Betamethasone comes in ointment, cream, lotion, gel, and aerosol (spray) in various strengths for use on the skin and as a foam to apply to the scalp. It is usually applied once or twice daily. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use betamethasone exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor. Do not apply it to other areas of your body or use it to treat other skin conditions unless directed to do so by your doctor.
betamethasone
This medication is only for use on the skin. Do not let betamethasone topical get into your eyes or mouth and do not swallow it. Avoid use in the genital and rectal areas and in skin creases and armpits unless directed by your doctor.
Children who use betamethasone topical may have an increased risk of side effects including slowed growth and delayed weight gain. Talk to your child's doctor about the risks of applying this medication to your child's skin.
Most other betamethasone skin treatments can be used by children over the age of 1 year. Occasionally a specialist may prescribe them for a younger child. However, some betamethasone creams and foams will only be prescribed for children aged 6 years and older.
Do not use betamethasone skin cream or ointment at the same time as any other creams or ointments, such as a moisturiser or emollient. Wait at least 30 minutes before using any other skin product after you put on betamethasone cream or ointment.
If you forget to use your betamethasone skin treatment, do not worry. Use it as soon as you remember unless it's nearly time for your next dose. In this case, skip the missed dose and apply the next one at the usual time.
Serious side effects are rare. They happen to less than 1 in 10,000 people who use betamethasone skin treatments. You're more likely to have a serious side effect if you use betamethasone on a large area of skin for a long time.
Small amounts of betamethasone used on small areas of skin are unlikely to cause any problems in pregnancy. There's not enough research into betamethasone to know if it's safe to use larger amounts in pregnancy.
To reduce the risk of side effects, your doctor may recommend that you only use betamethasone skin treatments for a few weeks at a time or for a day or two each week. Tell your doctor if your skin gets worse or does not improve within 2 to 4 weeks.
Do not use betamethasone skin cream, ointment or lotion for more than 4 weeks without talking to your doctor. If you need treatment for a long time, they may decide you need to use a milder cream or ointment.
Talk to your doctor before stopping treatment if you've been using betamethasone for a long time. They may tell you to gradually use less of it, and use it less often, before you stop completely. This reduces the chance of your symptoms coming back.
Using betamethasone for a long time without stopping can mean some of the medicine gets into your bloodstream. If this happens, there's a very small chance it can cause serious side effects, such as adrenal gland problems, high blood sugar (hyperglycaemia), thinning of your skin, or problems with your eyesight.
As a member of the corticosteroid family, betamethasone is indicated for the treatment of several inflammatory conditions. As topical monotherapy, betamethasone is indicated to relieve pruritic and inflammatory symptoms of corticosteroid-responsive-dermatoses.12,14,15 Betamethasone can be used topically in combination with a vitamin D analog such as calcipotriene to treat plaque psoriasis.16 The corticosteroid is also available as an injectable suspension and can be used to manage a range of inflammatory conditions including endocrine disorders, gastrointestinal disorders, and rheumatic disorders among other conditions.13
Corticosteroids like betamethasone can act through nongenomic and genomic pathways.3 The genomic pathway is slower and occurs when glucocorticoids activate glucocorticoid receptors and initiate downstream effects that promote transcription of anti-inflammatory genes including phosphoenolpyruvate carboxykinase (PEPCK), IL-1-receptor antagonist, and tyrosine amino transferase (TAT).3 On the other hand, the nongenomic pathway is able to elicit a quicker response by modulating T-cell, platelet and monocyte activity through the use of existing membrane-bound receptors and second messengers.3
The absorption and potency of any topical corticosteroid including betamethasone depends on the vehicle in which the steroid is delivered. For example, betamethasone dipropionate 0.05% ointment is classified as a highly potent topical steroid, while betamethasone dipropionate 0.05% cream or lotion is considered to be moderately potent.4
There are several structural modifications that can determine the potency of a topical corticosteroid. For example, corticosteroids containing a halogen at specific carbons, or that contain esters are more potent due to enhanced lipophilicity.5 As such, there is a marked difference between topical products containing betamethasone dipropionate vs. betamethasone valerate. Betamethasone dipropionate contains 2 esters which enhances its potency, while betamethasone valerate has only one ester and is less potent.5
The metabolism of betamethasone yields 6 metabolites.10 The metabolic processes include 6β hydroxylation, 11β-hydroxyl oxidation, and reduction of the C-20 carbonyl group followed by removal of the side chain.10
It is used as a topical cream to relieve skin irritation, such as itching and flaking from eczema. It is used as a treatment for local psoriasis, as betamethasone dipropionate and salicylic acid, or as the combination calcipotriol/betamethasone dipropionate. Betamethasone sodium phosphate is used orally and via injection with the same indications as other steroids. Many betamethasone-based pharmaceuticals include the steroid as the valerate ester.
A cream with 0.05% betamethasone appears effective in treating phimosis in boys,[12] and often averts the need for circumcision.[13][14][15] It has replaced circumcision as the preferred treatment method for some physicians in the British National Health Service.[16][17]
Betamethasone is also used prior to delivery of a preterm baby to help prepare the lungs for breathing. However, because betamethasone crosses the placenta, which is required for its beneficial effects, it may also be associated with complications, such as hypoglycemia and leukocytosis in newborns exposed in utero.
Betamethasone is available in a number of compound forms: betamethasone dipropionate (branded as Diprosone, Diprolene, Celestamine, Procort (in Pakistan), and others), betamethasone sodium phosphate (branded as Bentelan in Italy) and betamethasone valerate (branded as Audavate, Betnovate, Celestone, Fucibet, and others). In the United States and Canada, betamethasone is mixed with clotrimazole and sold as Lotrisone and Lotriderm. It is also available in combination with salicylic acid (branded as Diprosalic) for using in psoriatic skin conditions. In some countries, it is also sold mixed with both clotrimazole and gentamicin to add an antibacterial agent to the mix.
It may not be safe to breast-feed a baby while you are using this medicine. Ask your doctor about any risks. If you apply betamethasone to your chest, avoid areas that may come into contact with the baby's mouth.
Use betamethasone cream, gel, ointment, lotion, foam, or spray exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use betamethasone cream, gel, ointment, lotion, foam, or spray only for the indication prescribed.
Betamethasone has not been well studied during breastfeeding. Systemic betamethasone is best avoided in favor of one of the shorter-acting and better studied alternatives because of its potency and low protein binding which would favor its passage into milk. Use of betamethasone 3 to 9 days prior to delivery of a preterm infant might decrease postpartum milk production in some women. Local injections, such as for tendinitis, would not be expected to cause any adverse effects in breastfed infants,[1] but might occasionally cause temporary loss of milk supply. See also Betamethasone, Topical.
A 5.7 mg dose of depot betamethasone injected into the shoulder for bursitis had no effect in the milk supply in one mother.[2] However, medium to large doses of depot corticosteroids injected into joints have been reported to cause temporary reduction of lactation.[2,3]
A double-blind study in the 1970s randomized pregnant women in preterm labor to either 6 mg of short-acting betamethasone phosphate plus 6 mg long-acting betamethasone acetate or a control treatment containing 6 mg cortisone acetate. Later in the trial, the doses were doubled because of an incomplete response. A total of 560 women received betamethasone and 582 received cortisone. No difference was seen in the percentage of women lactating at hospital discharge (32% and 30.5%, respectively); however, these percentages are very low compared to the rates in many hospitals today.[4]
A study of 46 women who delivered an infant before 34 weeks of gestation found that a course of betamethasone (2 intramuscular injections of 11.4 mg of betamethasone 24 hours apart) given between 3 and 9 days before delivery resulted in delayed lactogenesis II and lower average milk volumes during the 10 days after delivery. Milk volume was not affected if the infant was delivered less than 3 days or more than 10 days after the mother received the corticosteroid.[5]
A study of 87 pregnant women found that betamethasone given as above during pregnancy caused a premature stimulation of lactose secretion during pregnancy. Although the increase was statistically significant, the clinical importance appears to be minimal.[6] 2ff7e9595c
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