QNASL Side Effects

Generic Name: beclomethasone nasal

Note: This page contains side effects data for the generic drug beclomethasone nasal. It is possible that some of the dosage forms included below may not apply to the brand name QNASL.

It is possible that some side effects of QNASL may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

For the Consumer

Applies to beclomethasone nasal: nasal aerosol liquid, nasal aerosol powder, nasal spray

As well as its needed effects, beclomethasone nasal (the active ingredient contained in QNASL) may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking beclomethasone nasal, check with your doctor immediately:

More common
  • Chills
  • dizziness
  • fast heartbeat
  • lightheadedness
  • rapid, shallow breathing
  • rash
  • unusual bleeding or bruising
Less common
  • change in vision
  • eye pain
  • headache
  • nausea or vomiting
  • tearing
  • unexplained nosebleeds
Incidence not known
  • Bloody mucus
  • cough or hoarseness
  • difficulty with breathing
  • dizziness
  • hives or welts
  • itching
  • loss of taste and smell
  • sores inside the nose

For Healthcare Professionals

Applies to beclomethasone nasal: nasal aerosol with adapter, nasal spray

General

Beclomethasone is generally well tolerated and, due to the nature of its administration, is not inclined to produce the systemic adverse effects generally associated with the use of corticosteroids.[Ref]

Respiratory

Respiratory side effects including dysphonia and sore throat are commonly reported in patients receiving beclomethasone. This may or may not occur in the presence of oral thrush. Coughing and wheezing is frequently reported with inhaled beclomethasone use, especially in patients whose disease is under poor control. Nasal irritation and sneezing have been reported with intranasal administration.[Ref]

One study suggests that dysphonia occurring in the absence of oral thrush may be due to a vocal cord abnormality attributable to inhaled steroid use. In some cases, dysphonia and vocal cord abnormalities persisted for months following discontinuation of beclomethasone.

Pulmonary eosinophilia, apparently associated with beclomethasone use, has been reported in at least two patients. Nasal candidiasis has been reported in a woman with undiagnosed chronic lymphocytic leukemia. Nasal perforation has been reported rarely.[Ref]

Gastrointestinal

Gastrointestinal adverse effects due to beclomethasone are reported most commonly. Oropharyngeal candidiasis occurs in approximately 5% to 14% of patients treated with beclomethasone and occurs more often at higher dosages greater than 800 mcg per day. Candidiasis is generally limited to the oropharyngeal area.[Ref]

Although candidiasis is generally limited to the oropharyngeal area, rare cases of esophageal candidiasis have been reported.[Ref]

Nervous system

Nervous system side effects including headache have also been reported.[Ref]

Endocrine

Endocrine abnormalities associated with beclomethasone rarely include suppression of the hypothalamic-pituitary-adrenal axis. The risk of adrenal suppression is less than that associated with systemic corticosteroids and occurs less frequently with daily doses of 2 mg per day or lower.[Ref]

Immunologic

The danger of infections from immune suppression associated with inhaled corticosteroids has been debated. No conclusive evidence is available to support an increase in tuberculosis or viral infections in patients receiving inhaled beclomethasone.[Ref]

In a study of 548 asthmatic patients receiving beclomethasone, eight patients developed tuberculosis. Two patients who agreed to resume beclomethasone use following treatment experienced a reactivation of tuberculosis within 2 weeks.

In 1993, the American Academy of Allergy and Immunology (AAAI) requested that the FDA review its decision regarding the relabeling of inhaled corticosteroids following concerns about the risk of their use during severe viral infections. The AAAI's request was based on the lack of data linking inhaled corticosteroids to increases in complications of viral infections.[Ref]

Musculoskeletal

The reduction in bone density may be due to suppressed osteoblast function, as evidenced by decreased serum osteocalcin levels.[Ref]

Long-term use of inhaled beclomethasone may be associated with a reduction in bone density. This effect may be dose-related and has been reported with high dosages (>=800 mcg/day for >= 1 year). Reduced levels of total body calcium have also been demonstrated in patients receiving lower dosages.[Ref]

Ocular

Ocular adverse effects are more commonly seen with systemic administration of corticosteroids. However, posterior capsular cataracts have been occasionally reported with beclomethasone, especially with long-term use. In addition, prolonged use of high-dose inhaled corticosteroids ( >= 400 mcg of beclomethasone nasal (the active ingredient contained in QNASL) may be associated with increased risk of ocular hypertension and open angle glaucoma.[Ref]

Dermatologic

Rosacea, presenting as new-onset facial eruptions, has been reported.[Ref]

Dermatologic adverse effects may include acne. Easy bruising has been associated with beclomethasone use in some patients.[Ref]

Psychiatric

Psychiatric adverse effects include rare cases of mania precipitated by beclomethasone.[Ref]

Hypersensitivity

Hypersensitivity side effects have included rare cases of immediate and delayed anaphylactoid/anaphylactic reactions, urticaria, angioedema, rash, and bronchospasm.[Ref]

References

1. Brogden RN, Heel RC, Speight TM, Avery GS "Beclomethasone dipropionate. A reappraisal of its pharmacodynamic properties and therapeutic efficacy after a decade of use in asthma and rhinitis." Drugs 28 (1984): 99-126

2. Brannan MD, Herron JM, Reidenberg P, Affrime MB "Lack of hypothalamic-pituitary-adrenal axis suppression with once-daily or twice-daily beclomethasone dipropionate aqueous nasal spray administered to patients with allergic rhinitis." Clin Ther 17 (1995): 637-47

3. Webb EL "Nasal candidiasis in a patient on long-term topical intranasal corticosteroid therapy." J Allergy Clin Immunol 91 (1993): 680-1

4. Klotz LR, Klotz SD, Moeller RK "The use of beclomethasone diproprionate inhaler complicated by the development of an eosinophilic pneumonia reaction." Ann Allergy 39 (1977): 133-6

5. "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome, Research Triangle Park, NC.

6. Shim C, Williams MH, Jr "Cough and wheezing from beclomethasone aerosol." Chest 91 (1987): 207-9

7. "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome, Research Triangle Park, NC.

8. Mollura JL, Bernstein R, Fine SR, Vevaina J "Pulmonary eosinophilia in a patient receiving beclomethasone dipropionate aerosol." Ann Allergy 42 (1979): 326-9

9. Williams AJ, Baghat MS, Stableforth DE, Cayton RM, Shenoi PM, Skinner C "Dysphonia caused by inhaled steroids: recognition of a characteristic laryngeal abnormality." Thorax 38 (1983): 813-21

10. Clark TJ "Safety of inhaled corticosteroids." Eur J Respir Dis Suppl 122 (1982): 235-42

11. Kesten S, Hyland RH, Pruzanski WR, Kortan PP "Esophageal candidiasis associated with beclomethasone dipropionate aerosol therapy." Drug Intell Clin Pharm 22 (1988): 568-9

12. Hemstreet MP, Reynolds DW, Meadows J Jr "Oesophagitis--a complication of inhaled steroid therapy." Clin Allergy 10 (1980): 733-8

13. Milne LJ, Crompton GK "Beclomethasone dipropionate and oropharyngeal candidiasis." Br Med J 3 (1974): 797-8

14. Toogood JH, Jennings B, Greenway RW, Chuang L "Candidiasis and dysphonia complicating beclomethasone treatment of asthma." J Allergy Clin Immunol 65 (1980): 145-53

15. Prenner BM, Chervinsky P, Hampel FC, Howland WC, Lawrence M, Meltzer EO, Munk ZM, Ratner PH, Seltzer JM, Settipane GA, Lor "Double-strength beclomethasone dipropionate (84 mu g/spray) aqueous nasal spray in the treatment of seasonal allergic rhinitis." J Allergy Clin Immunol 98 (1996): 302-8

16. Sorkin S, Warren D "Probable adrenal suppression from intranasal beclomethasone." J Fam Pract 22 (1986): 449-50

17. Harris DM, Martin LE, Harrison C, Jack D "The effect of oral and inhaled beclomethasone dipropionate on adrenal function." Clin Allergy 3 (1973): 243-8

18. Brown PH, Greening AP, Crompton GK "Hypothalamo-pituitary-adrenal axis suppression in asthmatic adults taking high dose beclomethasone dipropionate." Br J Clin Pract 46 (1992): 102-4

19. Wilson AM, McFarlane LC, Lipworth BJ "Effects of repeated once daily dosing of three intranasal corticosteroids on basal and dynamic measures of hypothalamic-pituitary-adrenal-axis activity." J Allergy Clin Immunol 101 (1998): 470-4

20. Messerli C, Studer H, Scherrer M "Systemic side effects of beclomethasone dipropionate aerosols (becotide, aldecine, sanasthmyl) in otherwise non steroid treated asthmatic patients." Pneumonologie 153 (1975): 29-42

21. Robinson DS, Geddes DM "Inhaled corticosteroids: benefits and risks." J Asthma 33 (1996): 5-16

22. Shaikh WA "Pulmonary tuberculosis in patients treated with inhaled beclomethasone." Allergy 47 (1992): 327-30

23. Executive Committee American Academy of Allergy and Immunology "Inhaled corticosteroids and severe viral infections." J Allergy Clin Immunol 92 (1993): 223-8

24. Hanania NA, Chapman KR, Sturtridge WC, Szalai JP, Kesten S "Dose-related decrease in bone density among asthmatic patients treated with inhaled corticosteroids." J Allergy Clin Immunol 96 (1995): 571-9

25. Goldstein MF, Fallon JJ, Harning R "Chronic glucocorticoid therapy-induced osteoporosis in patients with obstructive lung disease." Chest 116 (1999): 1733-49

26. Packe GE, Douglas JG, McDonald AF, Robins SP, Reid DM "Bone density in asthmatic patients taking high dose inhaled beclomethasone diproprionate and intermittent systemic corticosteroids." Thorax 47 (1992): 414-7

27. Kewley GD "Possible association between beclomethasone diproprionate aerosol and cataracts." Aust Paediatr J 16 (1980): 117-8

28. Dreyer EB "Inhaled steroid use and glaucoma." N Engl J Med 329 (1993): 1822

29. Karim AK, Thompson GM, Jacob TJ "Steroid aerosols and cataract formation." BMJ 299 (1989): 918

30. Fraunfelder FT, Meyer SM "Posterior subcapsular cataracts associated with nasal or inhalation corticosteroids." Am J Ophthalmol 109 (1990): 489-90

31. Garbe E, LeLorier J, Boivin JF, Suissa S "Inhaled and nasal glucocorticoids and the risks of ocular hypertension or open-angle glaucoma." JAMA 277 (1997): 722-7

32. Ghanchi F "Young patients on inhaled steroids and cataract." Lancet 342 (1993): 1306-7

33. Allen MB, Ray SG, Leitch AG, Dhillon B, Cullen B "Steroid aerosols and cataract formation." BMJ 299 (1989): 432-3

34. Monk B, Cunliffe WJ, Layton AM, Rhodes DJ "Acne induced by inhaled corticosteroids." Clin Exp Dermatol 18 (1993): 148-50

35. Egan CA, Rallis TM, Meadows KP, Krueger GG "Rosacea induced by beclomethasone dipropionate nasal spray." Int J Dermatol 38 (1999): 133-4

36. Roy A, Leblanc C, Paquette L, Ghezzo H, Cote J, Cartier A, Malo JL "Skin bruising in asthmatic subjects treated with high doses of inhaled steroids: frequency and association with adrenal function." Eur Respir J 9 (1996): 226-31

37. Mak VH, Melchor R, Spiro SG "Easy bruising as a side-effect of inhaled corticosteroids." Eur Respir J 5 (1992): 1068-74

38. Phelan MC "Beclomethasone mania." Br J Psychiatry 155 (1989): 871-2

39. Goldstein ET, Preskorn SH "Mania triggered by a steroid nasal spray in a patient with stable bipolar disorder." Am J Psychiatry 146 (1989): 1076-7

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.

Hide
(web1)