Symptoms and Signs: Topically applied BETNOVATE-N may be absorbed in sufficient amounts to produce systemic effects. Acute overdosage is very unlikely to occur, however, in the case of chronic overdosage or misuse the features of hypercortisolism may occur (see Adverse Reactions).
Treatment: In the event of chronic overdose or misuse, topical corticosteroids should be withdrawn gradually by reducing the frequency of application, or by substituting a less potent steroid because of the risk of adrenal insufficiency.
Consideration should also be given to significant systemic absorption of neomycin sulphate (see Precautions). If this is suspected, use of the product should be stopped and the patient's general status, hearing acuity, renal and neuromuscular functions should be monitored.
Blood levels of neomycin sulphate should also be determined. Haemodialysis may reduce the serum level of neomycin sulphate.
Further management should be as clinically indicated or as recommended by the National Poisons Centre, where available.