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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/07/04 18:49:40」(JST)

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Beclometasone dipropionate, also spelled beclomethasone dipropionate and sold under the brand name Qvar among others, is a steroid medication.^[1] It is available as an inhaler, cream, pills, and nasal spray.^[2] The inhaled form is used in the long term management of asthma.^[1] The cream may be used for dermatitis and psoriasis.^[3] The pills have been used to treat ulcerative colitis.^[4] The nasal spray is used to treat allergic rhinitis and nasal polyps.^[5]

Common side effects with the inhaled form include respiratory infections, headaches, and throat inflammation. Serious side effects include an increased risk of infection, cataracts, Cushing’s syndrome, and severe allergic reactions.^[1] Long term use of the pill form may cause adrenal insufficiency.^[4] The pills may also cause mood or personality changes.^[4] The inhaled form is generally regarded as safe in pregnancy.^[6] Beclometasone is mainly a glucocorticoid.^[1]

Beclometasone dipropionate was first patented in 1962 and used medically in 1972.^[7] It was approved for medical use in the United States in 1976.^[1] It is on the World Health Organization's List of Essential Medicines, the most important medications needed in a basic health system.^[8] The wholesale price in the developing world for an inhaler containing 200 doses of medication is about 3.20 USD as of 2014.^[9] In the United States it costs between 50 and 100 USD for a typical month supply of the inhaled form.^[10]

Side effects

Occasionally, it may cause a cough upon inhalation. Deposition on the tongue and throat may promote oral candidiasis, which appears as a white coating, possibly with irritation.^[11]^[12]^[13] This may usually be prevented by rinsing the mouth with water after using the inhaler. Other adverse drug reaction side effects may rarely include: a smell similar to burning plastic, unpleasant taste, hoarseness or nasal congestion, pain or headache, and visual changes. Allergic reactions may occur, but rarely.

Nasal corticosteroids may be associated with central serous retinopathy.^[14]

Names

Beclometasone dipropionate is the INN modified and beclomethasone dipropionate is the USAN and former BAN. It is a prodrug of the free form, beclometasone (INN).

Clenil, Qvar are brandnames for the inhalers. Beconase, alanase, Vancenase, Qnasl for the nasal spray or aerosol.

References

^ ^a ^b ^c ^d ^e "Beclomethasone Dipropionate". The American Society of Health-System Pharmacists. Retrieved Dec 2, 2015.
^ "List of products: BECLOMETASONE DIPROPIONATE". MHRA. Retrieved 6 December 2015.
^ "Beclometasone dipropionate 0.25 mg/g Cream" (PDF). MHRA. Retrieved 6 December 2015.
^ ^a ^b ^c "Clipper" (PDF). MHRA. Retrieved 6 December 2015.
^ "Beclomethasone Dipropionate eent". The American Society of Health-System Pharmacists. Retrieved Dec 2, 2015.
^ Hamilton, Richart (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 349. ISBN 9781284057560.
^ McPherson, Edwin M. (2007). Pharmaceutical Manufacturing Encyclopedia. (3rd ed.). Burlington: Elsevier. p. 539. ISBN 9780815518563.
^ "WHO Model List of Essential Medicines" (PDF). Apps.WHO.int. World Health Organization. October 2013. Retrieved 22 April 2014.
^ "Beclometasone". International Drug Price Indicator Guide. Retrieved 6 December 2015.
^ Hamilton, Richart (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 451. ISBN 9781284057560.
^ Willey R, Milne L, Crompton G, Grant I (1976). "Beclomethasone dipropionate aerosol and oropharyngeal candidiasis". Br J Dis Chest 70 (1): 32–8. doi:10.1016/0007-0971(76)90004-8. PMID 1259918.
^ Salzman G, Pyszczynski D (1988). "Oropharyngeal candidiasis in patients treated with beclomethasone dipropionate delivered by metered-dose inhaler alone and with Aerochamber". J Allergy Clin Immunol 81 (2): 424–8. doi:10.1016/0091-6749(88)90911-6. PMID 3339197.
^ Fukushima C, Matsuse H, Tomari S, Obase Y, Miyazaki Y, Shimoda T, Kohno S (2003). "Oral candidiasis associated with inhaled corticosteroid use: comparison of fluticasone and beclomethasone". Ann Allergy Asthma Immunol 90 (6): 646–51. doi:10.1016/S1081-1206(10)61870-4. PMID 12839324.
^ Haimovici R, Gragoudas ES, Duker JS, Sjaarda RN, Eliott D (October 1997). "Central serous chorioretinopathy associated with inhaled or intranasal corticosteroids". Ophthalmology 104 (10): 1653–60. doi:10.1016/s0161-6420(97)30082-7. PMID 9331207.

UpToDate Contents

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1. 思春期および成人における中等度持続型喘息の治療 treatment of moderate persistent asthma in adolescents and adults
2. 吸入ステロイドの主な副作用 major side effects of inhaled glucocorticoids
3. 12歳未満の小児における慢性喘息：持続性喘息の治療およびコントロール薬 asthma in children younger than 12 years treatment of persistent asthma with controller medications
4. 味覚および嗅覚障害の評価および治療 evaluation and treatment of taste and smell disorders
5. アレルギー性鼻炎の薬物療法 pharmacotherapy of allergic rhinitis

English Journal

The Effect of Active Pharmaceutical Ingredients on Aerosol Electrostatic Charges from Pressurized Metered Dose Inhalers.

Chen Y1, Young PM, Fletcher DF, Chan HK, Long E, Lewis D, Church T, Traini D.
Pharmaceutical research.Pharm Res.2015 Sep;32(9):2928-36. doi: 10.1007/s11095-015-1674-6. Epub 2015 Mar 19.
PURPOSE: This study investigated the effect of different active pharmaceutical ingredients (API) on aerosol electrostatic charges and aerosol performances for pressurized metered dose inhalers (pMDIs), using both insulating and conducting actuators.METHODS: Five solution-based pMDIs containing diffe
PMID 25788449

Differences in Adherence to Common Inhaled Medications in COPD.

Huurne KK1, Movig K, van der Valk P, van der Palen J, Brusse-Keizer M.
COPD.COPD.2015 Aug 19:1-6. [Epub ahead of print]
OBJECTIVE: To study differences in adherence to common inhaled medications in COPD.METHODS: Adherence of 795 patients was recorded from pharmacy records over 3 years in the COMIC cohort. It was expressed as percentage and deemed good at ≥75-≤125%, sub-optimal ≥50-<75%, and poor <50% (un
PMID 25775100

Prevalence of over-/misdiagnosis of asthma in patients referred to an allergy clinic.

Heffler E1, Pizzimenti S, Guida G, Bucca C, Rolla G.
The Journal of asthma : official journal of the Association for the Care of Asthma.J Asthma.2015 Aug 19:1-4. [Epub ahead of print]
OBJECTIVE: Increasing asthma incidence may be due to an overall increase in asthma awareness by physicians, potentially resulting in overdiagnosis. One of the unique features of asthma is bronchial hyperresponsiveness, which can be assessed by methacholine bronchial challenge (MBC). Overdiagnosis ma
PMID 26291138

「ベクロメタゾン」

Beclometasone dipropionate
Systematic (IUPAC) name
	(8S,9R,10S,11S,13S,14S,16S,17R)-9-chloro-11-hydroxy-10,13,16-trimethyl-3-oxo-17-[2-(propionyloxy)acetyl]-6,7,8,9,10,11,12,13,14,15,16,17-dodecahydro-3H-cyclopenta[a]phenanthren-17-yl propionate
Clinical data
Trade names	Qvar, Beconase AQ, others
AHFS/Drugs.com	Monograph
MedlinePlus	a681047
Pregnancy; category	AU: B3; ;
Routes of; administration	Oral inhalation, nasal inhalation, topical
Legal status
Legal status	AU: S2 (Pharmacy only); UK: Prescription-only (POM), but some nasal sprays are General sales list (GSL, OTC);
Pharmacokinetic data
Bioavailability	Converted to beclometasone-17-monopropionate (17-BMP) during absorption
Protein binding	87% of 17-BMP to albumin and transcortin
Metabolism	By esterase enzymes found in most tissues
Biological half-life	2.8 hours
Excretion	Biliary (60%), renal (12%)
Identifiers
CAS Number	5534-09-8
ATC code	A07EA07 (WHO) D07AC15 (WHO), R01AD01 (WHO), R03BA01 (WHO)
PubChem	CID 21700
IUPHAR/BPS	5894
DrugBank	DB00394
ChemSpider	20396
UNII	5B307S63B2
ChEBI	CHEBI:3002
ChEMBL	CHEMBL1200500
Chemical data
Formula	C28H37ClO7
Molar mass	521.042 g/mol
	SMILES O=C(OCC(=O)[C@]3(OC(=O)CC)[C@]2(C[C@H](O)[C@]4(Cl)[C@@]/1(\C(=C/C(=O)\C=C\1)CC[C@H]4[C@@H]2C[C@@H]3C)C)C)CC ;
	InChI InChI=1S/C28H37ClO7/c1-6-23(33)35-15-22(32)28(36-24(34)7-2)16(3)12-20-19-9-8-17-13-18(30)10-11-25(17,4)27(19,29)21(31)14-26(20,28)5/h10-11,13,16,19-21,31H,6-9,12,14-15H2,1-5H3/t16-,19-,20-,21-,25-,26-,27-,28-/m0/s1 ; Key:KUVIULQEHSCUHY-XYWKZLDCSA-N ;
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