Betamethasone

Indications
 Oral
Allergic and inflammatory disorders
Adult: 0.5-5 mg daily.
Child: For inflammatory conditions: ≤12 yr: 0.0175-0.125 mg base/kg daily, dose may be divided every 6-12 hr.
Oral
Congenital adrenal hyperplasia
Adult: 0.5-5 mg daily.
Child: For inflammatory conditions: ≤12 yr: 0.0175-0.125 mg base/kg daily, dose may be divided every 6-12 hr.
Intramuscular
Allergic and inflammatory disorders
Adult: As betamethasone sodium phosphate and betamethasone acetate: Initially, 0.25-9 mg daily may be given in 1-2 divided doses. Dose should be individualised based on the severity of the condition being treated and patient's response. Reduce dose gradually when an adequate response is achieved.
Child: ≤12 yr: 0.0175-0.125 mg base/kg daily, dose may be divided every 6-12 hr.
Elderly:
Ophthalmic
Allergic and inflammatory conditions of the eye
Adult: As sodium phosphate: Apply a 0.1% solution every 1-2 hr until symptoms are controlled or a 0.1% ointment 2-4 times daily or at night in conjunction with the eye drops into the affected eye/s.
Topical/Cutaneous
Skin disorders
Adult: As dipropionate: Apply 0.05% into affected area. As valerate: Apply 0.025 or 0.1% into affected area.

Special Populations: Adjustments may be necessary in patients with liver failure.
Contraindications
 Hypersensitivity; systemic fungal or acute infections.
Warnings / Precautions
 Uncontrolled diabetes, peptic ulcer, osteoporosis, psychosis, psychoneurosis, pregnancy and lactation. Congestive heart failure, hypertension, epilepsy, CRF, elderly, regular monitoring of patients on long term therapy, withdraw gradually, glaucoma, hypothyroidism, cirrhosis, ocular herpes simplex, ulcerative colitis, infants and children.
Adverse Reactions
 Sodium and fluid retention, potassium and calcium depletion. Muscle wasting, weakness, osteoporosis. GI disturbances and bleeding. Increased appetite and delayed wound healing; hirsutism, bruising, striae, acne; raised intracranial pressure, headache, depression, psychosis, menstrual irregularities. Hyperglycaemia, DM. Suppression of pituitary-adrenocortical axis. Growth retardation in children (prolonged therapy). Increased susceptibility for infections. Topical use: Dermal atrophy, local irritation, folliculitis, hypertrichosis. Inhalation: Hoarseness, candidiasis of mouth and throat. Topical application to the eye: Corneal ulcers, raised IOP and reduced visual acuity. Intradermal injection: Local hypopigmentation of deeply pigmented skin. Intra-articular injection: Joint damage, fibrosis, esp in load bearing joints.
Potentially Fatal: Abrupt withdrawal leading to acute adrenal insufficiency manifesting as malaise, weakness, mental changes, muscle and joint pains, dystonia, hypoglycaemia, hypotension, dehydration and death. Rapid IV inj may cause CV collapse.
Drug Interactions
 Increased hyperglycaemia and hypokalaemia with thiazide diuretics. Increased incidence of peptic ulcer or GI bleeding with concurrent NSAIDs admin. Response to anticoagulants altered. Dose of antidiabetics and antihypertensives needs to be increased. Decreases serum conc of salicylates and antimuscarinic agents.
Potentially Fatal: Reduced efficacy with concurrent use of carbamazepine, phenytoin, primidone, barbiturates and rifampicin. Enhanced effect in women taking oestrogens or oral contraceptives.
See Below for More betamethasone Drug Interactions
Food Interactions
 May be taken with food to decrease GI stress.
Mechanism of Actions
 Betamethasone is a corticosteroid with mainly glucocorticoid activity. It prevents and controls inflammation by controlling the rate of protein synthesis, depressing the migration of polymorphonuclear leukocytes and fibroblasts, and reversing capillary permeability and lysosomal stabilisation.
Absorption: Readily absorbed from the GI tract (oral).
Distribution: Distributed throughout body tissues; crosses the placenta and enters the breast milk.
Metabolism: Hepatic.
Excretion: Via urine (<5% as unchanged drug).
Administration
 Should be taken with food.
Storage Conditions
 Intramuscular: Store below 25°C. Ophthalmic: Store below 25°C. Oral: Store below 25°C. Topical/Cutaneous: Store at 2-30°C.
ATC Classification
 C05AA05 - betamethasone ; Belongs to the class of products containing corticosteroids for topical use. Used in the treatment of hemorrhoids and anal fissures.
D07AC01 - betamethasone ; Belongs to the class of potent (group III) corticosteroids. Used in the treatment of dermatological diseases.
D07XC01 - betamethasone ; Belongs to the class of potent (group III) corticosteroids in other combinations. Used in the treatment of dermatological diseases.
H02AB01 - betamethasone ; Belongs to the class of glucocorticoids. Used in systemic corticosteroid preparations.
A07EA04 - betamethasone ; Belongs to the class of corticosteroids acting locally. Used in the treatment of intestinal inflammation.
R01AD06 - betamethasone ; Belongs to the class of topical corticosteroids used for prophylaxis and treatment of allergic rhinitis.
R03BA04 - betamethasone ; Belongs to the class of other inhalants used in the treatment of obstructive airway diseases, glucocorticoids.
S01BA06 - betamethasone ; Belongs to the class of corticosteroids. Used in the treatment of inflammation of the eye.
S01CB04 - betamethasone ; Belongs to the class of corticosteroids/antiinfectives/mydriatics combinations. Used in the treatment of eye diseases.
S02BA07 - betamethasone ; Belongs to the class of corticosteroids used in the treatment of inflammation of the ear.
S03BA03 - betamethasone ; Belongs to the class of corticosteroids used in ophthalmologic and otologic preparations.
Storage
 Intramuscular: Store below 25°C. Ophthalmic: Store below 25°C. Oral: Store below 25°C. Topical/Cutaneous: Store at 2-30°C.
Available As
  • Betamethasone
  • Betamethasone 0.005% w/w
  • Betamethasone Valerate 0.01% w/v
  • Betamethasone 0.01% w/v
  • Betamethasone 0.0125%
  • Betamethasone 0.0125% w/w
  • Betamethasone 0.025 mg
  • Betamethasone 0.025%
  • Betamethasone 0.025% w/v
  • Betamethasone 0.025% w/w
  • Betamethasone Valerate 0.025% w/w
  • Betamethasone 0.05%
  • Betamethasone 0.05% w/v
  • Betamethasone 0.05% w/w
  • Betamethasone Valerate 0.05% w/w
  • Betamethasone Valerate 0.06%
  • Betamethasone Valerate 0.06% w/w
  • Betamethasone 0.061
  • Betamethasone Valerate 0.061%
  • Betamethasone Valerate 0.061% w/w
  • Betamethasone 0.064%
  • Betamethasone 0.064% w/w
  • Betamethasone Valerate 0.1%
  • Betamethasone Sodium Phosphate 0.1%
  • Betamethasone 0.1%
  • Betamethasone Sodium 0.1%
  • Betamethasone Sodium Phosphate 0.1% w/v
  • Betamethasone Valerate 0.1% w/v
  • Betamethasone 0.1% w/v
  • Betamethasone Sodium 0.1% w/v
  • Betamethasone 0.1% w/w
  • Betamethasone Sodium Phosphate 0.1% w/w
  • Betamethasone Valerate 0.1% w/w
  • Betamethasone 0.12%
  • Betamethasone Valerate 0.12%
  • Betamethasone Valerate 0.12% w/v
  • Betamethasone 0.12% w/w
  • Betamethasone Valerate 0.12% w/w
  • Betamethasone 0.25% w/v
  • Betamethasone Valerate 0.5 mg
  • Betamethasone Sodium Phosphate 0.5 mg
  • Betamethasone 0.5 mg
  • Betamethasone Sodium 0.5 mg
  • Betamethasone Valerate 0.5%
  • Betamethasone 0.5%
  • Betamethasone 0.5% w/v
  • Betamethasone 0.5% w/w
  • Betamethasone 0.50 mg
  • Betamethasone Valerate 0.50 mg
  • Betamethasone 0.6 gm
  • Betamethasone 0.6 mg
  • Betamethasone Valerate 0.61 mg
  • Betamethasone 0.61 mg
  • Betamethasone 0.64 mg
  • Betamethasone 0.64%
  • Betamethasone 0.64% w/v
  • Betamethasone 0.643 mg
  • Betamethasone Sodium Phosphate 01% w/v
  • Betamethasone 1 mg
  • Betamethasone Valerate 1 mg
  • Betamethasone 1% w/v
  • Betamethasone Valerate 1.2 mg
  • Betamethasone Sodium Phosphate 4 mg
  • Betamethasone Sodium 4 mg
  • Betamethasone 4 mg
  • Betamethasone 5 mg

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