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Beta Met Has One

Beta Met Has One

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Published by: api-3797941 on Oct 17, 2008
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betamethasone
(bay tameth' a sone)
betamethasone
Topical dermatologic ointment, cream, lotion, gel:
betamethasone dipropionate
Topical dermatologic ointment, cream, lotion, aerosol:
Alphatrex, Diprolene, Diprolene AF, Diprosone, Maxivate, Taro-Sone (CAN),
Teladar
betamethasone sodium phosphate
Systemic, including IV and local injection:
Betnesol (CAN), Celestone Phosphate
betamethasone sodium phosphate and acetate
Systemic, IM, and local intra-articular, intralesional, intradermal injection:
Celestone Soluspan
betamethasone valerate
Topical dermatologic ointment, cream, lotion:
Betaderm (CAN), Betatrex, Beta-Val, Betnovate (CAN), Celestoderm (CAN),
Luxiq, Prevex B (CAN), Psorion Cream, Valisone
Pregnancy Category C
Drug classes

Corticosteroid (long acting)
Glucocorticoid
Hormonal agent

Therapeutic actions
Binds to intracellular corticosteroid receptors, thereby initiating many natural complex
reactions that are responsible for its anti-inflammatory and immunosuppressive effects.
Indications
Systemic administration
\u2022
Hypercalcemia associated with cancer
\u2022

Short-term management of inflammatory and allergic disorders, such as
rheumatoid arthritis, collagen diseases (eg SLE), dermatologic diseases (eg
pemphigus), status asthmaticus, and autoimmune disorders

\u2022
Hematologic disorders: Thrombocytopenia purpura, erythroblastopenia
\u2022
Ulcerative colitis, acute exacerbations of multiple sclerosis, and palliation in some
leukemias and lymphomas
\u2022
Trichinosis with neurologic or myocardial involvement
\u2022
Unlabeled use: Prevention of respiratory distress syndrome in premature neonates
Intra-articular or soft-tissue administration
\u2022
Arthritis, psoriatic plaques, and so forth
Dermatologic preparations
\u2022
Relief of inflammatory and pruritic manifestations of steroid-responsive
dermatoses
Contraindications and cautions
Systemic (oral and parenteral) administration
\u2022
Contraindicated with infections, especially tuberculosis, fungal infections,
amebiasis, vaccinia and varicella, and antibiotic-resistant infections, lactation.
All forms
\u2022

Use cautiously with kidney or liver disease, hypothyroidism, ulcerative colitis
with impending perforation, diverticulitis, active or latent peptic ulcer,
inflammatory bowel disease, CHF, hypertension, thromboembolic disorders,
osteoporosis, seizure disorders, diabetes mellitus.

Available forms

Tablets\u20140.6 mg; syrup\u20140.6 mg/5 mL; injection\u20144 mg, 3 mg betamethasone sodium phosphate with 3 mg betamethasone acetate; ointment\u20140.1%, 0.05%; cream\u20140.01%, 0.05%, 0.1%; lotion\u20140.1%, 0.05%; gel\u20140.05%

Dosages
ADULTS
Systemic administration

Individualize dosage, based on severity and response. Give daily dose before 9 AM to minimize adrenal suppression. Reduce initial dose in small increments until the lowest dose that maintains satisfactory clinical response is reached. If long-term therapy is needed, alternate-day therapy with a short-acting corticosteroid should be considered. After long-term therapy, withdraw drug slowly to prevent adrenal insufficiency.

\u2022
Oral (betamethasone): Initial dosage 0.6\u20137.2 mg/day
\u2022
IV (betamethasone sodium phosphate): Initial dosage up to 9 mg/day.
\u2022
IM (betamethasone sodium phosphate; betamethasone sodium phosphate and
acetate): Initial dosage 0.5\u20139 mg/day. Dosage range is one-third to one-half oral
dose given q 12 hr. In life-threatening situations, dose can be in multiples of the
oral dose.
Intrabursal, intra-articular, intradermal, intralesional (betamethasone sodium phosphate
and acetate)
0.25\u20132 mL intra-articular, depending on joint size; 0.2 mL/cm3 intradermally, not to
exceed 1 mL/wk; 0.25\u20131 mL at 3- to 7-day intervals for disorders of the foot.
Topical dermatologic cream, ointment (betamethasone dipropionate)
Apply sparingly to affected area bid\u2013qid.
PEDIATRIC PATIENTS
Systemic administration

Individualize dosage on the basis of severity and response rather than by formulae that
correct adult doses for age or weight. Carefully observe growth and development in
infants and children on prolonged therapy.

Pharmacokinetics
Route
Onset
Duration
Systemic
Varies
3 days

Metabolism: Hepatic; T1/2: 36\u201354 hr
Distribution: Crosses placenta; enters breast milk
Excretion: Unchanged in the urine

IV facts
Preparation: No further preparation needed.
Infusion: Infuse by direct IV injection over 1 min or into the tubing of running IV of
dextrose or saline solutions.
Adverse effects
\u2022
CNS: Vertigo, headache, paresthesias, insomnia, seizures, psychosis, cataracts,
increased IOP, glaucoma (long-term therapy)
\u2022
C V:Hypotension, shock, hypertension, and CHF secondary to fluid retention,
thromboembolism, thrombophlebitis, fat embolism, cardiac arrhythmias
\u2022
Electrolyte imbalance: Na+ and fluid retention, hypokalemia, hypocalcemia
\u2022
Endocrine: Amenorrhea, irregular menses, growth retardation, decreased

carbohydrate tolerance, diabetes mellitus, cushingoid state (long-term effect),
increased blood sugar, increased serum cholesterol, decreased T3 and T4 levels,
hypothalamic-pituitary-adrenal (HPA) suppression with systemic therapy longer
than 5 days

\u2022
GI: Peptic or esophageal ulcer, pancreatitis, abdominal distention, nausea,
vomiting, increased appetite, weight gain (long-term therapy)
\u2022
Musculoskeletal: Muscle weakness, steroid myopathy, loss of muscle mass,
osteoporosis, spontaneous fractures (long-term therapy)
\u2022
Other: Immunosuppression, aggravation, or masking of infections; impaired
wound healing; thin, fragile skin; petechiae, ecchymoses, purpura, striae;
subcutaneous fat atrophy; hypersensitivity or anaphylactoid reactions
The following effects are related to various local routes of steroid administration:
\u2022
Intra-articular: Osteonecrosis, tendon rupture, infection
\u2022
Intralesional therapy: Blindness when applied to face and head
\u2022
Topical dermatologic ointments, creams, sprays: Local burning, irritation,
acneiform lesions, striae, skin atrophy
Interactions
Drug-drug
\u2022
Risk of severe deterioration of muscle strength in myasthenia gravis patients
receiving ambenonium, edrophonium, neostigmine, pyridostigmine
\u2022
Decreased steroid blood levels with barbiturates, phenytoin, rifampin

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