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| Patient Group | Starting Dose | Maintenance Dose | Max Daily Dose |
|---|---|---|---|
| Adults & Adolescents ≥12 yrs (ICS-naive) | 200 mcg twice daily | 200–400 mcg twice daily | 800 mcg/day |
| Adults ≥12 yrs (switching from higher ICS) | As per prior ICS equivalence | Titrate to lowest effective dose | 800 mcg/day |
| Children 6–11 years | 100 mcg twice daily | 100–200 mcg twice daily | 400 mcg/day |
| COPD (Adults) | 200 mcg twice daily | As directed by physician | 800 mcg/day |
| Interacting Drug / Class | Effect of Interaction | Clinical Recommendation |
|---|---|---|
| Strong CYP3A4 Inhibitors (ketoconazole, ritonavir, cobicistat) | Increased systemic Beclomethasone exposure; risk of adrenal suppression | Avoid combination where possible; monitor closely if unavoidable |
| Systemic Corticosteroids (oral/injectable) | Additive adrenal suppression risk | Minimise concurrent use; taper systemic steroids cautiously when transitioning to ICS |
| Beta-Blockers (propranolol, atenolol) | May reduce efficacy of rescue bronchodilators used alongside Beclate 200 | Prefer cardioselective beta-blockers; discuss with prescriber |
| Diuretics (furosemide, hydrochlorothiazide) | Additive hypokalaemia — particularly relevant when combined with beta-2 agonists | Monitor potassium levels; supplement if required |
| Live Vaccines | Reduced vaccine immunogenicity with high-dose ICS | Discuss timing of vaccination with physician during ICS therapy |
| Feature | Beclate 200 (BDP) | Budecort (Budesonide) | Foracort 200 (BUD+FM) | Digihaler SF 250 (FP+Salm) |
|---|---|---|---|---|
| Active Ingredient | Beclomethasone | Budesonide | Budesonide + Formoterol | Fluticasone + Salmeterol |
| Type | ICS only (preventer) | ICS only (preventer) | ICS + LABA (combination) | ICS + LABA (combination) |
| Manufacturer | Cipla | Cipla | Cipla | Glenmark |
| Onset of Steroid Effect | Days to weeks | Days to weeks | Days to weeks | Days to weeks |
| Bronchodilator Effect | ✗ None | ✗ None | ✓ Formoterol (LABA) | ✓ Salmeterol (LABA) |
| Best Suited For | ICS monotherapy step-up | ICS monotherapy step-up | Step 3–4 combination therapy | Step 3–4 combination therapy |
| Cost Position | ✓ Very affordable | ✓ Affordable | Mid-range | Mid-range |
| Beclate Inhaler 200 Mcg | 1 Pack/s, 2 Pack/s, 3 Pack/s |
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