Betamethasone


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Allergic and inflammatory disorders; Congenital adrenal hyperplasia As betamethasone Na phosphate: 0-5-5 mg/day in divided doses. IM/IV Allergic and inflammatory disorders As betamethasone Na phosphate: 4-20 mg via deep IM inj, IV inj or IV infusion, repeated 3-4 times in 24 hr, as necessary. IM Allergic and inflammatory disorders As betamethasone Na phosphate and betamethasone acetate: 0.25-9 mg/day. Topical Corticosteroid-responsive dermatoses As 0.05% betamethasone dipropionate oint/cream/gel/lotion: Apply to affected area 1-2 times/day for up to 2 wk. As 0.025 or 0.1% betamethasone valerate cream/oint/lotion: Apply thinly into affected area 1-3 times/day for up to 4 wk or until improvement occurs. As 0.1% betamethasone valerate soln: Rub gently into affected area bid. As 0.12% betamethasone valerate foam: Massage gently into scalp bid. Mild to moderate plaque psoriasis As 0.05% betamethasone dipropionate spray: Apply to affected area bid for up to 4 wk. Ophth Allergic and inflammatory disorders Initial: 1-2 drops into affected eye(s) 2 hrly, reduce frequency once condition is under control. Otic Allergic and inflammatory disorders Initial: 2-3 drop into affected ear(s) 3-4 hrly, reduce frequency once condition is under control. Nasal Allergic and inflammatory disorders Instill 2-3 drops into each nostril bid as required.
Dosage Details
Intramuscular
Allergic and inflammatory disorders
Adult: As betamethasone Na phosphate and betamethasone acetate: 0.25-9 mg daily.

Nasal
Allergic and inflammatory disorders
Adult: Instill 2-3 drops into each nostril bid as required.
Child: Same as adult dose.

Ophthalmic
Allergic and inflammatory disorders
Adult: Initially, 1-2 drops instilled into affected eye(s) 2 hrly, reduce frequency once the condition is under control.
Child: Same as adult dose.

Oral
Allergic and inflammatory disorders, Congenital adrenal hyperplasia
Adult: As betamethasone Na phosphate: 0-5-5 mg daily in divided doses, depending on the severity of the disease and clinical response. Recommended regimen: Short-term treatment: 2-3 mg daily for the first few days, then gradually decrease by 0.25 or 0.5 mg every 2-5 days, depending on response. Rheumatoid arthritis: 0.5-2 mg daily. Other conditions: 1.5-5 mg daily for 1-3 wk, then gradually reduce to Min effective dose.
Child: Dose is proportional to adult dose (e.g. 1 yr 25% of adult dose; 7 yr 50% of adult dose; 12 yr 75% of adult dose). Treatment is limited to the Min dosage for the shortest possible time.

Otic/Aural
Allergic and inflammatory disorders
Adult: Initially, 2-3 drops instilled into affected ear(s) 3-4 hrly, reduce frequency once the condition is under control.
Child: Same as adult dose.

Parenteral
Allergic and inflammatory disorders
Adult: As betamethasone Na phosphate: 4-20 mg via deep IM inj, IV inj over 0.5-1 min, or IV infusion, repeated 3-4 times in 24 hr, as necessary.
Child: As betamethasone Na phosphate: ≤1 yr 1 mg; >1-5 yr 2 mg; 6-12 yr 4 mg. Doses are given via IV inj or infusion, repeated 3-4 times in 24 hr as necessary.

Topical/Cutaneous
Corticosteroid-responsive dermatoses
Adult: As 0.05% betamethasone dipropionate oint, cream, gel, or lotion: Apply to affected area 1-2 times daily for up to 2 wk. As 0.025 or 0.1% betamethasone valerate cream, oint, or lotion: Apply thinly into affected area 1-3 times daily for up to 4 wk or until improvement occurs. As 0.1% betamethasone valerate soln: Rub gently into affected area bid. As 0.12% betamethasone valerate foam: Massage gently into scalp bid.

Topical/Cutaneous
Mild to moderate plaque psoriasis
Adult: As 0.05% betamethasone dipropionate spray: Apply to affected area bid for up to 4 wk.
Administration
Should be taken with food.
Contraindications
Untreated infections (systemic and topical). Idiopathic thrombocytopenic purpura (IM).
Special Precautions
Patient w/ history of severe affective disorder esp steroid psychosis, osteoporosis, CHF or HTN, recent MI, DM, history of TB, glaucoma, corticosteroid-induced myopathy, epilepsy, peptic ulceration, hypothyroidism, myasthenia gravis; psoriasis (topical). Renal and hepatic impairment. Childn. Pregnancy and lactation.
Adverse Reactions
Suppression of HPA axis, growth suppression esp in childn, menstrual irregularity and amenorrhoea, Cushingoid facies, hirsutism, wt gain, impaired carbohydrate tolerance, increased appetite, hyperhidrosis; recurrence of dormant TB, opportunistic infections; osteoporosis, vertebral and long bone fractures, avascular osteonecrosis, tendon rupture, proximal myopathy; Na and water retention, HTN, K loss, hypokalaemic alkalosis; affective disorder (e.g. irritable, euphoric, depressed and labile mood, suicidal thoughts), psychotic reactions ( e.g. mania, delusions, hallucinations and aggravation of schizophrenia), behavioural disturbances, irritability, anxiety, sleep disturbances and cognitive dysfunction (e.g. confusion, amnesia), epilepsy aggravation; increased intraocular pressure, glaucoma, papilloedema, posterior subcapsular cataracts, corneal or scleral thinning, exacerbation of ophth viral or fungal disease; abdominal distension, oesophageal ulceration, nausea, dyspepsia, peptic ulceration w/ perforation and haemorrhage, acute pancreatitis, candidiasis; impaired healing, skin atrophy, bruising, telangiectasia, striae, acne, Stevens-Johnson syndrome; thrombo-embolism, malaise, hiccups.
IM/Intrabursal/Intradermal/Intralesional/Parenteral/Periarticular/Topical: C
Patient Counseling Information
Avoid abrupt withdrawal. Avoid exposure to chickenpox or measles.
MonitoringParameters
Monitor for hypothalamic-pituitary-adrenal (HPA) axis suppression, esp in childn.
Drug Interactions
Increased plasma concentration when used w/ CYP3A4 inhibitors (e.g. ritonavir, itraconazole), and OCs. Decreased therapeutic effect when concurrently used w/ rifampicin, rifabutin, carbamazepine, phenobarbitone, phenytoin, primidone, aminoglutethimide and ephedrine. May antagonise the effect of hypoglycaemic agents, antihypertensives, neuromuscular blockers (e.g. vecuronium), and diuretics. Increased risk of hypokalaemia w/ acetazolamide, loop/thiazide diuretics, carbenoxolone, theophylline, cardiac glycosides. May inhibit the growth promoting effects of somatropin. Increased risk of tendon rupture w/ concurrent use of fluoroquinolones. May increase the metabolism of quetiapine and tretinoin. Increased risk of GI bleeding when used w/ NSAIDs. May enhance the efficacy of coumarin anticoagulants.
Lab Interference
May suppress the wheal and flare reaction to skin test antigens.
Action
Description: Betamethasone is a corticosteroid w/ mainly glucocorticoid activity. It induces phospholipase A2 inhibitory lipase (lipocortins) and sequentially inhibits the release of arachidonic acid, thereby depressing the formation, release, and activity of prostaglandins, leukotrienes, and other inflammatory mediators.
Pharmacokinetics:
Absorption: Rapidly absorbed (IM); readily absorbed from the GI tract (oral) and from intact skin (topical).
Distribution: Readily crosses the placenta and enters breast milk.
Metabolism: Metabolised primarily in the liver.
Excretion: Via urine and faeces.
Chemical Structure

Click on icon to see table/diagram/image
Storage
Store between 15-30°C.
ATC Classification
S01BA06 - betamethasone ; Belongs to the class of corticosteroids. Used in the treatment of inflammation of the eye.
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.
R01AD06 - betamethasone ; Belongs to the class of topical corticosteroids used for prophylaxis and treatment of allergic rhinitis.
D07AC01 - betamethasone ; Belongs to the class of potent (group III) corticosteroids. Used in the treatment of dermatological diseases.
H02AB01 - betamethasone ; Belongs to the class of glucocorticoids. Used in systemic corticosteroid preparations.
Disclaimer: This information is independently developed by MIMS based on Betamethasone from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
  • Beavate
  • Besone
  • Betamet
  • Betasone DHA
  • Uniflex
  • Upha Betamethasone
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in