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Look Up > Drugs > Betamethasone
Betamethasone
Pronunciation
U.S. Brand Names
Generic Available
Canadian Brand Names
Synonyms
Pharmacological Index
Use
Pregnancy Risk Factor
Pregnancy/Breast-Feeding Implications
Contraindications
Warnings/Precautions
Adverse Reactions
Overdosage/Toxicology
Drug Interactions
Mechanism of Action
Pharmacodynamics/Kinetics
Usual Dosage
Dietary Considerations
Mental Health: Effects on Mental Status
Mental Health: Effects on Psychiatric Treatment
Dental Health: Local Anesthetic/Vasoconstrictor Precautions
Dental Health: Effects on Dental Treatment
Patient Information
Nursing Implications
Dosage Forms
References

Pronunciation
(bay ta METH a sone)

U.S. Brand Names
Alphatrex®; Betatrex®; Celestone®; Celestone® Soluspan®; Cel-U-Jec®; Diprolene®; Diprolene® AF; Diprosone®; Maxivate®; Teladar®; Valisone®

Generic Available

Yes


Canadian Brand Names
Betnesol®[Disodium Phosphate]; Diprolene® Glycol [Dipropionate]; Occlucort®; Rhoprolene; Rhoprosone; Taro-Sone; Topilene; Topisone

Synonyms
Betamethasone Dipropionate; Betamethasone Dipropionate, Augmented; Betamethasone Sodium Phosphate; Betamethasone Valerate; Flubenisolone

Pharmacological Index

Corticosteroid, Oral; Corticosteroid, Parenteral; Corticosteroid, Topical


Use

Dental: Treatment of a variety of oral diseases of allergic, inflammatory or autoimmune origin

Medical: Inflammatory dermatoses such as seborrheic or atopic dermatitis, neurodermatitis, anogenital pruritus, psoriasis, inflammatory phase of xerosis


Pregnancy Risk Factor

C


Pregnancy/Breast-Feeding Implications

Clinical effects on the fetus: There are no reports linking the use of betamethasone with congenital defects in the literature; betamethasone is often used in patients with premature labor [26-34 weeks gestation] to stimulate fetal lung maturation


Contraindications

Systemic fungal infections; hypersensitivity to betamethasone or any component


Warnings/Precautions

Fatalities have occurred due to adrenal insufficiency in asthmatic patients during and after transfer from systemic corticosteroids to aerosol steroids; several months may be required for recovery of this syndrome; during this period, aerosol steroids do not provide the systemic steroid needed to treat patients having trauma, surgery, or infections; use with caution in patients with hypothyroidism, cirrhosis, ulcerative colitis; do not use occlusive dressings on weeping or exudative lesions and general caution with occlusive dressings should be observed; discontinue if skin irritation or contact dermatitis should occur; do not use in patients with decreased skin circulation


Adverse Reactions

>10%:

Central nervous system: Insomnia

Gastrointestinal: Increased appetite, indigestion

Ocular: Temporary mild blurred vision

1% to 10%:

Dermatologic: Erythema, itching

Endocrine & metabolic: Diabetes mellitus

Local: Dryness, irritation, papular rashes, burning

Ocular: Cataracts

<1%: Hypertension, convulsions, vertigo, confusion, headache, thin fragile skin, hyperpigmentation or hypertrichosis, hypopigmentation, impaired wound healing, acneiform eruptions, perioral dermatitis, maceration of skin, skin atrophy, striae, miliaria, cushingoid state, sodium retention, peptic ulcer, sterile abscess, myalgia, osteoporosis, glaucoma, sudden blindness


Overdosage/Toxicology

When consumed in excessive quantities for prolonged periods, systemic hypercorticism and adrenal suppression may occur; in those cases, discontinuation and withdrawal of the corticosteroid should be done judiciously


Drug Interactions

CYP3A enzyme substrate


Mechanism of Action

Controls the rate of protein synthesis, depresses the migration of polymorphonuclear leukocytes, fibroblasts, reverses capillary permeability, and lysosomal stabilization at the cellular level to prevent or control inflammation


Pharmacodynamics/Kinetics

Protein binding: 64%

Metabolism: Extensively in the liver

Half-life: 6.5 hours

Time to peak serum concentration: I.V.: Within 10-36 minutes

Elimination: <5% of dose excreted renally as unchanged drug


Usual Dosage

Base dosage on severity of disease and patient response

I.M.: 0.0175-0.125 mg base/kg/day divided every 6-12 hours or 0.5-7.5 mg base/m2/day divided every 6-12 hours

Oral: 0.0175-0.25 mg/kg/day divided every 6-8 hours or 0.5-7.5 mg/m2/day divided every 6-8 hours

Adolescents and Adults:

Oral: 2.4-4.8 mg/day in 2-4 doses; range: 0.6-7.2 mg/day

I.M.: Betamethasone sodium phosphate and betamethasone acetate: 0.6-9 mg/day (generally, 1/3 to 1/2 of oral dose) divided every 12-24 hours

Foam: Apply twice daily, once in the morning and once at night

Dosing adjustment in hepatic impairment: Adjustments may be necessary in patients with liver failure because betamethasone is extensively metabolized in the liver

Intrabursal, intra-articular, intradermal: 0.25-2 mL

Intralesional: Rheumatoid arthritis/osteoarthritis:

Very large joints: 1-2 mL

Large joints: 1 mL

Medium joints: 0.5-1 mL

Small joints: 0.25-0.5 mL

Topical: Apply thin film 2-4 times/day. Therapy should be discontinued when control is achieved; if no improvement is seen, reassessment of diagnosis may be necessary.


Dietary Considerations

May be taken with food to decrease GI distress


Mental Health: Effects on Mental Status

Insomnia is common


Mental Health: Effects on Psychiatric Treatment

Enzyme inducers (barbiturates) may decrease the effects of corticosteroids


Dental Health: Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions


Dental Health: Effects on Dental Treatment

No effects or complications reported


Patient Information

Take exactly as directed; do not increase dose or discontinue abruptly, consult prescriber. Take oral medication with or after meals. Limit intake of caffeine or stimulants. Prescriber may recommend increased dietary vitamins, minerals, or iron. Diabetics should monitor glucose levels closely (antidiabetic medication may need to be adjusted). Inform prescriber if you are experiencing greater than normal levels of stress (medication may need adjustment). Some forms of this medication may cause GI upset (oral medication may be taken with meals to reduce GI upset; small frequent meals and frequent mouth care may reduce GI upset). You may be more susceptible to infection (avoid crowds and persons with contagious or infective conditions). Report promptly excessive nervousness or sleep disturbances; signs of infection (sore throat, unhealed injuries); excessive growth of body hair or loss of skin color; changes in vision; excessive or sudden weight gain (>3 lb/week); swelling of face or extremities; difficulty breathing; muscle weakness; change in color of stools (tarry) or persistent abdominal pain; or worsening of condition or failure to improve. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to be pregnant. Consult prescriber if breast-feeding.


Nursing Implications

Apply topical sparingly to areas; not for use on broken skin or in areas of infection; do not apply to wet skin unless directed; do not apply to face or inguinal area. Not for alternate day therapy; once daily doses should be given in the morning; do not administer injectable sodium phosphate/acetate suspension I.V.


Dosage Forms

Base (Celestone®), Oral:

Syrup: 0.6 mg/5 mL (118 mL)

Tablet: 0.6 mg

Dipropionate (Diprosone®)

Aerosol: 0.1% (85 g)

Cream: 0.05% (15 g, 45 g)

Lotion: 0.05% (20 mL, 30 mL, 60 mL)

Ointment: 0.05% (15 g, 45 g)

Dipropionate augmented (Diprolene®)

Cream: 0.05% (15 g, 45 g)

Gel: 0.05% (15 g, 45 g)

Lotion: 0.05% (30 mL, 60 mL)

Ointment, topical: 0.05% (15 g, 45 g)

Valerate (Betatrex®, Valisone®)

Cream: 0.01% (15 g, 60 g); 0.1% (15 g, 45 g, 110 g, 430 g)

Lotion: 0.1% (20 mL, 60 mL)

Ointment: 0.1% (15 g, 45 g)

Valerate (Beta-Val®)

Cream: 0.01% (15 g, 60 g); 0.1% (15 g, 45 g, 110 g, 430 g)

Lotion: 0.1% (20 mL, 60 mL)

Valerate (Luxiq™): Foam: 100 g aluminum can (box of 1)

Injection: Sodium phosphate (Celestone® Phosphate, Cel-U-Jec®): 4 mg betamethasone phosphate/mL (equivalent to 3 mg betamethasone/mL) (5 mL)

Injection, suspension: Sodium phosphate and acetate (Celestone® Soluspan®): 6 mg/mL (3 mg of betamethasone sodium phosphate and 3 mg of betamethasone acetate per mL) (5 mL)


References

Gamsu HR, Mullinger BM, Donnai P, et al, "Antenatal Administration of Betamethasone to Prevent Respiratory Distress Syndrome in Preterm Infants: Report of a UK Multicentre Trial," Br J Obstet Gynaecol, 1989, 96(4):401-10.

Liggins GC and Howie RN, "A Controlled Trial of Antepartum Glucocorticoid Treatment of Respiratory Distress Syndrome in Premature Infants," Pediatrics, 1972, 50:515-25.


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