Recommended Dosage of Qvar (Beclomethasone Dipropionate) for a 9-Year-Old Weighing 33 kg
For a 9-year-old child weighing 33 kg, the recommended dosage of Qvar (beclomethasone dipropionate) is 80-160 mcg daily, which falls within the low daily dose range for children aged 5-11 years. 1
Dosing Guidelines Based on Age and Weight
- For children 5-11 years old, the low daily dose of beclomethasone HFA (Qvar) is 80-160 mcg, medium daily dose is >160-320 mcg, and high daily dose is >320 mcg 1
- Since the patient weighs 33 kg (which is less than 40 kg), careful attention to dosing is particularly important 1
- The medication should be administered via the appropriate inhaler device with proper technique to ensure optimal delivery 1
Administration Considerations
- Qvar can be administered in divided doses, typically twice daily, though some studies suggest that twice-daily dosing may be as effective as four-times-daily dosing in children with stable asthma 2
- Morning and evening administration is typically recommended for better compliance in children 2
- A spacer or valved holding chamber should be used with the MDI to improve drug delivery and decrease the risk of local side effects 1
Clinical Considerations for This Patient
- Qvar is not intended for treatment of acute asthma attacks but rather for maintenance therapy 3
- For this 9-year-old patient, start with the lower end of the dosing range (80 mcg daily) and titrate up based on clinical response 1
- The most important determinant of appropriate dosing is the clinician's judgment of the patient's response to therapy - monitor clinical parameters and adjust accordingly 1
- Once asthma control is achieved, the dose should be carefully titrated to the minimum dose required to maintain control 1
Monitoring Recommendations
- Regular follow-up is essential to assess the effectiveness of the treatment and adjust the dosage if needed 1
- Monitor for potential adverse effects, particularly oropharyngeal candidiasis, which is more common with higher doses 3
- Instruct the patient to rinse mouth and spit after inhalation to decrease the risk of oral candidiasis 1
Potential Adverse Effects
- Common side effects include cough, dysphonia, and oral thrush 1
- At dosages of 400-800 mcg daily, beclomethasone dipropionate has little or no adverse effect on adrenal function 3
- Long-term studies in children using 300 mcg daily have not shown significant effects on adrenal function, growth, or other systemic parameters 4
Important Clinical Pearls
- Qvar preparations are not interchangeable with other inhaled corticosteroids on a mcg or per-puff basis 1
- For children using face masks, washing the face after each treatment helps prevent local side effects 1
- Beclomethasone has high topical activity with lower systemic activity due to metabolic inactivation of the swallowed portion of the dose 3
- If the patient experiences an acute exacerbation of asthma during maintenance therapy with beclomethasone, additional therapy including systemic corticosteroids may be necessary 3