BETAMETHASONE

Long-acting synthetic corticosteroid

Dosage Forms

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Injection

4 mg/ml

Cream/ointment

0.1%

Eye/ear drops

0.1%

Uses

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  • Allergic and inflammatory conditions of skin, eyes, ears
  • Foetal lung maturation in mothers with pre-term labour
  • Acute allergic reactions and anaphylactic reactions
  • Status asthmaticus
  • Adrenal insufficiency (specialist use only)

Dose and Duration

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Lung maturation in preterm births
Adult (give to mother): Slow IV injection 5.7 mg/ml as betamethasone sodium phosphate 3.9 mg (in solution) or betamethasone acetate 3 mg (in suspension) in an aqueous vehicle
Eczema, psoriasis and skin allergies
Apply a thin layer of cream every 12 hours until improvement is seen
Eye or ear inflammation (without infection)
Apply 1‒2 drops every 2 hours until controlled; reduce frequency to 2‒4 times daily
Acute allergic reactions including anaphylactic reactions, status asthmaticus, adrenal insufficiency
Adult and child over 12 years:4–20 mg by slow IV injection over 30–60 seconds every 6–8 hours or as required
Child 6–12 years:4 mg every 6–8 hours
Child 1–6 years:2 mg every 6–8 hours
Infants up to 1 year1 mg every 6–8 hours

Contraindications

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  • Topical application in bacterial, fungal or viral infection and in glaucoma
  • Otitis externa with perforated eardrum
  • Systemic administration in systemic infections unless specific anti-infective therapy
  • Hypersensitivity

Side Effects

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  • Stomach upset
  • Allergic reaction

Interactions

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Systemic side effects are less likely to occur in topical application. They include:

  • Growth suppression in infants, children and adolescents
  • Menstrual irregularity, amenorrhoea
  • Adrenal suppression on prolonged use
  • Moon face, hirsutism, weight gain
  • Impaired carbohydrate tolerance, sodium and water retention
  • Increased susceptibility and severity of infection with suppression of clinical symptoms and signs, opportunistic infections, recurrence of dormant tuberculosis
  • Osteoporosis, vertebral and long bone fractures, tendon rapture, proximal myopathy, avascular osteonecrosis
  • Affective disorder, psychotic reactions
  • Increased intra-ocular pressure and glaucoma
  • Abdominal distension
  • Oesophageal ulceration
  • Impaired skin healing
  • Hypersensitivity reactions, Stevens-Johnson syndrome

Patient Instructions

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  • Report to the health worker immediately if skin rash develops after receiving the injectionDo not apply more than twice daily
  • Keep away from eyes
  • Avoid prolonged use especially on the face and in children

Pregnancy

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  • Can be used

Breastfeeding

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  • Do not use

⚠️ Caution

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  • Administer the lowest effective dose for the minimum period, as a single morning dose to minimise side effects.
  • Avoid prolonged use to prevent adrenal suppression
  • In mild skin allergies, use hydrocortisone cream instead
  • If there is infection as well, use the products that are combined with an antibiotic e.g. neomycin
  • Should not be used in management of head injury or stroke since benefit is unlikely and may even be harmful
  • Use with caution in patients with recent myocardial infarction because of risk of myocardial rupture, in patients with osteoporosis, diabetes, epilepsy
  • Should not be withdrawn abruptly after prolonged treatment