Beclometasone dipropionate

Figure Q12.1 Betamethasone (top left), betamethasone (as valerate) (top right), beclometasone (bottom left) and beclometasone dipropionate (bottom right).

Betamethasone valerate and beclometasone dipropionate both mask the polar hydroxyl groups to increase lipophilicity. This increases the topical penetration for topical formulations used in eczema and psoriasis and aerosol formulations used in asthma. The log P0ctanoi/PH7 value of betamethasone is 2.01, whereas the log P0ctanoi/PH7 value f°r betamethasone (as valerate) is 3.60. 

Dhillon, S., and Keating, G. M. (2006), Beclometasone dipropionate/formoterol In an HFA-propelled pressurised metered-dose inhaler, Drugs, 66,1475-1483. 

The stoichiometry of some of the solvates is unusual. Fludrocortisone pentanol solvate, for example, contains 1.1 molecules of pentanol for each steroid molecule, and its ethyl acetate solvate contains 0.5 molecules of ethyl acetate per steroid molecule. A succinylsulfathiazole solvate appears to have 0.9 moles of pentanol per mole of dmg. Beclometasone dipropionate forms solvates with chlorofluorocarbon propellants. 

Intranasal beclometasone dipropionate in a dose as low as 200 / g daily is a useful addition to the therapy of perennial rhinitis. Considerable attention is being paid to the delivery by the... 

Horses appear to be more sensitive to the adrenosuppressive effects of aerosolized corticosteroids than human patients. Documentation of systemic absorption (adrenal suppression) of inhaled beclometasone and fluticasone raises concerns that other systemic glucocorticoid effects may occur following aerosol administration of corticosteroids. The administration of adrenosuppressive doses (>1600 p,g/day) of beclometasone dipropionate to asthmatic human patients does not produce the other systemic side-effects of glucocorticoid administration, including a roimd face (Cushingoid facies), polyuria, polydipsia, hyperglycemia, obesity, altered carbohydrate metabolism, osteoporosis, abortion, posterior subcapsular cataract and aseptic necrosis of the... 

There are three aerosolized corticosteroid preparatioias available in MDI formulation for administration to horses via the Equine AeroMask beclometasone dipropionate, fluticasone propionate and flunisolide (Table 16.2). In terms of the relative potency, fluticasone is more potent than beclometasone, which is more potent than flunisolide, which is equipotent to triamcinolone. Using dexamethasone as the standard (1.0), the relative glucocorticoid receptor affinity of the common corticosteroids is flunisolide 1.9, triamcinolone 2.0, beclometasone (active metabolite) 13.5 and fluticasone propionate 22.0 (Barnes et al 1998). The pulmonary residence time of the aerosolized corticosteroids is determined by the lipophilicity of each drug. Flunisolide has intermediate water solubility (lOmg/ml), simitar to... 

Beclometasone dipropionate is the most widely dispensed inhaled anti-inflammatory agent for astfunatic human patients. Inhaled beclometasone dipropionate reduces inflammatory cell populations in bronchoalveolar lavage fluid, controls clinical signs of airway obstruction and improves parameters of pulmonary function in human asthmatics. Consequently, aerosolized beclometasone dipropionate is the first line of therapy for mod-erate-to-severe allergic airway disease in human patients. Aerosolized beclometasone does not cause adrenal suppression in asthmatic human patients at therapeutic dosages (800-1600 xg/day) and initiation of beclometasone therapy as a replacement for systemic corticosteroid administration permits recovery of the hypothalamic-pituitary-adrenal axis (Barnes et al 1998). 

Beclometasone dipropionate is a synthetic, chlorinated, diester corticosteroid. The majority (>75%) of parent drug is hydrolyzed rapidly (within 5 min) in the lung to the more active metabolite beclometasone 17-monopropionate,... 

Beclometasone dipropionate and budesontde pass membranes poorly and are more active topically than when given orally. They are used in asthma (as an aerosol) and topically in severe eczema to provide a local ami-iiiHammatory action with minimal systemic effects. 

A corticosteroid such as beclometasone acts almost exclusively locally due to a large first-pass effect in the gut wall and the liver and is therefore ideal for local application. Beclometasone dipropionate in a suspension enema of 100 mL is used for chronic intestinal inflammations. A beclometasone suppository may be used to treat proctitis. There is clinical experience with beclometasone dipropionate in an oily base, but literature is still lacking. 

The pH of a beclometasone rectal suspension with carbomer as viscosity enhancer has been adjusted to 5-6. That pH is lower than usual for a carbomer hydrogel and is chosen as a compromise for two aspects the viscosity of the carbomer hydrogel and the stability of beclometasone dipropionate. The same pH is chosen for the beclometasone and mesalazine rectal suspension of Table 11.16. As an additional benefit mesalazine is less soluble at pH 5.5 and hence more stable than at a higher pH. To protect the dissolved fraction of mesalazine against oxidation sodium metabisulfite is added. Adequate storage conditions are important to obtain a reasonable shelf life protected from light and in the refrigerator. 

A 23-year-old man with ulcerative proctitis was treated successfully with topical mesalazine and beclometasone dipropionate [94 ]. After 1 month the treatment was stopped, but 5 years later, a relapse was treated with topical mesalazine and then oral mesalazine 2.4 g/day. After 3 days the patient developed pleuritic chest pain, exertional dyspnea, fever (38°C), and arthralgias, in particular in the shoulders and spine. Chest X-ray showed a right-sided basal pleural effusion. He was given intramuscular ceftriaxone 1 g/day and oral methylprednisolone 16 mg/day and after 11 days the chest symptoms resolv 1 month later mesalazine and glucocorticoid treatment were withdrawn, but 1 month later a relapse was treated again with oral mesalazine 2.4 g/ day. After 3 days the same pleuritic symptoms occurred and disappeared promptly on withdrawal of mesalazine. 

C HiqOj 123-62-6) see Alclometasone dipropionate Alfentanil Alphaprodine Beclometasone Dextropropoxyphene Diethylstilbestrol dipropionate Fentanyl Propiram Sulindac Testosterone propionate propanol... 

Beclometasone (as dipropionate) is a pro-drug with weak glucocorticoid receptor-binding activity. It is hydrolysed via esterase enzymes to the active metabolite beclometasone-17-monopropionate (B-17-MP), which has high topical anti-inflammatory activity. 

Beclometasone (as dipropionate) undergoes extensive first-pass metabolism and is rapidly excreted from the systemic circulation. The main active metabolite is beclometasone-17-monopropionate and the minor inactive metabolites are beclometasone-21-monopropionate and beclometasone. 

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