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beclomethasone

Sold as Qnasl, Beconase, Qvar. Class: Corticosteroids acting locally; Corticosteroids, potent (group III); Corticosteroids; Glucocorticoids. First FDA approval 05/12/1976: 50 years on the US market.

This grade answers one narrow question: how strong is the public evidence and safety record behind this drug, and how clean is its money trail and court record? It is not a verdict on whether the drug is right for you.

B

Score breakdown (85/100)

Safety ×35%
B
Evidence ×25%
D
Regulatory ×15%
A
Money & lawsuits ×15%
A
Options ×10%
A

Safety: 85

Evidence: 62

Regulatory history: 96

Money & lawsuits: 100

Options: 100

What the FDA label says

Approved uses

Beclomethasone dipropionate HFA inhalation aerosol is indicated in the maintenance treatment of asthma as prophylactic therapy in patients 5 years of age and older. Important Limitations of Use: Beclomethasone dipropionate HFA inhalation aerosol is NOT indicated for the relief of acute bronchospasm. Beclomethasone dipropionate HFA inhalation aerosol is a corticosteroid indicated for: Maintenance treatment of asthma as prophylactic therapy in patients 5 years of age and older. (1) Important Limitations: Not indicated for the relief of acute bronchospasm. (1)

Contraindications

Primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required. (4) Hypersensitivity to any of the ingredients of beclomethasone dipropionate HFA inhalation aerosol. (4) 4.1 Status Asthmaticus Beclomethasone dipropionate HFA inhalation aerosol is contraindicated in the primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required. 4.2 Hypersensitivity Beclomethasone dipropionate HFA inhalation aerosol is contraindicated in patients with known hypersensitivity to beclomethasone dipropionate or any of the ingredients in beclomethasone dipropionate HFA inhalation aerosol [see Warnings and Precautions (5.6) ] .

Warnings and precautions

Localized infections: Candida albicans infection of the mouth and throat may occur. Monitor patients periodically for signs of adverse effects on the oral cavity. Advise patients to rinse the mouth with water without swallowing after inhalation. (5.1) Deterioration of asthma and acute episodes: Do not use beclomethasone dipropionate HFA inhalation aerosol for relief of acute symptoms. Patients require immediate re-evaluation during rapidly deteriorating asthma. (5.2) Transferring patients from systemic corticosteroids: Risk of impaired adrenal function when transferring from oral steroids. Taper patients slowly from systemic corticosteroids if transferring to beclomethasone dipropionate HFA inhalation aerosol. (5.3) Immunosuppression: Potential worsening of existing tuberculosis, fungal, bacterial, viral, or parasitic infection; or ocular herpes simplex infections. More serious or even fatal course of chickenpox or measles can occur in susceptible patients. Use with caution in patients with these infections because of the potential for worsening of these infections. (5.4) Paradoxical Bronchospasm: Bronchospasm, with an immediate increase in wheezing, may occur after dosing. Treat b...

Adverse reactions (label)

Systemic and local corticosteroid use may result in the following: Candida albicans infection [see Warnings and Precautions (5.1) ] Immunosuppression [see Warnings and Precautions (5.4) ] Hypercorticism and adrenal suppression [see Warnings and Precautions (5.7) ] Growth effects [see Warnings and Precautions (5.8) and Use in Specific Populations (8.4) ] Eye Disorders [see Warnings and Precautions (5.10) ] Most common adverse reactions (incidence ≥3% and > placebo) include headache, pharyngitis, oral symptoms (inhalation route), and sinusitis. (6.1) To report SUSPECTED ADVERSE REACTIONS, contact Amneal Pharmaceuticals at 1-877-835-5472 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. The following reporting rates of common adverse experiences are based upon 4 clinical trials in which 1196 patients (671 female and 525 male adults previously treated with as-needed bronchodilators and/or inhaled...

Source: FDA SPL label for Beclomethasone Dipropionate (Amneal Pharmaceuticals NY LLC), effective 20200731. Full label on DailyMed.

Side-effect reports sent to the FDA

These are counts of reports people filed, not rates of harm. Anyone can file one, and nobody checks whether the drug was the cause. Millions of doses are taken for every report sent, so the useful part is how this drug compares with the average across all drugs.

25,868reports that mention this drug
25,805of those blame this drug, not another one the person was taking
72%of reports describe a serious outcome, such as a hospital stay (average for all drugs: 57%)
5.0%of reports include a death, from any cause (average for all drugs: 9.1%)

Problems reported most often

Dyspnoea · 3,237Asthma · 2,652Cough · 1,816Vomiting · 1,696Pneumonia · 1,685Malaise · 1,658Wheezing · 1,600Drug Ineffective · 1,576Headache · 1,305Fatigue · 1,268Pain · 1,262Nausea · 1,248Drug Hypersensitivity · 1,194Dizziness · 1,089Off Label Use · 948

Reports per year

20192020202120222023202420252026
2,9572,5321,8181,6581,5961,7941,661697

17,599 reports blaming this drug for every million Medicare prescriptions filled, which is 6.4× the typical drug on this site. (4,120 reports in 2024–2026, against 234,101 Medicare fills in one year. This is the one number here that accounts for how many people take the drug.)

Source: the FDA's Adverse Event Reporting System (FAERS). Reports are voluntary and unverified. Drugs that are prescribed a lot, in the news, or in lawsuits attract more reports, so the percentages are compared with the whole database to correct for that partly, not fully.

Recalls and regulatory record

0recall actions on file
11 / 2brand / generic applications
2label changes since 2021
NoREMS program

Evidence base

491randomized trials (PubMed)
19systematic reviews
255registered trials
31%of completed trials posted results
10%terminated or withdrawn
62%industry-funded

Independent Cochrane reviews

Counts measure how much evidence exists and how transparent it is, not how big the benefit is. For that, ask your prescriber: if 100 people like me took this, how many would get better because of it, and how many would be harmed? (Doctors call these the "number needed to treat" and "number needed to harm.") It differs by condition and is the number drug ads leave out. Sources: PubMed, ClinicalTrials.gov.

Money and lawsuits

In 2024, drug companies reported $0 in payments to US physicians and hospitals tied to this drug across 0 transactions.

No pending federal MDL names this drug or its brands.

Not named in any federal pharmaceutical settlement of $100M or more on record.

Sources: CMS Open Payments (Sunshine Act); Judicial Panel on Multidistrict Litigation pending docket list; DOJ settlements as tabulated on Wikipedia with links to the primary record. State-court and individual suits are not included.

Who takes it and what it costs

86,699Medicare Part D patients (2024)
234,101prescriptions filled
$330average cost per fill
$77Mtotal Medicare spend
ProductFills$/fill
Qvar Redihaler222,782$325
Qnasl10,598$427
Qnasl Children372$440
Beconase Aq349$372

Same-class alternatives

1 drug in the same class grades a letter or more higher than beclomethasone on this site. Worth asking whether one of them would do the same job for you.

amcinonideciclesonidedesoximetasonediflorasonediflucortolonedifluprednateflucloroloneflunisolidefluocinolone acetonidefluocortoloneflurandrenolidefluticasone furoatehalobetasolhalometasonehydrocortisone aceponatemethylprednisolone aceponateprednicarbatetixocortol

Same ATC pharmacological class, graded ones first, best grade at the top. Being in the same class does not make them interchangeable for your condition; it makes them worth asking about.

Questions to ask your prescriber

  1. The most-reported problems in FDA's adverse event data are dyspnoea, asthma, cough, vomiting. How would we recognize and handle those?
  2. Why this one over amcinonide, betamethasone, budesonide? What would make you pick one of those instead?
  3. What result are we expecting, by when, and what is the plan if it does not happen?
  4. If 100 people like me took this drug, how many would actually get better because of it, and how many would be harmed by it? (Doctors call these the number needed to treat and the number needed to harm.)