Betamethasone

Medical uses

Betamethasone is a corticosteroid that is available as a pill, by injection, and as an ointment, cream, lotion, gel, or aerosol (spray) for the skin, and a foam for the scalp. When given by injection, anti-inflammatory effects begin in around two hours and last for seven days.

It is used as a topical cream to relieve skin irritation, such as itching and flaking from eczema. It is used as a treatment for local psoriasis, as betamethasone dipropionate and salicylic acid, or as the combination calcipotriol/betamethasone dipropionate. Betamethasone sodium phosphate is used orally and via injection with the same indications as other steroids. Many betamethasone-based pharmaceuticals include the steroid as the valerate ester.

In a randomized controlled trial betamethasone was shown to reduce some of the ataxia (poor coordination) symptoms associated with ataxia telangiectasia (A-T) by 28-31%.

Betamethasone is also used to stimulate fetal maturation of the lungs and cerebral blood vessels.

A cream with 0.05% betamethasone appears effective in treating phimosis in boys, and often averts the need for circumcision. Longer-term research is needed on this treatment method. This approach has replaced circumcision as the preferred treatment method for some physicians in the British National Health Service.

Side effects

• Euphoria
• Depression
• Adrenal suppression
• Hypertension
• Groupings of fine blood vessels becoming prominent under the skin, petechiae
• Excessive hair growth (hypertrichosis)
• Ecchymoses

Betamethasone crosses the placenta.

When injected into the epidural space or the spine, it may cause serious side effects like loss of vision, stroke, and paralysis.

Pharmacology

Main article: Glucocorticoid#Pharmacology

Forms

Betamethasone is available in a number of compound forms: betamethasone dipropionate (branded as Diprosone, Diprolene, Celestamine, Procort (in Pakistan), and others), betamethasone sodium phosphate (branded as Bentelan in Italy) and betamethasone valerate (branded as Audavate, Betnovate, Celestone, Fucibet, and others). In the United States and Canada, betamethasone is mixed with clotrimazole and sold as Lotrisone and Lotriderm. It is also available in combination with salicylic acid (branded as Diprosalic) for using in psoriatic skin conditions. In some countries, it is also sold mixed with both clotrimazole and gentamicin to add an antibacterial agent to the mix.

Betamethasone sodium phosphate mixed with betamethasone acetate is available in the United States as Celestone Soluspan.

References

References

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5. (2023). "The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023)". World Health Organization.
6. "Betamethasone Drug Usage Statistics, United States, 2014 - 2023".
7. (19 March 2020). "Betamethasone Topical".
8. (September 2012). "A randomized trial of oral betamethasone to reduce ataxia symptoms in ataxia telangiectasia". Movement Disorders.
9. (January 2024). "Topical corticosteroids for treating phimosis in boys". The Cochrane Database of Systematic Reviews.
10. (October 1998). "Cost-effective treatment of phimosis". Pediatrics.
11. (April 2008). "Topical steroid application versus circumcision in pediatric patients with phimosis: a prospective randomized placebo controlled clinical trial". Springer Science and Business Media LLC.
12. (April 2007). "Phimosis and topical steroids: new clinical findings". Pediatric Surgery International.
13. (February 2001). "Cost-effectiveness analysis of treatments for phimosis: a comparison of surgical and medicinal approaches and their economic effect". BJU International.
14. (September 1999). "Topical steroid treatment of phimosis in boys". The Journal of Urology.
15. (2017). "betamethasone". F.A. Davis.
16. (23 April 2014). "FDA Drug Safety Communication: FDA requires label changes to warn of rare but serious neurologic problems after epidural corticosteroid injections for pain".
17. (18 November 2019). "Celestone Soluspan- betamethasone acetate and betamethasone sodium phosphate injection, suspension".