Recommended Dosage of Qvar (Beclomethasone) for Asthma Treatment
The recommended dosage of Qvar (beclomethasone dipropionate) for asthma treatment is 40-160 mcg twice daily for adults and 40-80 mcg twice daily for children aged 5-12 years, with the specific dose determined by asthma severity. 1
Adult Dosing
Initial Dosing
For patients not previously on inhaled corticosteroids:
- Start with 40-80 mcg twice daily 1
- Total daily dose: 80-160 mcg/day
For patients previously on inhaled corticosteroids:
- Start with 40-160 mcg twice daily 1
- Total daily dose: 80-320 mcg/day
Maintenance Dosing
- Adjust dose based on asthma control assessment after 4-6 weeks
- Maximum recommended dose: 320 mcg/day (160 mcg twice daily) 1
- Once control is achieved, titrate to lowest effective dose
Pediatric Dosing (5-12 years)
- Recommended dose range: 40-80 mcg twice daily 1, 2
- Initial dose: 40 mcg twice daily
- Maximum dose: 80 mcg twice daily (160 mcg/day)
Special Considerations
Dosing Equivalence
- Qvar (HFA-beclomethasone) provides equivalent asthma control at approximately half the dose of conventional CFC-beclomethasone or budesonide 3, 4
- 400 mcg/day of Qvar is equivalent to 800 mcg/day of budesonide DPI (Pulmicort Turbuhaler) 3
Administration
- Administer via metered-dose inhaler
- Use with spacer device recommended, especially for children
- Some patients may achieve adequate control with once-daily dosing (200 mcg) in the evening 5
Efficacy and Safety
Efficacy
- Clinical trials demonstrate significant improvement in FEV1, peak expiratory flow, and reduction in asthma symptoms at doses as low as 40 mcg twice daily 1
- In children, doses of 80-160 mcg/day showed significant improvement in FEV1 percent predicted compared to placebo 2
Safety
- Well-tolerated at recommended doses 1, 2
- Common side effects: oral thrush, dysphonia, cough
- At recommended doses, minimal impact on hypothalamic-pituitary-adrenal axis function 2
- Rare cases of paradoxical bronchospasm have been reported 6
Monitoring and Follow-up
- Assess response within 4-6 weeks of initiation
- Monitor for symptom control, lung function, and medication side effects
- Consider step-down therapy once asthma control is maintained for at least 3 months 7
- Reduce dose by 25-50% every 3 months to identify minimum effective dose 7
Exacerbation Management
If asthma control deteriorates despite maintenance therapy:
- Short course of oral corticosteroids may be needed
- For adults: Prednisone 40-60 mg daily for 5-10 days 7
- For children: Prednisone 1-2 mg/kg/day (maximum 60 mg/day) for 3-10 days 7
- No tapering needed for courses less than 7 days 7
Qvar's extrafine particle formulation provides improved lung deposition compared to older CFC-based inhalers, allowing for effective control at lower doses while minimizing potential systemic effects 4.