Beclomet Nasal Aqua Special Precautions

Patients suffering from tuberculosis should be treated with care. Sinusitis must be treated properly. Patients should be thought the proper use of Beclomet Nasal Aqua to ensure good clinical efficacy. They should also be aware that Beclomet Nasal Aqua has to be used regularly for optimal benefit. Patients should be advised that the drug will not provide immediate symptomatic relief and use of topical nasal decongestant or oral antihistamines may be necessary until the effects of intranasal beclomethasone dipropionate are fully manifested. Infections of the nasal passages and paranasal sinuses should be appropriately treated but do not constitute a specific contraindication to treatment with Beclomet Nasal Aqua.
Care must be taken while transferring patients from systemic steroid treatment to Beclomet Nasal Aqua if there is any reason to suppose that their adrenal function is impaired.
A heavy challenge of summer allergens may in certain instances necessitate appropriate additional therapy particularly to control eye symptoms. In the continuous long-term treatment with intranasal steroids, the nasal mucosa should be inspected regularly, at least once a year. Intranasal corticosteroids should be used with caution until healing occurs in patients with recent nasal septal ulcers, nasal surgery or nasal trauma, since the drug may inhibit wound healing.
Use in Children: Controlled clinical studies have shown that intranasal corticosteroids may cause a reduction in growth velocity in pediatric patients. This effect has been observed in the absence of laboratory evidence of hypothalamic-pituitary-adrenal (HPA) axis suppression, suggesting that growth velocity is a more sensitive indicator or systemic corticosteroid exposure in pediatric patients than some commonly used tests of HPA axis function. The long-term effects of this reduction in growth velocity associated with intranasal corticosteroids, including the impact on final adult height, are unknown. The potential for "catch up" growth following discontinuation of treatment with intranasal corticosteroids has not been adequately studied. The growth of pediatric patients receiving intranasal corticosteroids should be monitored routinely (e.g. via stadiometry). The potential growth effects of prolonged treatment should be weighed against clinical benefits obtained and the availability of safe and effective noncorticosteroid treatment alternatives. To minimise the systemic effects of intranasal corticosteroids, each patient should be titrated to his/her lowest effective dose.