QNASL Side Effects
Generic name: beclomethasone nasal
Note: This document contains side effect information about beclomethasone nasal. Some of the dosage forms listed on this page may not apply to the brand name QNASL.
Some side effects of QNASL may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
For the Consumer
Applies to beclomethasone nasal: nasal spray
Get emergency medical help if you have any of these signs of an allergic reaction while taking beclomethasone nasal (the active ingredient contained in QNASL) hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have a serious side effect such as:
severe or ongoing nose bleed;
sores in the nose that won't heal;
wheezing, trouble breathing;
blurred vision, eye pain, or seeing halos around lights; or
fever, chills, body aches, flu symptoms.
Less serious side effects of beclomethasone nasal may include:
sneezing, runny or stuffy nose;
dryness or irritation in your nose or throat;
nausea, headache, feeling light-headed;
unpleasant taste or smell;
mild itching or rash; or
sores or white patches inside or around your nose.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.
For Healthcare Professionals
Applies to beclomethasone nasal: nasal aerosol with adapter, nasal spray
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.
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.
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.
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.
Although candidiasis is generally limited to the oropharyngeal area, rare cases of esophageal candidiasis have been reported.
Nervous system side effects including headache have also been reported.
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.
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.
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.
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.
The reduction in bone density may be due to suppressed osteoblast function, as evidenced by decreased serum osteocalcin levels.
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.
Dermatologic adverse effects may include acne. Easy bruising has been associated with beclomethasone use in some patients.
Rosacea, presenting as new-onset facial eruptions, has been reported.
Psychiatric adverse effects include rare cases of mania precipitated by beclomethasone.
Hypersensitivity side effects have included rare cases of immediate and delayed anaphylactoid/anaphylactic reactions, urticaria, angioedema, rash, and bronchospasm.
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