Qvar asked
My 11 year old daughter suffers with asthma. She takes Qvar inhaler two puffs once daily, Levocetirizine 5mg one daily, and Zafirlukast 10mg once daily. In October, we refilled her Qvar and the inhaler looked different, but since the directions and dosage the pharmacy printed on the medication were the same, I didn't think much of it. My daughter is old enough now that she gives herself her inhaler. I haven't paid anymore attention to it until tonight when I replaced her inhaler and I noticed the inhaler looks exactly as it did in the past. Upon further inspection, she has actually been taking Qnasl by mouth for over a month. The pharmacy labeled everything Qvar but actually gave us Qnasl. I feel absolutely terrible and am worried sick about ant possible side effects. I do not know what type of danger she may be in. Any advice would be extremely helpful. Thank you.
Answer
While it may seem concerning that your daughter was using Qnasl instead of Qvar, I would not expect her to have significant side effects from this medication error. Qnasl and Qvar both contain the same active and inactive ingredients with the only difference being the delivery mechanism. Both Qvar and Qnasl even come with the same doses per actuation—beclomethasone 40 and 80 mcg per spray.
I would recommend notifying the dispensing pharmacy so that they
can be aware of the mistake. Making them aware can help reduce the likelihood
of the error reoccurring.
Qnasl Vs. Qvar: What’s The Difference?
Both Qnasl and Qvar contain beclomethasone, a type of steroid that suppresses the body’s inflammation and immune response. Beclomethasone is indicated to treat a few disease states, depending on the route of delivery.
Qvar is an inhaler that is used to treat asthma, COPD, bronchitis, emphysema, and exercise-induced bronchospasm. Qvar is inhaled orally and is delivered primarily to the lungs. The inactive ingredients include ethanol and the propellant HFA.
Qnasl is a non-aqueous nasal spray that is used to treat allergic and nonallergic rhinitis (nasal inflammation), as well as, prevention of nasal polyps after surgery. Qnasl is delivered as a nasal aerosol and is delivered primarily to the nose. The inactive ingredients are the same as Qvar—ethanol and HFA.
When using inhalers like Qvar, it is important to understand how to use each unique device. Qvar should be primed with two sprays prior to use. It is important to breathe out fully and then spray as you breathe in deeply and slowly. Holding your breath for 5-10 seconds after inhaling also helps the medication absorb in the lungs.
If Qvar is prescribed for two doses, it is recommended to
repeat the entire process per spray (i.e. two sprays at the same time is not
nearly as effective). Finally, steroids can sometimes cause thrush, a yeast
infection that can develop in the mouth in throat. To prevent this, make sure to rinse your mouth with water
after each dose.
Source: Qvar
package insert, Qnasl
package insert
