Qvar Side Effects

Generic name: beclomethasone

Note: This document contains side effect information about beclomethasone. Some of the dosage forms listed on this page may not apply to the brand name Qvar.

Some side effects of Qvar 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: inhalation aerosol

Get emergency medical help if you have any of these signs of an allergic reaction while taking beclomethasone (the active ingredient contained in Qvar) hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• weakness, tired feeling, nausea, loss of appetite, weight loss;

• white patches or sores inside your mouth or on your lips;

• wheezing, choking, or other breathing problems after using this medication;

• skin rash, bruising, severe tingling, numbness, pain, muscle weakness;

• changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist);

• blurred vision, eye pain, or seeing halos around lights; or

• worsening asthma symptoms.

Common side effects may include:

• headache;

• dryness in your mouth, nose, or throat after use;

• stuffy nose, sinus pain, sore throat, cough; or

• hoarseness or deepened voice.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

For Healthcare Professionals

Applies to beclomethasone: compounding powder, inhalation aerosol, inhalation aerosol with adapter

General

Beclomethasone (the active ingredient contained in Qvar) 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.

Gastrointestinal

Gastrointestinal adverse effects due to beclomethasone (the active ingredient contained in Qvar) 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. To reduce the incidence of thrush, patients should be instructed to rinse their mouths following the use of beclomethasone. Limited data suggest that the incidence of thrush may be lower in patients utilizing a spacer device and good inhalation technique.

Respiratory

Respiratory side effects have commonly included dysphonia and sore throat in patients receiving beclomethasone (the active ingredient contained in Qvar) This may or may not occur in the presence of oral thrush. Coughing and wheezing have frequently been reported with inhaled beclomethasone use, especially in patients whose disease is under poor control.

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.

Many patients experiencing coughing and wheezing may benefit from pretreatment with an inhaled beta agonist prior to administration of beclomethasone.

Pulmonary eosinophilia, apparently associated with beclomethasone use, has been reported in at least two patients.

Endocrine

Endocrine abnormalities associated with beclomethasone (the active ingredient contained in Qvar) rarely include suppression of the hypothalamus-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. The use of a large-volume spacer may also help minimize HPA suppression when beclomethasone is inhaled orally.

Immunologic

Immunologic effects of infection from immune suppression associated with inhaled corticosteroids have been debated. No conclusive evidence is available to support an increase in tuberculosis or viral infections in patients receiving inhaled beclomethasone (the active ingredient contained in Qvar)

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.

Musculoskeletal

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

Musculoskeletal side effects from 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.

Ocular

Ocular adverse effects are more commonly seen with systemic administration of corticosteroids. However, posterior capsular cataracts have been occasionally reported with beclomethasone (the active ingredient contained in Qvar) use, especially with long-term use. In addition, one epidemiologic study suggests that prolonged use of high-dose inhaled corticosteroids (>= 1600 mcg of beclomethasone) may be associated with increased risk of ocular hypertension and open angle glaucoma.

Dermatologic

Dermatologic adverse effects may include acne. Skin atrophy and easy bruising has been associated with beclomethasone (the active ingredient contained in Qvar) use in some patients.

In one prospective study, patients receiving at least 1 mg/day of inhaled beclomethasone (or 800 mcg of budesonide) for 3 months or more had a significantly higher incidence of ecchymosis than matched controls. In addition, the severity was more pronounced in the treatment group. Older patients were more likely to be affected. The presence of skin bruising was associated with lower urinary cortisol levels, suggesting systemic absorption of the inhaled drug.

Psychiatric

Psychiatric adverse effects include rare cases of mania.

Postmarketing reports have included cases of psychiatric events and behavioral changes (aggression, depression, sleep disorders, psychomotor hyperactivity, and suicidal ideation) primarily in children.

Nervous system

Nervous system side effects have included headache.

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