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.