A daily ICS preventer pMDI containing beclometasone dipropionate 200 micrograms per actuation, used for the long-term management of moderate persistent asthma. Generic equivalent to Clenil Modulite 200. Supplied at Courier Pharmacy after an online consultation reviewed by a UK pharmacist prescriber, then delivered to your door.
The Soprobec 200 inhaler is a pressurised metered-dose inhaler (pMDI) used as a daily preventer for the long-term management of asthma in adults and adolescents.
Firstly, each actuation delivers 200 micrograms of beclometasone dipropionate — an inhaled steroid (ICS). Additionally, a standard pack contains 200 actuations per inhaler.
What sets Soprobec 200 apart from other ICS preventers
Several features distinguish Soprobec 200:
Firstly, it uses the same active as Clenil Modulite — beclometasone dipropionate at the same 200mcg strength. Clinically, they work the same way.
Additionally, it uses HFA propellant — the modern hydrofluoroalkane (HFA-134a) propellant, not the older CFC. This matches Clenil.
Furthermore, it uses standard particle size beclometasone — not the extra-fine particle formulation that sets QVAR apart.
Meanwhile, it uses pMDI delivery — pressurised, breath-coordinated, with most patients benefiting from a spacer.
Above all, it is a twice-daily moderate-dose preventer — sitting in the Step 2-3 range of the asthma ladder.
How beclometasone dipropionate works as a preventer
Firstly, beclometasone dipropionate is one of the most established inhaled steroids worldwide, in clinical use since the 1970s. Additionally, it is a prodrug — the body converts beclometasone dipropionate in lung tissue to beclometasone monopropionate, the active form. Furthermore, both forms have anti-inflammatory action, with the monopropionate being much stronger.
What it does in asthma
In asthma, Soprobec 200:
Calms the underlying airway swelling (the ongoing process that drives asthma)
Reduces pro-inflammatory cytokines and inflammatory cell recruitment
Reduces airway twitchiness
Cuts the frequency and severity of flare-ups
Cuts your reliever requirement
As a result, the effect builds over 1-2 weeks. However, the full benefit typically takes 4-6 weeks.
Preventer vs reliever: how they differ
This is fundamentally different from how a reliever works. Firstly, a SABA (Ventolin, Bricanyl) relaxes bronchial smooth muscle in minutes — fast relief, short duration. In contrast, the ICS does not act on the muscle directly. Instead, it dampens the underlying swelling that makes the muscle twitchy.
Furthermore, over weeks, this changes the airway from “easily provoked” to “harder to provoke”. As a result, attacks become less likely in the first place.
Who uses Soprobec 200
Firstly, Soprobec 200 suits several patient groups:
Adults with ongoing asthma at Step 2-3 — patients whose symptoms or reliever use point to needing a moderate-dose ICS
Patients stepping up from Soprobec 100 when the low-dose ICS is not enough
Patients stepping down from higher-dose ICS as control improves
Patients with previously poorly controlled asthma as part of treatment tuning
Patients on Clenil Modulite 200 who have been switched to Soprobec by their pharmacy or formulary
Additional information
Quantity
1 inhaler, 2 inhalers, 3 inhalers
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What is the Soprobec 200 inhaler?
Asthma that isn’t quite settled on a lower-dose preventer — you’re using your reliever a few times a week, you’re waking with a cough at night, your peak flow keeps dipping, the cold weather sets you off.
Maybe your GP has stepped you up from Soprobec 100 to 200 to get better control.
Maybe you’ve been managing on Clenil 200 and your pharmacy has supplied Soprobec 200 because the formulary changed, and you want to know if it’s the same medicine.
Maybe you’ve been newly diagnosed with persistent asthma and your prescriber went straight to a moderate-dose ICS because your symptoms warranted it.
Soprobec 200 contains beclometasone dipropionate 200 micrograms per actuation in a pressurised metered-dose inhaler.
At Courier Pharmacy we want you to understand how it sits between the 100 and 250 strengths, the technique that makes it work, the rinse-and-spit that prevents thrush, and how it fits into the bigger picture of asthma management.
Five key takeaways
Soprobec 200 is a pressurised metered-dose inhaler (pMDI) containing beclometasone dipropionate 200 micrograms per actuation. It is an inhaled corticosteroid (ICS) used as a daily preventer for asthma in adults and adolescents.
The 200mcg strength sits between Soprobec 100 (lower-dose entry preventer) and Soprobec 250 (higher-strength variant). Typical adult dose is 2 inhalations twice daily (total 800mcg/day) — a moderate-dose ICS regimen on the BTS/SIGN ladder. Step-up from the lower strength happens when control on Soprobec 100 is inadequate (reliever use more than 3 times a week, nocturnal symptoms, exacerbations).
Used daily as preventer therapy, not as a reliever. Onset is gradual: effect builds over 1-2 weeks of consistent use, with full benefit established by 4-6 weeks. For acute attacks, you still need a SABA reliever (Ventolin, Salbutamol Easyhaler, etc.). Patients who use Soprobec as needed rather than daily get a fraction of the benefit.
Critical technique points: slow gentle inhalation (4-5 seconds, deeper than reflex breath), coordination between press and breath, spacer strongly recommended (Volumatic or AeroChamber compatible), 5-10 second breath hold, and rinse-and-spit immediately after each use to prevent oral candidiasis (thrush) and dysphonia (voice changes).
Step-up vs step-down: asthma management is dynamic. Patients with persistent symptoms on Soprobec 200 may need to step up to 250 or add a LABA (combination inhaler like Seretide). Patients with sustained good control may step down to 100. The decision lives with your GP or asthma nurse based on the British Thoracic Society guidelines.
Overview of Soprobec 200
Five things worth knowing:
The 200mcg strength sits in the middle of the Soprobec range. Lower (100) for mild persistent asthma or step-down; this (200) for moderate persistent; higher (250) for step-up. Movement between strengths is based on control, not on time. Many adults end up on Soprobec 200 long-term because it captures their disease well.
Soprobec and Clenil Modulite are clinically equivalent at the same strength. They contain the same active ingredient (beclometasone dipropionate) in the same formulation (HFA-134a propellant, non-extra-fine particles), delivered through similar pMDI devices. Switching between them shouldn’t change your asthma control. If you’ve been changed by your pharmacy, this is usually a formulary decision (Cipla’s Soprobec is often cheaper to the NHS) and shouldn’t require any technique adjustment.
The “more than 3 reliever uses per week” threshold remains the most important number in your asthma management. Daily Soprobec doesn’t eliminate the need for occasional reliever use, but if you’re using your SABA more than 3 times a week (other than pre-exercise), your control is inadequate and the answer is a treatment review, not more reliever.
The spacer is the single most evidence-based way to improve pMDI delivery. Even patients with perfect coordination get better lung deposition with a spacer. Patients with imperfect coordination get dramatically better delivery. If you don’t currently have one, getting a spacer is one of the most underrated interventions in asthma care.
The rinse-and-spit is your defence against oral thrush. ICS preventer therapy without rinse-and-spit leads to thrush in 5-30% of patients depending on dose and technique. With consistent rinse-and-spit, the rate drops substantially. Ten seconds, every dose, every time.
The asthma treatment ladder (BTS/SIGN with NICE NG80 elements):
Step 1: SABA as needed for very mild intermittent (no longer recommended without ICS in most cases under current guidance)
Step 2: low-dose ICS preventer plus SABA reliever — typically Soprobec 100 or equivalent at 200-400mcg/day
Step 3: moderate-dose ICS preventer plus SABA, OR low-dose ICS-LABA combination — Soprobec 200 at 800mcg/day or step to Seretide 100 / Symbicort
Step 4: high-dose ICS plus LABA, sometimes with LTRA — Soprobec 250 at 1000mcg/day plus LABA, or higher-strength combination
Soprobec 200 sits at Step 2-3. Patients well-controlled here often stay on this strength for years. Patients with persistent symptoms despite good adherence usually step up rather than just continuing with poor control.
For people living with asthma, the strength of your preventer reflects the severity of your underlying disease. Step-up isn’t a failure; it’s a response to what your asthma needs. Step-down (when control is sustained) is part of good practice.
Why choose Courier Pharmacy for Soprobec 200
ICS preventers are the most under-used category of asthma medication. Patients consistently underestimate the importance of daily use and over-rely on the reliever. Every Soprobec 200 supply at Courier Pharmacy is reviewed by a UK pharmacist prescriber who confirms the indication, the technique, and the place in your overall asthma management.
We’ll discuss the daily-use principle. The fluticasone effect — sorry, the beclometasone effect — builds over weeks and is lost over weeks if doses are skipped. Patients who use preventers as needed (only when symptomatic) get a small fraction of the benefit. Daily use even when you feel well is the entire point.
We’ll explain the spacer recommendation. Spacers are one of the most evidence-based interventions in asthma management and one of the most under-used. If you don’t currently have one, getting a spacer dramatically improves drug delivery and reduces side effects.
We’ll explain the rinse-and-spit. Oral thrush is the most common preventable ICS side effect. A 10-second water rinse after every dose prevents it for most patients. Skipping “just this once” is how candida starts.
We’ll explain the Soprobec/Clenil equivalence. If you’ve been on Clenil 200 and your pharmacy now supplies Soprobec 200, this is a formulary change rather than a clinical change. Same active, same strength, same expected effect.
We’ll discuss the step-up/step-down framework. Asthma management isn’t static. The decision to move between strengths is based on your control, your reliever use, your nocturnal symptoms, and your exacerbation history. We can help you understand the framework even if the prescribing decision lives with your GP.
Our brand guide, Dr Ada Jex-Cori, sums it up: you’re not broken. The system that’s failed you might be. We want to do the part we can do, properly, and connect you with the rest. That includes our free fortnightly drop-in clinics and talks at Insomnia in Derby, where you can ask questions face-to-face without spending a penny.
Buy Soprobec 200 from Courier Pharmacy
Soprobec 200 is a prescription only medicine in the UK. Buying through Courier Pharmacy is straightforward and built around your time, not ours.
Here’s how it works:
Complete a quick online consultation about your asthma and current inhaler regimen
A UK pharmacist prescriber reviews your information
If suitable, a prescription is issued
We dispense and deliver discreetly to your door
If it isn’t suitable for you, we’ll explain why and suggest the next best option.
Active ingredients in Soprobec 200
The active ingredient is beclometasone dipropionate, a synthetic corticosteroid.
Chemical and pharmacological class:
Beclometasone dipropionate (BDP)
Synthetic glucocorticoid; the dipropionate ester is the form used in inhalers
Acts as a prodrug — metabolised in lung tissue to beclometasone monopropionate (BMP), the active form
BMP has approximately 25 times the receptor binding affinity of BDP
Highly lipophilic, allowing good airway tissue penetration
Low oral bioavailability (around 15-20%) — minimises systemic effects from any swallowed dose
Mechanism of action:
Beclometasone (as BMP after metabolism) works by:
Diffusing across the bronchial cell membrane
Binding to the cytoplasmic glucocorticoid receptor
Standard beclometasone formulations (Soprobec, Clenil Modulite) have a typical particle size of around 3-5 microns. These particles deposit mainly in the larger central airways.
Extra-fine particle beclometasone (QVAR, Fostair) has particles around 1-2 microns. These penetrate further into the smaller peripheral airways. Some asthma phenotypes — particularly small-airway-predominant disease — may benefit from extra-fine particles.
For most patients, standard beclometasone (Soprobec 200) provides good control. Extra-fine alternatives are typically considered if standard ICS isn't achieving control, or when specific small-airway disease is identified.
The microgram equivalence consideration:
When switching between standard and extra-fine beclometasone, the doses are not 1:1:
- QVAR 50mcg ? Soprobec 100mcg (in clinical effect)
- QVAR 100mcg ? Soprobec 200mcg
If switching between QVAR and Soprobec, your GP will adjust the strength accordingly. This is a common point of confusion at pharmacy switches.
Other excipients in Soprobec include the HFA-134a propellant and ethanol. Specific excipients are on the patient information leaflet.
What is Soprobec 200 for?
Soprobec 200 is used in adults and adolescents for:
Persistent asthma at Step 2-3 of the BTS/SIGN ladder
Moderate-dose ICS preventer therapy — total daily dose typically 400-800mcg of beclometasone
Step-up from lower-dose ICS when control is inadequate
Step-down from higher-dose ICS when control is sustained
Maintenance therapy in adults who do well on this dose
It's appropriate for:
Daily long-term use (not as-needed)
Combined with SABA reliever for acute relief
Adults and older adolescents who can use a pMDI (with or without spacer)
Patients without contraindications to ICS
Soprobec 200 is not appropriate for:
Acute asthma attacks (use SABA reliever)
Mild intermittent asthma needing only SABA-PRN under older guidelines (current guidance favours low-dose ICS plus SABA)
Children under 4 (limited evidence for pMDI use without spacer at this age)
Patients with hypersensitivity to beclometasone
Use as the only inhaler in asthma (a SABA for emergency use should always be available)
Step 4+ asthma where ICS-LABA combination is preferred over high-dose ICS alone
NICE NG80 and BTS/SIGN guidance position moderate-dose ICS as a Step 2-3 mainstay of asthma management, with combination ICS-LABA preferred at Step 3-4 over further dose escalation of ICS alone.
How does Soprobec 200 work?
Asthma is fundamentally an inflammatory disease. The chronic inflammation in the airway wall:
Causes airway hyperreactivity (the airway is over-twitchy)
Leads to mucus hypersecretion
Causes basement membrane thickening over time (airway remodelling)
Predisposes to acute bronchoconstriction when triggers occur
A SABA (reliever) addresses the bronchoconstriction directly — relaxes the muscle, opens the airway. But it doesn't touch the inflammation. The inflammation is still there; the next trigger will provoke another attack.
An ICS like beclometasone treats the inflammation:
Time course of action:
Day 1: drug deposited in airways; binds to glucocorticoid receptors
Day 1-3: modest reduction in inflammatory mediator production
Week 1-2: detectable improvement in symptoms; reduced reliever use
Week 2-4: noticeable improvement in lung function; reduced airway hyperreactivity
Week 4-6: full benefit established
Continued daily use: sustained protection while compliance maintained
1-2 weeks after stopping: control deteriorates; reliever use rises; exacerbations more likely
This time course explains some common patient experiences:
Patients starting Soprobec often feel "it's not doing anything" for the first week — the effect hasn't built yet
Patients who skip doses for a week feel fine but lose protection
Patients who stop because they "feel better" often have an exacerbation 2-4 weeks later
The daily-discipline aspect of preventer therapy is the principal cause of poor asthma control in primary care.
What it doesn't do:
Doesn't act as a reliever during an attack (effect takes hours/days)
Doesn't cure asthma (controls it; doesn't change the underlying tendency)
Don't immerse in water — moisture damages the formulation
Priming the inhaler:
New inhaler or unused for 7+ days: shake well, then spray 2 actuations into the air to prime
Daily routine use: priming not needed between doses
Clean the device weekly:
Wipe the plastic actuator with a dry cloth or tissue
Don't immerse the canister
Don't expose the canister to water or excessive moisture
Side effects worth knowing about:
Oral thrush — white patches in mouth; preventable by rinse-and-spit; treatable with antifungal lozenges
Hoarse voice (dysphonia) — reduced by spacer use and rinse-and-spit
Cough on inhalation — usually settles with technique improvement
Throat irritation — typically mild, transient
Step-up considerations:
If on Soprobec 200 you have:
Reliever use more than 3 times a week (excluding pre-exercise)
Symptoms waking you at night more than 1 night a week
Symptoms limiting your normal activity
Falling peak flow
Exacerbations needing oral steroids
Then control is inadequate. Step up options include:
Increase Soprobec to 250 (modest step)
Add LABA — switch to combination inhaler (Seretide, Symbicort, Fostair)
Add montelukast (LTRA)
Specialist referral
The decision lives with your GP.
Step-down considerations:
If on Soprobec 200 you have:
No symptoms day or night
No exacerbations for 3-6 months
Normal lung function
Minimal reliever use
Then step-down to Soprobec 100 may be possible. Your GP would typically reduce after 3 months of sustained control, then re-assess.
Warnings and precautions of Soprobec 200
Beclometasone is generally well-tolerated. Specific considerations:
Contraindicated in:
Known hypersensitivity to beclometasone or any excipient
Untreated active respiratory infections (relative; ICS may continue but the infection needs treatment)
Use with care in:
Active untreated tuberculosis or other chronic infections
Recurrent oral candidiasis
Pregnancy and breastfeeding (use generally considered acceptable; uncontrolled asthma is worse)
Severe hepatic impairment
Risk factors for osteoporosis (long-term high-dose ICS may affect bone density)
Diabetes (ICS at high doses can affect glucose; rarely clinical issue at standard inhaled doses)
The systemic effect threshold:
Inhaled corticosteroids are designed for topical action on the airways with minimal systemic absorption. At standard doses (Soprobec 200 at 2 puffs twice daily = 800mcg/day), systemic effects are uncommon and minor.
At higher doses (1600-2000mcg/day) or with long-term use over years:
Mild HPA axis suppression possible (rare but measurable)
Bone density effects in vulnerable patients
Cataract and glaucoma risk slightly elevated with very long-term high doses
For most patients using Soprobec 200 at the standard dose, these aren't clinical concerns. The protective effect against asthma exacerbations vastly outweighs the small systemic risks.
The oral candidiasis warning:
5-30% of ICS users without spacer or rinse develop thrush at some point
Rate drops substantially with consistent spacer use and rinse-and-spit
Treatment: antifungal lozenges (nystatin) or oral gel (miconazole)
Continue ICS during treatment of thrush; improve technique afterwards
Pregnancy and breastfeeding:
Inhaled beclometasone is generally considered acceptable. Uncontrolled asthma during pregnancy is dangerous to both mother and baby. The choice is between controlled asthma on standard preventer therapy or uncontrolled asthma; the former is far safer.
Drug interactions:
Strong CYP3A4 inhibitors (ritonavir, ketoconazole, itraconazole): may increase beclometasone systemic exposure modestly; clinically relevant for ritonavir specifically. Consider alternative ICS or monitor for systemic effects
Other corticosteroids (oral, inhaled, topical): additive systemic exposure
Live vaccines: caution at high doses of ICS; standard inhaled doses generally not a concern
If you experience signs of an allergic reaction (rash, swelling, breathing difficulty) seek immediate medical attention.
Side effects of Soprobec 200
Beclometasone is well-tolerated for most patients. Side effects are typically mild and local.
Common side effects, between 1 in 100 and 1 in 10 people, include hoarseness (dysphonia), oral candidiasis (thrush), throat irritation, cough on inhalation (usually transient), and unpleasant taste.
Uncommon side effects, between 1 in 1,000 and 1 in 100 people, include paradoxical bronchospasm (worsening wheeze immediately after use — discontinue), pneumonia in COPD patients, and behavioural changes (especially in children).
Rare side effects, fewer than 1 in 1,000 people, include hypersensitivity reactions (rash, angioedema), HPA axis suppression (with long-term high-dose use), and growth retardation in children (a known but modest effect with chronic ICS use).
Very rare and serious side effects include severe allergic reactions including anaphylaxis, glaucoma (with long-term high-dose use), cataracts, and significant adrenal crisis.
If you experience any side effect that worries you, you can report it directly to the MHRA's Yellow Card scheme. This helps improve safety data for everyone who uses the product. Our pharmacy team are happy to help you submit a Yellow Card report if you'd like assistance.
Drug interactions with Soprobec 200
Clinically relevant interactions:
Ritonavir and other strong CYP3A4 inhibitors: modest increase in systemic beclometasone exposure; consider alternative ICS or monitor for systemic corticosteroid effects
Ketoconazole, itraconazole, clarithromycin: similar but less marked
Other corticosteroids (oral, IV, intranasal, topical): additive systemic effects with long-term combined use
Live vaccines: caution at high doses; standard inhaled doses generally not a concern
Diuretics, theophylline, salbutamol: minimal interaction at standard inhaled doses; relevant only at very high cumulative steroid exposure
Tell your pharmacist about all medicines you take when starting any new inhaler.
Frequently Asked Questions about Soprobec 200
What is Soprobec 200 used for?
Soprobec 200 is a daily preventer inhaler containing beclometasone dipropionate 200 micrograms per actuation. It's used as ICS preventer therapy for moderate persistent asthma in adults and adolescents, typically at Step 2-3 of the BTS/SIGN ladder.
Is Soprobec the same as Clenil?
Both contain beclometasone dipropionate at equivalent strengths in HFA pMDI form.
Is Soprobec a reliever inhaler?
No. Soprobec is a PREVENTER, taken daily even when feeling well. For acute asthma attacks, you need a SABA reliever (Ventolin, Salbutamol Easyhaler, etc.). Soprobec takes 1-2 weeks to build effect.
How long does it take to work?
Effect builds gradually: noticeable improvement in symptoms after 1-2 weeks, full benefit by 4-6 weeks. Daily consistent use is essential — the effect dissipates over 1-2 weeks if doses are skipped.
Why is the rinse-and-spit important?
The ICS deposits a proportion of each dose in the mouth and throat. If left there, it can cause oral candidiasis (thrush) and dysphonia (voice changes). Rinsing with water and spitting (don't swallow) washes away the residual drug and prevents these side effects.
Should I use a spacer?
Yes — spacers are strongly recommended for most adults using pMDIs. They improve drug delivery to the airways, reduce mouth/throat deposition, and reduce side effects. Ask your pharmacist or GP about a Volumatic or AeroChamber Plus spacer.
What's the difference between Soprobec 100, 200, and 250?
The numbers refer to the beclometasone dose per actuation (in micrograms). Lower doses (50, 100) are for milder asthma or step-down; higher doses (200, 250) are for moderate-to-severe asthma or step-up. Movement between strengths is based on asthma control.
How do I know if I should step up to Soprobec 250?
The principal triggers for step-up are reliever use more than 3 times a week (other than pre-exercise), symptoms waking you at night more than 1 night a week, symptoms limiting normal activity, or exacerbations needing oral steroids. Discuss with your GP.
How do I know if I can step down to Soprobec 100?
Step-down may be considered if you have sustained good control on Soprobec 200 — no symptoms, no exacerbations, normal lung function — typically for at least 3 months. Your GP would manage the step-down.
Can children use Soprobec 200?
For older children (typically 6+ with spacer; 12+ without spacer) under specific prescriber guidance. Younger children typically use lower-strength ICS (Soprobec 50 or 100) and spacers with masks.
Can I use Soprobec during pregnancy?
Yes. Inhaled beclometasone is generally considered acceptable in pregnancy and breastfeeding. Uncontrolled asthma is more dangerous to mother and baby than appropriate inhaler use. Don't stop or reduce without specialist advice.
What if I forget a dose?
Take it as soon as you remember unless close to the next dose; don't double up. Occasional missed doses don't undo the benefit, but consistent regular use is what works.
What if I run out?
Reorder before running out. The beclometasone effect dissipates over 1-2 weeks if doses are skipped. Don't let your asthma destabilise because of a supply gap.
Will Soprobec cure my asthma?
No. Soprobec controls asthma; it doesn't cure it. Asthma is a chronic condition. Effective preventer therapy can keep you symptom-free, but the underlying tendency to airway inflammation remains.
Why do I get a hoarse voice?
ICS deposits in the throat can affect the larynx, causing dysphonia. Spacer use and rinse-and-spit reduce this; if persistent and bothersome, mention to your GP.
What if I develop oral thrush?
White patches in the mouth indicate oral candidiasis. Treatable with antifungal lozenges (nystatin) or oral gel (miconazole). Continue Soprobec while treating thrush; improve your technique afterwards.
Can I exercise on Soprobec?
Yes. Many patients find their exercise tolerance improves significantly with effective preventer therapy. Use your SABA 15 minutes before exercise if exercise-induced symptoms occur.
Can I use Soprobec with my other asthma medications?
Yes — Soprobec is the preventer; you typically use it alongside a SABA reliever (Ventolin, etc.) and sometimes add-on therapies (montelukast, LABA combinations). The combination is built into the BTS/SIGN treatment ladder.
Does Soprobec interact with steroid tablets?
If you're taking oral steroids (prednisolone) for an asthma exacerbation, continue Soprobec at your usual dose. Don't stop the preventer when starting oral steroids.
Why was my Clenil changed to Soprobec?
Usually a pharmacy or NHS formulary decision based on cost-effectiveness. Soprobec is the cheaper Cipla beclometasone product; clinically equivalent at the same strength. Same medicine, different brand.
Will Soprobec affect my immune system?
At standard inhaled doses (Soprobec 200 at 800mcg/day), systemic effects are minimal. The drug acts predominantly in the lung. The dose absorbed systemically is far below what would suppress overall immunity. Very high doses over many years are a separate consideration.
Disclaimer: This information is for education only and isn’t a substitute for personal medical advice. Always follow your prescriber’s instructions.
