Beclometasone Nasal Spray for Sinusitis: Who It Suits and How to Use It
The twice-daily option—who it fits, what that rhythm means day to day, and the inhaler mix-up worth avoiding.
Part of our Sinusitis condition guide.
Get urgent help first. Call 999 or go to A&E for swelling or redness around an eye, double or reduced vision, a severe headache unlike your usual, a stiff neck, confusion or drowsiness. For a very high temperature, or if you're getting worse quickly, contact NHS 111 or your GP the same day. Online treatment isn't suitable in these situations.
The headline: Beclometasone has the longest clinical history of any nasal steroid still in routine use—decades of it. It's used twice a day, and it isn't one of the two sprays NICE names for sinusitis, so prescribers more often start with mometasone. Where mometasone hasn't suited someone, or they've used beclometasone before without problems, it's a well-established alternative.
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Prescription-only. A GPhC-registered pharmacist independent prescriber reviews your online consultation and decides which treatment, if any, is right for your symptoms.
Start Sinusitis Consultation →Adults only online. Access Doctor’s online sinusitis service is for adults aged 18 and over. Children and young people should see their GP or, in England, a community pharmacist through NHS Pharmacy First (age 12 and over).
Who beclometasone suits
Start here rather than with pharmacology, because the choice between the available sprays is mostly about you rather than about the molecules.
| Beclometasone is a good fit if | Consider the alternative if |
|---|---|
| You've used it before without trouble | You'd prefer the spray NICE names for sinusitis (mometasone) |
| You want the option with the longest track record | You already use a steroid inhaler and want to keep total exposure lowest |
| You aren't especially sensitive to tastes and smells | You gag easily or are very taste-sensitive |
| Mometasone hasn't suited you | You want the lowest absorption into the bloodstream |
The direct comparison between the two, including which we'd suggest for a first course, is in our guide on the best nasal spray for sinusitis. For the alternative in depth, see mometasone nasal spray for sinusitis.
The drug in one minute
Beclometasone dipropionate is a corticosteroid. Delivered as a nasal spray, it settles on the swollen lining of the nose and the sinus openings and damps down the inflammation there.
That matters because sinusitis is fundamentally a plumbing problem. Each sinus drains through a channel a few millimetres wide. Swelling closes those channels, mucus is sealed in, and pressure builds. Reduce the swelling and the channels reopen.
It's not a decongestant and won't feel like one. Decongestant sprays open your nose within minutes but can't be used for more than 5 days without causing rebound congestion. Beclometasone does nothing noticeable on day one and everything useful by week two.
You may know it by a brand name. Beconase is the best-known beclometasone nasal spray in the UK, Nasobec is another, and generic beclometasone sprays contain the same active ingredient at the same 50 microgram strength, held to the same MHRA standards. For hay fever, we supply these through our hay fever treatments, which have their own consultation.
Worth knowing: for sinusitis this is off-label use. Beclometasone nasal spray is licensed in the UK for allergic rhinitis, not for sinusitis, so using it for a sinus infection sits outside the product licence. NICE recommends a high-dose steroid nasal spray for this situation, naming mometasone and fluticasone, and flags the use as off-label in the guideline itself. Beclometasone works in the same way but isn't one of the two sprays NICE names. A prescriber should tell you when a medicine is being used outside its licence, so we're telling you here, and our prescribers will explain it during your consultation.
The inhaler mix-up
Beclometasone appears in two completely different products, and confusing them is a genuine and recurring problem.
Nasal spray
A pump bottle. Small dose, delivered to the lining of the nose. For nasal and sinus inflammation.
Inhaler
A pressurised canister, often brown. Much larger dose, designed to reach the lungs. For asthma.
Never spray an asthma inhaler into your nose, and never try to treat asthma with a nasal spray. The doses aren't comparable and the devices are engineered for entirely different destinations. If you have both in the house, keep them apart and check the label each time.
There's a legitimate reason this matters even when nobody makes a mistake. If you use a beclometasone inhaler for asthma and a beclometasone nasal spray for your sinuses, your total steroid intake is the sum of the two. Say so at consultation.
What twice daily means in practice
This is the defining feature of beclometasone, so it deserves more than a line in a table.
Beclometasone is licensed as a twice-daily spray, with the daily amount split between morning and evening. For hay fever, mometasone is usually used once a day, but at the higher dose NICE recommends for sinusitis it's used twice a day too. So for a sinus course, the routine is similar whichever spray you're prescribed.
Either way, the evening dose is the one most worth getting right.
Things that make the second dose stick:
- Attach it to something you already do without fail—brushing your teeth is the obvious candidate, morning and night
- Keep the bottle physically next to your toothbrush rather than in a drawer
- Set a repeating evening alarm for the first fortnight, until the habit forms
- If you regularly miss the evening dose, say so at your next consultation, so your prescriber can talk through what would work better for you
If you do miss a dose, take it when you remember unless the next one is nearly due—in which case skip it. Don't double up.
Dose and course length
Your prescriber will confirm the dose for your situation, and the label is what to follow. As a general shape:
| Situation | Typical pattern | Typical duration |
|---|---|---|
| Acute sinusitis persisting past day 10 | Usually 2 sprays into each nostril, morning and evening (400 micrograms a day) | Around 2 weeks, reviewed after |
| Symptoms recurring after a course | As directed following review | Longer, with reassessment |
| Chronic rhinosinusitis | Regular ongoing use as directed | Months, under clinical review |
Don't stop the moment you feel better. Symptoms settle before the lining has recovered, and stopping at that point is one of the most common reasons the blockage returns within days. Complete the course you were given. Unlike steroid tablets, there's no need to taper the dose down.
Four mistakes that waste the dose
Rather than list the steps, here's what actually goes wrong. Fixing these matters more than which spray you were prescribed.
1
Tipping the head back
It feels right and it's wrong. The spray runs straight down the throat, which is where the taste comes from and where it does nothing. Keep your head level or tipped very slightly forward.
2
Aiming at the middle
Pointing the nozzle inwards hits the septum, the thin wall between the nostrils. That's the tissue that bleeds. Use your right hand for the left nostril and your left for the right—the crossover naturally angles the nozzle outwards, roughly towards the ear on that side.
3
Sniffing hard
A sharp sniff drags the mist past the lining and into the throat. A slow, gentle inward breath as you press is all that's needed.
4
Spraying onto mucus
If your nose is full, the medicine lands on mucus and gets blown away. Clear it first—a gentle blow, or better, a saline rinse a few minutes beforehand. Then leave your nose alone for a while afterwards.
Shake the bottle before use, and prime it into the air until a fine mist appears if it's new or has been sitting unused.
What to expect, week by week
| Point in the course | Realistic expectation |
|---|---|
| Days 1–2 | Nothing obvious. This is normal and not a sign of failure. |
| Days 3–7 | Slightly easier breathing, a little less pressure. Subtle rather than dramatic. |
| Week 2 | The clearest benefit. Facial pressure noticeably reduced. |
| Week 2 onwards | Sense of smell usually returns last, sometimes after everything else has settled. |
| No change by week 2 | Seek advice. Something else may be going on. |
People abandon these sprays on day three far more often than the sprays fail. Judge it at two weeks of consistent use, not before.
The taste question
Beclometasone is noticed by taste more often than mometasone is. It comes up enough to be worth addressing directly.
It's harmless. It usually means some of the spray has reached the back of the throat, which points at technique rather than the drug—head tipped back, or a hard sniff. Correcting those two things removes it for most people.
If it persists and bothers you enough to make you skip doses, that's a reason to mention it. A spray you avoid isn't working.
Absorption and steroid load
All modern nasal steroids deliver a small dose locally with limited entry into the bloodstream. Beclometasone sits noticeably higher on that scale than mometasone or fluticasone, mainly because the part you swallow is absorbed: the product information gives a bioavailability of about 44%, compared with under 1% for mometasone. The dose is still small.
For a two-week course in an otherwise healthy adult, this is a technicality rather than a concern. It becomes worth thinking about when steroids are coming from several directions at once:
- A steroid inhaler for asthma or COPD
- Steroid creams or ointments for eczema or psoriasis, particularly strong ones over large areas
- Steroid eye drops
- Steroid tablets, now or recently
- Long-term rather than short-course nasal spray use
None of these rules beclometasone out. They're simply things the prescriber needs to know, so mention every steroid you use even if it seems unrelated.
Unwanted effects
| Effect | Frequency | What helps |
|---|---|---|
| Dryness or stinging in the nose | Common early on | Usually settles. A saline spray beforehand often helps |
| Sneezing straight after the dose | Can happen | Normal. The dose isn't lost |
| Unpleasant taste or smell | Common with this spray | Head level, gentle breath in |
| Nosebleeds | Common | Nearly always aim. Direct it outwards, not at the septum |
| Dry or irritated throat | Common | Often technique. Sipping water after can help |
| Headache | Uncommon | Mention it if it persists |
| Blurred vision or other eye changes | Very rare | Tell a doctor promptly |
Stop and get urgent help if you develop swelling of the face, lips or tongue, difficulty breathing, or a widespread rash. Serious allergic reactions to nasal steroids are rare but need immediate attention.
When it's the wrong choice
Beclometasone won't be prescribed, or won't be the right answer, if:
- You're pregnant or breastfeeding. Tell the prescriber—you'll be directed to your GP or midwife rather than treated online.
- The patient is under 18. We treat adults only.
- You've had recent nasal surgery or injury, or have an untreated infection in the nose.
- You have glaucoma or cataracts, which warrant a conversation first.
- You take HIV medicines containing ritonavir or cobicistat, which can increase the amount of steroid in the body.
- The problem is bacterial rather than blockage. A worsening picture with fever points towards needing an antibiotic instead—see steroid spray vs antibiotics.
- The diagnosis may be something else. Facial pain that recurs without any nasal blockage is often migraine rather than sinusitis.
Warning signs to act on
Don't wait for the spray to work if any of these appear. Go to A&E or call 999 for swelling or redness around an eye, an eye that looks pushed forward, double or reduced vision, a headache far worse or different from your usual, a stiff neck, confusion or drowsiness. Complications of sinusitis are uncommon, but they need same-hour attention rather than same-week.
Arrange a routine review if nothing has changed after two weeks of consistent use, if symptoms return quickly each time you finish a course, or if this keeps happening several times a year. Our guide on sinusitis that won't go away covers what a repeating pattern usually means.
Get Assessed for a Steroid Nasal Spray
For adults 18 and over with sinus symptoms past 10 days. Complete a short online consultation and a GPhC-registered pharmacist independent prescriber will decide which treatment fits your situation.
Start Sinusitis Consultation →UK safety and reporting side effects
Steroid nasal sprays and antibiotics for sinusitis are prescription-only medicines in the UK. Before anything is prescribed, a GPhC-registered pharmacist independent prescriber reviews your consultation, including the other medicines you take. Always read the patient information leaflet in the pack. If you’re prescribed an antibiotic, never share it or keep leftovers for another time: return any unused tablets to a pharmacy.
If you think you have had a side effect from a medicine, tell your pharmacist or doctor. You can also report it to the MHRA through the Yellow Card scheme, which helps keep medicines safe for everyone.
In England, people aged 12 and over may be able to get sinusitis treatment free from a community pharmacy through the NHS Pharmacy First service. Our private online service is for adults aged 18 and over. Our guide to private vs NHS prescriptions for sinusitis compares the two routes.
Frequently Asked Questions
Who is beclometasone nasal spray most suitable for?
It suits adults with persistent sinus symptoms who have used it before without problems, or for whom mometasone hasn't suited. It has the longest clinical track record of the nasal steroids. Mometasone is more often the first choice for sinusitis, because NICE names it and less of it's absorbed into the bloodstream. Your prescriber will advise which suits you.
Is beclometasone nasal spray the same as a beclometasone inhaler?
No. They contain the same active ingredient but are entirely different products with different strengths and different devices. The inhaler is designed to deliver medicine deep into the lungs for asthma. The nasal spray delivers a much smaller dose to the lining of the nose. An inhaler must never be sprayed into the nose, and a nasal spray won't treat asthma. If you use both, tell the prescriber so your total steroid exposure can be considered.
Why is beclometasone taken twice a day?
Beclometasone is licensed as a twice-daily spray, with the total daily amount split into a morning and an evening dose. Mometasone is usually used once a day for hay fever, but at the higher dose NICE recommends for sinusitis it's also used twice a day. So for a sinus course the routine is similar with either spray. What matters most is taking every dose.
Does beclometasone nasal spray have a taste?
Some people do notice a taste with it, more often than with mometasone. It isn't harmful and usually reflects some of the spray reaching the back of the throat. It can often be reduced by tilting the head slightly forward rather than back, breathing in gently rather than sniffing sharply, and not tipping the bottle upwards inside the nostril. Most people who notice it stop being bothered within the first week.
Is beclometasone absorbed into the body more than other nasal sprays?
More than mometasone or fluticasone, mainly from the small amount that is swallowed, though the dose is still small and it isn't a reason to avoid it for a normal course. It becomes more relevant if you're already using a steroid inhaler for asthma, steroid creams for a skin condition, or steroid eye drops, because those add up. Tell the prescriber about every steroid you use so the total can be weighed.
How soon should I expect beclometasone to help my sinuses?
Expect a gradual change rather than a sudden one. Many people notice a little less pressure and easier breathing by the end of the first week, with the clearest benefit somewhere in the second week. Sense of smell often returns last. If you have had no change at all after two weeks of consistent twice-daily use, that is the point to seek advice rather than continuing to hope.
Can I stop beclometasone once my sinuses feel better?
Finish the course you were given rather than stopping the moment symptoms settle. The inflammation subsides before the lining has fully recovered, and stopping early is a common reason symptoms return within days. You don't need to reduce the dose gradually the way you would with steroid tablets. If you have been advised to use it longer term, don't stop without discussing it first.
Can I use beclometasone nasal spray in pregnancy?
This needs individual advice rather than a general answer. Steroid nasal sprays are sometimes used in pregnancy where the benefit justifies it, but the decision should be made by a clinician who knows your full history, ideally your GP or midwife. Access Doctor won't issue a prescription for sinusitis in pregnancy through an online consultation, and will direct you to your own maternity team instead.
Completing the treatment
A steroid spray works best alongside daily saline rinsing, which clears the mucus so the medicine can reach the lining. Access Doctor supplies beclometasone nasal spray for sinusitis and mometasone nasal spray for sinusitis to adults following an online consultation reviewed by a GPhC-registered pharmacist independent prescriber. Where a bacterial infection is genuinely likely instead, an antibiotic may be more appropriate: phenoxymethylpenicillin, or doxycycline or clarithromycin if you're allergic to penicillin. See all the options for sinusitis treatment online.
Steroid spray · Rx
Beclometasone Nasal Spray for Sinusitis
Twice daily, with the longest clinical track record.
View product →Steroid spray · Rx
Mometasone Nasal Spray for Sinusitis
Named by NICE for sinusitis, with very low absorption into the bloodstream.
View product →Antibiotic · Rx
Phenoxymethylpenicillin for Sinusitis
First-choice antibiotic for bacterial sinusitis: 500mg four times a day for 5 days. Prescribed after an online consultation.
View product →Antibiotic · Rx
Doxycycline Capsules for Sinusitis
Alternative where penicillin can't be used.
View product →References
- Joint Formulary Committee. British National Formulary: Beclometasone dipropionate. bnf.nice.org.uk
- National Institute for Health and Care Excellence. Sinusitis (acute): antimicrobial prescribing (NG79). nice.org.uk
- NICE Clinical Knowledge Summaries. Sinusitis. cks.nice.org.uk
- NHS. Steroid nasal sprays. nhs.uk
- NHS. Sinusitis (sinus infection). nhs.uk
- Electronic Medicines Compendium. Beclometasone dipropionate nasal spray: Summary of Product Characteristics. medicines.org.uk
- Fokkens WJ et al. European Position Paper on Rhinosinusitis and Nasal Polyps. rhinologyjournal.com
Medical disclaimer: This article is for informational purposes only and doesn't constitute medical advice. Always follow the dosing instructions on your own prescription label. Consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999.