Betamethasone

DEA Class; Rx

Common Brand Names; Celestone, Celestone Soluspan, Betaject, Betamethasone IM/PO

Synthetic glucocorticoid with little mineralocorticoid activity
Used as an antiinflammatory or immunosuppressive agent; available systemically (injectable and oral)
Topical formulations are of medium (e.g., betamethasone valerate) or high-to-very high (i.e., betamethasone dipropionate) potency

Hypersensitivity to betamethasone

Idiopathic thrombocytopenia purpura

Live or live, attenuated vaccines, when immunisuppressive doses of corticosteroids required

Underlying infection present

Hypersensitivity

Ophthalmic use

• Blurred vision
• Increased appetite
• Indigestion
• Nervousness
• Itching
• Arthralgia
• Cataracts
• Dizziness
• DM
• Edema
• Erythema (topical)
• Headache
• Seizure
• Skin dryness (topical)
• Vertigo
• Fluid/electrolyte disturbances
• Adrenal suppression
• Psychosis
• Insomnia
• Vertigo
• Pseudotumor cerebri (on withdrawal)
• Acne
• Osteoporosis
• Myopathy
• Delayed wound healing
• Skin atrophy
• Striae
• Allergic dermatitis
• Burning
• Dry skin
• Erythema folliculitis
• Hypertrichosis
• Irritation
• Miliaria
• Vesiculation
• Acneform lesions
• Pigmentation changes
• HPA suppression (with higher potency used >2 wk)

Not for IV administration

Use caution in cirrhosis, ocular herpes simplex, HTN, diverticulitis, hypothyroidism, myasthenia gravi, PUD, osteoporosis, ulcerative colitis, psychotic tendencies, untreated systemic infections, renal insufficiency, pregnancy

May cause adrenal suppresion in patients receiving high doses for prolonged periods of time

Prolonged use of corticosteroids may increase incidence of secondary infection

Kaposi sarcoma reported with prolonged treatment of corticosteroids

Thromboembolic disorders

Myopathy associated with high-dose corticosteroids

Seizures reported in patients with history of seizure disorders use caution

Corticosteroids may exacerbate systemic fungal infections

Patients receiving corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated

Restrict the use of corticosteroids in active tuberculosis to cases of fulminating or disseminated tuberculosis when it is used in conjunction with appropriate anti-tuberculous regimen

Monitor closely patients with latent tuberculosis or tuberculin reactivity, if corticosteroid therapy necessary; reactivation of the disease may occur

Killed or inactivated vaccines may be administered; however, the response to such vaccines cannot be predicted

Prolonged corticosteroid use may result in glaucoma and/or cataracts

Intraocular pressure may become elevated in some individuals; monitor if treatment is continued for >6 weeks

Not recommended for treatment of optic neuritis; may lead to an increase in risk of new episodes; should not be used in active ocular herpes simplex

Special consideration should be given to patients at increased risk of osteoporosis (ie, postmenopausal women) before initiating corticosteroid therapy

Chronic topical corticosteroid therapy may interfere with growth and development in children

Prolonged treatment with corticosteroids is associated with Kaposi sarcoma (consider discontinuation of therapy if diagnosed)

Discontinue if contact dermatitis occurs; not for use in patients with decreased skin circulation

Manifestations of Cushing syndrome, hyperglycemia, or glycosuria occur, especially if occlusive dressings are used

Pregnancy Category: C

Lactation: systemically administered corticosteroids enter breast milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other effects; use with caution

Corticosteroid dosage must be individualized and is highly variable depending on the nature and severity of the disease, route of treatment, and on patient response.