokinumab
- triamcinolone
- ublituximab
- umbralisib
- upadacitinib
- ustekinumab
- vamorolone
- vedolizumab
- venetoclax
- vilobelimab
- vinblastine
- vincristine
- vinorelbine
- voclosporin
- zanubrutinib
- zilucoplan
Adverse Reactions .
Serious Reactions
- hypersensitivity rxn
- anaphylaxis
- glaucoma
- cataracts
- hypercorticism
- adrenal suppression
- growth suppression (peds pts)
Common Reactions
- nasal irritation
- headache
- nausea
- lightheadedness
- epistaxis
- rhinorrhea
- watery eyes
- sneezing
- dry nose
- dry throat
- dysgeusia
- fever (peds pts)
- URI (peds pts)
- nasal septal perforation
- nasal ulcer
- candidiasis, nasal or oral
Safety/Monitoring .
Monitoring Parameters
nasal exam if tx >2mo; height in children/adolescents if long-term tx; ophthalmic exam if cataract/glaucoma hx
Pregnancy/Lactation .
Pregnancy
Clinical Summary
may use during pregnancy; no human data available, though risk of fetal harm not expected based on limited systemic absorption
Lactation
Clinical Summary
may use while breastfeeding; no human data available, though risk of infant harm and adverse effects on milk production not expected based on limited maternal systemic absorption
Pharmacology .
Metabolism: tissue, liver; CYP450: 3A substrate; Info: prodrug converted to beclomethasone-17-monopropionate (17-BMP); 44% systemic absorption
Excretion: feces 60%, urine <10%; Half-life: 0.3h (beclomethasone dipropionate), 4.5h (17-BMP)
Subclass: Corticosteroids, Intranasal
Mechanism of Action
exact mechanism of anti-inflammatory action unknown; inhibits multiple inflammatory cytokines; produces multiple glucocorticoid and mineralocorticoid effects
Formulary .
No Formulary Selected
Manufacturer/Pricing .
Manufacturer: Teva Pharmaceuticals USA, Inc.
DEA/FDA: Rx
Approximate Retail Price
from http://www.goodrx.com/qnasl
nasal spray:
- 80 mcg (1 inhaler, 10.6 g): $272.00
nasal spray:
- 40 mcg (1 inhaler, 6.8 g): $272.00
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