Beclometasone Dipropionate + Formoterol Fumarate: Brands, Price & Uses in Bangladesh

Established / Approved Uses

• Maintenance treatment of asthma in adults and adolescents in whom use of a combination inhaler (inhaled corticosteroid + long-acting beta2-agonist) is appropriate — i.e. patients not adequately controlled on inhaled corticosteroids alone and short-acting bronchodilators "as needed", or patients already adequately controlled on both an inhaled corticosteroid and a long-acting beta2-agonist.
• Maintenance treatment of chronic obstructive pulmonary disease (COPD) for symptomatic relief in patients with severe COPD (FEV1 < 50% predicted) and a history of repeated exacerbations who have significant symptoms despite regular bronchodilator therapy.

Guideline-Supported Use

Some formulations of Beclometasone Dipropionate + Formoterol Fumarate are also used as combined maintenance-and-reliever therapy (MART) in asthma, in which the same inhaler is used both for regular daily dosing and for relief of symptoms, under specific physician-directed regimens.

Beclometasone Dipropionate + Formoterol Fumarate is not indicated for the initial management of acute asthma exacerbations or as a rescue/reliever inhaler used alone.

Dosage

Pediatric dose: Safety and efficacy of Beclometasone Dipropionate + Formoterol Fumarate in children under 18 years have not been established for general use; it is not recommended in this age group outside specialist guidance. See Use in Special Populations.

Renal/hepatic impairment: No dose adjustment is established or generally required, as systemic exposure from inhaled use is low; use with the usual caution in severe hepatic impairment. See Precautions and Warnings.

Administration

1. Shake the inhaler well before use (for pressurised metered-dose formulations).
2. Breathe out gently, away from the inhaler.
3. Place the mouthpiece between the teeth and close the lips around it without biting.
4. Begin to breathe in slowly and deeply through the mouth, pressing down on the canister to release one dose at the start of inhalation.
5. Hold the breath for about 10 seconds, then breathe out slowly.
6. Rinse the mouth with water (and spit it out) after each use to reduce the risk of oral thrush and hoarseness.

Do not use Beclometasone Dipropionate + Formoterol Fumarate to treat sudden breathlessness or an acute asthma attack; a separate fast-acting reliever inhaler should be available for such episodes unless specifically directed otherwise by a physician under a MART regimen.

Common

• Oral/oropharyngeal candidiasis (thrush) and hoarseness/dysphonia — reduced by rinsing the mouth after use
• Headache
• Nasopharyngitis, throat irritation, cough
• Tremor, palpitations, tachycardia
• Hypokalemia (low blood potassium)
• Muscle cramps

Less Common / Serious

• Paradoxical bronchospasm (immediate worsening of wheeze after inhalation) — discontinue immediately if this occurs and seek medical advice
• Hypersensitivity reactions (rash, urticaria, pruritus, angioedema of the face/throat)
• QT-interval prolongation and other cardiac arrhythmias
• Hyperglycemia
• Signs of systemic corticosteroid effect with long-term high-dose use (adrenal suppression, decreased bone mineral density, cataracts, glaucoma) — see Precautions and Warnings
• Increased incidence of pneumonia reported in COPD patients using inhaled corticosteroid combinations