Pharmacology · Inhaled corticosteroids
Beclometasone !
One of the oldest inhaled corticosteroids, a daily asthma preventer. It is a prodrug activated in the lung.
Updated 2026-11-01
Also called: Beclomethasone, Beclometasone dipropionate
No structure of beclometasone on the glucocorticoid receptor exists. The figure shows fluticasone furoate, another inhaled corticosteroid in the same steroid pocket, in the human receptor.
Mechanism of action
Beclometasone dipropionate is a prodrug: hydrolysis, partly in the lung itself, quickly turns it into beclometasone 17-monopropionate, the active form, which binds the glucocorticoid receptor with high affinity. The receptor switches off inflammatory genes and switches on anti-inflammatory ones, so airway inflammation and reactivity fall over days to weeks.
- Hydrolysis converts the prodrug to the active 17-monopropionate
- The active form binds the glucocorticoid receptor
- The receptor turns down inflammatory genes in the nucleus
- Airway inflammation and asthma attacks decrease
Pharmacokinetics
- Absorption
- Rapidly converted to the active 17-monopropionate during absorption
- Metabolism
- CYP3A converts it to further metabolites
- Elimination
- Mainly in the faeces
- Half-life
- Active metabolite about 3 hours
Indications
- Maintenance and preventive treatment of asthma Asthma →
Adverse effects
Common
- Oral thrush
- Hoarseness and sore throat
- Headache
- Sinusitis
Contraindications
- Primary treatment of status asthmaticus or acute attacks
- Hypersensitivity to any component
Key interactions
- Strong CYP3A4 inhibitors (ritonavir, ketoconazole)
- May increase systemic exposure and steroid effects
What is monitored
- Asthma control and reliever use
- Mouth for thrush
- Height in children
- Eyes with long use
Administration and safety
- Oral inhalation by pressurised inhaler, breath-actuated inhaler or dry powder inhaler
- A spacer is recommended with pressurised steroid inhalers at higher doses; with some propellant products it is not recommended in young children, so the product leaflet is followed
- After each use the mouth is rinsed with water and the water spat out
- Different beclometasone products are not interchangeable puff for puff; the product name is checked
Nursing care
- Check inhaler technique and spacer use
- Look at the mouth for thrush and ask about hoarseness
- Measure growth in children
- Teach that it is a daily preventer, not a reliever
Pregnancy and breastfeeding
Data are limited; the risks of poorly controlled asthma (preeclampsia, prematurity) are weighed against those of the drug, and good control is the aim.
Test yourself
Think of the answer, then tap the question to see it.
In what sense is beclometasone dipropionate a prodrug?
It is hydrolysed, partly in the lung, into beclometasone 17-monopropionate, the form that binds the glucocorticoid receptor.
Why are beclometasone products not swapped puff for puff?
Products differ in how much drug reaches the lungs and the blood; for example, newer propellant products give more systemic exposure than older ones used with a spacer.
What local adverse effect is reduced by rinsing the mouth after beclometasone?
Oral thrush (oropharyngeal candidiasis), as well as hoarseness.
Related drugs
Related conditions
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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: DailyMed - BECLOMETHASONE DIPROPIONATE aerosol, metered (DailyMed (U.S. National Library of Medicine), 2021); Beclometasone inhalers: a steroid medicine to treat asthma and COPD - NHS (NHS, 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.