Betamethasone + Neomycin

Ophthalmic
Ocular inflammation with suspected or confirmed bacterial infection

Topical/Cutaneous
Corticosteroid-responsive dermatoses with secondary infection

Topical/Cutaneous:
Dose reduction may be necessary.

Hypersensitivity. Rosacea, acne vulgaris, perioral dermatitis, perianal and genital pruritus and primary cutaneous viral infections. Not to be used in otitis externa complicated by ear-drum perforation. Treatment of primary infected skin lesions caused by fungi or bacteria; primary or secondary infections due to yeast; or secondary infections due to Pseudomonas or Proteus species. Children <2 yr. Ophthalmic preparation: Not to be used in patients with glaucoma or herpetic keratitis.

Avoid prolonged treatment as it may lead to systemic corticosteroid effects even withour occlusion. Avoid prolonged excessive application to the facial areas. Withdraw treatment if there is spread of the infection. Risk of glaucoma development if preparation enters eye(s). Regular monitoring is recommended when used in psoriasis due to treatment tolerance, rebound relapses, generalised pustular psoriasis or systemic toxicity. Increased risk of contact sensitisation when used for extended period or recurrently. Pregnancy and lactation. Ophthalmic preparation: Monitor intraocular pressure, cataract formation of unsuspected infections; evaluate treatment if there is no clinical improvement after 7 days. Not to be used for undiagnosed red eye.

Prolonged use may cause local atrophic changes in the skin e.g. thining, striae and dilatation of superficial blood vessels. Local skin burning sensation, pruritus, pigmentation changes, allergic contact dermatitis and hypertrichosis. Ophthalmic preparation: Corneal ulceration, increased intraocular pressure, mydriasis, ptosis, epithelial punctate keratitis.

Acute overdosage is unlikely to occur. Prolonged excessive use may lead to sufficient systemic absorption resulting in symptoms of Cushing's syndrome, in which case, gradual withdrawal of the drug is recommended. Significant systemic absorption of neomycin sulfate may cause ototoxicity and nephrotoxicity. Treatment involves withdrawal of drug and monitoring general status, hearing acuity, renal and neuromuscular functions of the patient.

If there is significant systemic absorption, neomycin sulfate may increase the respiratory depressant effects of neuromuscular blockers.

Description: Betamethasone valerate is a corticosteroid which is effective in inflammatory dermatoses. It is also effective in less responsive conditions such as psoriasis. Neomycin sulfate is a broad spectrum antibiotic. It is bactericidal against many bacteria which are commonly associated with skin infections.
Pharmacokinetics:
Absorption: Betamethasone: Absorption through the skin depends on several factors e.g. presence of occlusive dressing, integrity of the epidermal barrier.
Distribution: Betamethasone: Bound to plasma proteins to varying extent.
Metabolism: Betamethasone: Largely metabolised hepatically.
Excretion: Betamethasone: Mainly excreted via the kidneys.

Store <25°C.

Eye Antiseptics with Corticosteroids / Topical Anti-Infectives with Corticosteroids