Betamethasone valerate 0.05% Topical
Indications
Betamethasone valerate 0.05% Topical is used for:
Eczema, atopic dermatitis, contact dermatitis, systemic lupus erythematosus, lichen planus, lichen simplex, psoriasis, prurigo nodularis, plaque psoriasis
Adult Dose
As valerate: Apply sparingly 2-3 times daily.
Cream for moist & ointment for dry surface.
Child Dose
Renal Dose
Administration
Topical Administration
Use medium to very high potency for less than 2 weeks to reduce local and systemic side effects
Use low potency for chronic therapy
Avoid medium to very high potency on face, folds, and groin, because use in these areas can increase steroid absorption
Use lower potency for children (ie, increased BSA/kg, therefore increased systemic absorption)
Contra Indications
Underlying infection, Hypersensitivity, Ophthalmic use
Precautions
Chronic topical corticosteroid therapy may interfere with growth and development in children.
Lactation: It is not known whether topical corticosteroid use could result in sufficient systemic absorption to produce detectable quantities in human milk; use with caution.
Pregnancy-Lactation
Pregnancy
There are no available data on ointment use in pregnant women to identify a drug- associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes; observational studies suggest an increased risk of low birth weight infants with the use of greater than 300 grams of potent or very potent topical corticosteroid during a pregnancy; advise pregnant women that the ointment may increase risk of having a low birth weight infant and to use it on the smallest area of skin and for the shortest duration possible
Animal data
In animal reproduction studies, increased malformations, including umbilical hernias, cephalocele, and cleft palate, were observed after intramuscular administration to pregnant rabbits; the available data do not allow calculation of relevant comparisons between systemic exposure in animal studies to systemic exposure that would be expected in humans after topical use of the ointment
Lactation
There are no data regarding the presence of drug in human milk, effects on breastfed infant, or on milk production after topical ointment application to women who are breastfeeding
It is possible that topical administration of betamethasone could result in sufficient systemic absorption to produce detectable quantities in human milk; the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on breastfed infant drug or from underlying maternal condition
To minimize potential exposure to breastfed infant via breast milk, use ointment on smallest area of skin and for shortest duration possible while breastfeeding; advise breastfeeding women not to apply ointment directly to nipple and areola to avoid direct infant exposure
Interactions
Adverse Effects
Side effects of Betamethasone valerate 0.05% Topical :
Dermal atrophy, local irritation, folliculitis, hypertrichosis, burning, dry skin, pigmentation changes, HPA suppression (with higher potency used >2 wk)
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.