Betamethasone
Indications
Betamethasone is used for:
Ulcerative colitis, Rheumatoid arthritis, Ankylosing spondylitis, Lichen planus, Psoriasis, Asthma, Eczema, Contact dermatitis, Multiple sclerosis, Drug hypersensitivity reactions, Perennial or seasonal allergic rhinitis, Serum sickness, Transfusion reactions, Severe erythema multiforme (Stevens-Johnson syndrome), Leukemias, Lymphomas, Acute gouty arthritis, Acute rheumatic carditis, Psoriatic arthritis, Including juvenile rheumatoid arthritis, Dermatomyositis, Polymyositis, Systemic lupus erythematosus, Psoriatic plaques, Allergic and inflammatory disorders, Congenital adrenal hyperplasia
Adult Dose
Oral
Allergic and inflammatory disorders
Adult: 0.5-5 mg daily.
Child Dose
Oral
Allergic and inflammatory disorders
Child: For inflammatory conditions: <12 yr: 0.0175-0.125 mg base/kg daily, dose may be divided every 6-12 hr.
Renal Dose
Administration
Should be taken with food.
Contra Indications
Hypersensitivity; systemic fungal or acute infections.
Precautions
Uncontrolled diabetes, peptic ulcer, osteoporosis, psychosis, psychoneurosis, pregnancy and lactation. Congestive heart failure, hypertension, epilepsy, CRF, elderly, regular monitoring of patients on long term therapy, withdraw gradually, glaucoma, hypothyroidism, cirrhosis, ocular herpes simplex, ulcerative colitis, infants and children.
Lactation: systemically administered corticosteroids enter breast milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other effects; use with caution
Pregnancy-Lactation
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
Interactions
Increased hyperglycaemia and hypokalaemia with thiazide diuretics. Increased incidence of peptic ulcer or GI bleeding with concurrent NSAIDs admin. Response to anticoagulants altered. Dose of antidiabetics and antihypertensives needs to be increased. Decreases serum conc of salicylates and antimuscarinic agents.
Potentially Fatal: Reduced efficacy with concurrent use of carbamazepine, phenytoin, primidone, barbiturates and rifampicin. Enhanced effect in women taking oestrogens or oral contraceptives.
Adverse Effects
Side effects of Betamethasone :
>10% (selected)
Blurred vision, Increased appetite, Indigestion, Nervousness
1-10%
Itching
Frequency Not Defined (selected)
Arthralgia, Cataracts, Dizziness, DM, Edema, Headache, Seizure, Vertigo, Fluid/electrolyte disturbances, Adrenal suppression, Psychosis, Insomnia, Pseudotumor cerebri (on withdrawal), Acne, Osteoporosis, Myopathy, Delayed wound healing
Potentially Fatal: Abrupt withdrawal leading to acute adrenal insufficiency manifesting as malaise, weakness, mental changes, muscle and joint pains, dystonia, hypoglycaemia, hypotension, dehydration and death. Rapid IV inj may cause CV collapse.
Mechanism of Action
Betamethasone is a corticosteroid with mainly glucocorticoid activity. It prevents and controls inflammation by controlling the rate of protein synthesis, depressing the migration of polymorphonuclear leukocytes and fibroblasts, and reversing capillary permeability and lysosomal stabilisation.