Betamethasone
A glucocorticoid given orally, parenterally, by local injection, by inhalation, or applied topically in the management of various disorders in which corticosteroids are indicated. Its lack of mineralocorticoid properties makes betamethasone particularly suitable for treating cerebral edema and congenital adrenal hyperplasia.
Mechanism of effect
Potent glucocorticoid with minimal to no mineralocorticoid activity.
Controls or prevents inflammation by controling rate of protein synthesis, suppressing migration of PMNs & fibroblasts, reversing capillary permeability, & stabilizing lysosome at cellular level.Pharmacodynamic
Betamethasone and its derivatives, betamethasone sodium phosphate and betamethasone acetate, are synthetic glucocorticoids. Used for its antiinflammatory or immunosuppressive properties, betamethasone is combined with a mineralocorticoid to manage adrenal insufficiency and is used in the form of betamethasone benzoate, betamethasone dipropionate, or betamethasone valerate for the treatment of inflammation due to corticosteroid-responsive dermatoses. Betamethasone and clotrimazole are used together to treat cutaneous tinea infections.
Pharmacokinetics
Absorption : Minimal if applied topically.
Peak plasma time : IV: 10-36 min
Volume of distribution : 75-90 L
Protein binding : 64%
Metabolism : Hepatic
Route of elimination : Mainly in urine, minimally in bile
Half life : 6.5 hours
Renal clearance : 9.5 mL/min
Drug indications
Asthma , Allergy , Osteoporesis , Intestinal diseases , Acne , itching , allergic reactions , Allergic RhinitisDosage
- Adult:
Endocrine Disorders
0.6-7.2 mg PO divided BID/QID or 0.6-9 mg/day IM qDay/divided BID
Inflammatory Conditions
0.6-7.2 mg PO divided BID/QID or 0.6-9 mg/day IM qDay/divided BID
Rheumatoid Arthritis/Osteoarthritis
Intrabursal, intra-articular, intradermal: 0.25-2 mL (6 mg/mL)
Intralesional (6 mg/mL)
Very large joints: 1-2 mL
Large joints: 1 mL
Medium joints: 0.5 - 1 mL
Small joints: 0.25-0.5 mL
Administration: Base dosage on severity of disease and patient response.
- Pediatric:
Adrenal Insufficiency
<12 years old: 0.0175-0.25 mg/kg/day divided q6-12hr IM/PO; use lowest dose as initial dose
>12 years old: As in adults; use lowest dose as initial dose
Inflammatory Conditions
<12 years old: 0.0175-0.25 mg/kg/day IM/PO divided q6-12hr
>12 years old: As in adultsDrug contraindications
hypersensitivity to this drugSide effects
Anxiety , Insomnia , Headache , edema , dizziness , Seizures , Blurred vision , vertigo , itching , dry skin , Cataracts , increased appetite , indigestionInteractions
Amphotericin B , Bupropion , Deferasirox , Ciprofloxacin , Cyclosporine , Ketoconazole , Cholestyramine , Aminoglutethimide (Oral) , Phenindione , Desirudin , Tolfenamic Acid , Grepafloxacin , Tisagenlecleucel , Adenovirus types 4 and 7 live, oral , Axicabtagene ciloleucel , Lopinavir and Ritonavir , Glycerol Phenylbutyrate , Meningococcal conjugate vaccineAlerts
- NOT effective in treatment of RDS in premature neonates
- Minimal sodium retention activity: however, may increase with high doses
- If used to treat adrenocortical insufficiency should also use mineralocorticoid
- Thromboembolic disorders
- Myopathy,
- Delayed wound healing
- Patients receiving corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated
- Latent TB may be reactivated (monitor patients with positive tuberculin test)
- Some suggestion of slightly increased cleft palate risk if corticosteroids used in pregnancy, but not fully substantiated
- Prolonged corticosteroid use may result in elevated IOP, glaucoma, and/or cataracts
- Killed or inactivated vaccines may be administered; however, the response to such vaccines cannot be predicted
Points of recommendation
- If your symptoms or health problems do not get better or if they become worse, call your doctor.
- Do not share your drugs with others and do not take anyone else's drugs.
- Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
- Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.
- Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
- Check with your pharmacist about how to throw out unused drugs.
- Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this medicine, please talk with your doctor, nurse, pharmacist, or other health care provider.
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