BMA Concise Guide to Medicine & Drugs

Betamethasone

Brand names Betacap, Betesil, Betnelan, Betnesol, Betnovate, Bettamousse, Diprosone, Vistamethasone

Used in the following combined preparations Betnesol-N, Betnovate-C, Betnovate-N, Diprosalic, Fucibet, Lotriderm

QUICK REFERENCE

Drug group Corticosteroid

Overdose danger rating Low

Dependence rating Low

Prescription needed Yes

Available as generic Yes

GENERAL INFORMATION

Betamethasone is a corticosteroid drug used to treat a variety of conditions. When injected directly into the joints it relieves joint inflammation and the pain and stiffness of rheumatoid arthritis. It is also given by mouth or injection to treat certain endocrine conditions affecting the pituitary and adrenal glands, and some blood disorders. It is also used topically to treat skin complaints, such as eczema and psoriasis.

When taken for short periods, low or moderate doses of betamethasone rarely cause serious side effects. High dosages or prolonged use can lead to many adverse effects.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Tablets, injection, cream, ointment, rectal ointment, lotion, scalp solution, eye ointment, eye/ear/nose drops.

Frequency and timing of doses Usually once daily in the morning (systemic). Otherwise varies according to disorder being treated.

Dosage range Varies; follow your doctor’s instructions.

Onset of effect Within 30 minutes (injection); within 48 hours (other forms).

Duration of action Up to 24 hours.

Diet advice A low-sodium and high-potassium diet may be recommended when the oral form of the drug is prescribed for extended periods. Follow the advice of your doctor.

Storage Keep in original container at room temperature out of the reach of children. Protect from light.

Missed dose Take as soon as you remember. If your next dose is due within 2 hours, take a single dose now and skip the next.

Stopping the drug Do not stop tablets without consulting your doctor, who may supervise a gradual reduction in dosage. Abrupt cessation after long-term treatment may cause problems with the pituitary and adrenal gland system.

Exceeding the dose An occasional unintentional extra dose is unlikely to cause problems. But if you notice any unusual symptoms, or if a large overdose has been taken, notify your doctor.

POSSIBLE ADVERSE EFFECTS

Topical preparations are unlikely to cause adverse effects unless overused. Possible adverse effects of oral preparations include indigestion, weight gain, acne, muscle weakness, and mood changes. If any of these occur, discuss with your doctor. The drug may also cause bloody or tarry faeces; if so, stop taking the drug and call your doctor immediately. High oral doses taken for a long period may cause more serious adverse effects (see Prolonged use).

INTERACTIONS

Insulin, antidiabetic drugs, and oral anticoagulant drugs Betamethasone may alter insulin requirements and the effects of these drugs.

Antifungal drugs (e.g. itraconazole) may increase the effects of betamethasone.

Antihypertensive drugs and drugs used in myasthenia gravis Betamethasone may reduce the effects of these drugs.

Anticonvulsants and barbiturates These drugs may reduce the effects of betamethasone.

Vaccines Betamethasone can interact with some vaccines. Discuss with your doctor before having any vaccinations.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You suffer from a psychiatric disorder.

· You have a heart condition.

· You have glaucoma.

· You have high blood pressure.

· You have a history of epilepsy.

· You have had a peptic ulcer.

· You have had tuberculosis.

· You have any infection.

· You have diabetes.

· You have liver or kidney problems.

· You are taking other medicines.

Pregnancy No evidence of risk with topical preparations. Taken as tablets in low doses, harm to the baby is unlikely. Discuss with your doctor.

Breast-feeding No risk with topical preparations. Normal doses of tablets are unlikely to have adverse effects on the baby. Discuss with your doctor.

Infants and children Reduced dose necessary.

Over 60 Reduced dose may be necessary.

Driving and hazardous work No known problems.

Alcohol Keep consumption low. Betamethasone tablets increase the risk of peptic ulcers.

Infection Avoid exposure to chickenpox, measles, or shingles if you are on betamethasone tablets.

PROLONGED USE

Prolonged use by mouth can lead to peptic ulcers, glaucoma, osteoporosis, muscle weakness, and growth retardation in children. Prolonged use of topical treatment may also lead to skin thinning. People taking betamethasone tablets regularly should carry a steroid treatment card or wear a MedicAlert bracelet.