Betnelan , Celestone
BETAMETHASONE ACETATE AND BETAMETHASONE SODIUM PHOSPHATE
BETAMETHASONE SODIUM PHOSPHATE (PH 8.5)
Betameth, Betnesol , Celestone S
Betaderm , Beta-Val, Betnovate , Celestoderm , Ectosone Lotion , Luxiq, Metaderm , Novobetamet , Valnac
Classifications: antiinflammatory; adrenal corticosteroid; glucocorticoid; Therapeutic: antiinflammatory; adrenal corticosteroid
Pregnancy Category: C
Betamethasone: 0.6 mg tablets; 0.6 mg/5 mL syrup
Betamethasone Acetate and Betamethasone Sodium: 3 mg acetate, 3 mg sodium phosphate/mL suspension
Betamethasone Benzoate and Betamethasone Dipropionate: 4 mg/mL injection
Betamethasone Valerate: 0.1% ointment; 0.01%, 0.05%, 0.1% cream; 0.1% lotion; 1.2 mg/g foam
Betamethasone Sodium Phosphate: 0.6 mg/5 mL syrup
Synthetic, long-acting glucocorticoid with minor mineralocorticoid properties but strong immunosuppressive, antiinflammatory,
and metabolic actions.
Relieves antiinflammatory manifestations and is an immunosuppressive agent.
Reduces serum calcium in hypercalcemia, suppresses undesirable inflammatory or immune responses, produces temporary remission
in nonadrenal disease, and blocks ACTH production in diagnostic tests. Topical use provides relief of inflammatory manifestations
of corticosteroid-responsive dermatoses.
Prevention of neonatal respiratory distress syndrome (hyaline membrane disease).
In patients with systemic fungal infections. Pregnancy (category C), lactation; acne vulgaris; acne rosacea; Cushing's syndrome;
periorbital dermatitis; vaccines.
Ocular herpes simplex; concomitant use of aspirin; osteoporosis; diverticulitis, nonspecific ulcerative colitis, abscess
or other pyrogenic infection, peptic ulcer disease; asthmatics; diabetes mellitus; hypertension; renal insufficiency; myasthenia
Route & Dosage
Adult: PO 0.67.2 mg/d IM/IV Up to 9 mg/d as sodium phosphate
Topical (See Appendix A-4)
Child: PO 0.01750.25 mg/kg/d or 0.50.75 mg/m2/d divided q68h IM 0.01750.125 mg/kg/d or 0.50.75 mg/m2/d divided q68h
Respiratory Distress Syndrome
Adult: IM 2 mL of sodium phosphate to mother once daily 23 d before delivery
- Give with food or milk to lessen stomach irritation.
- Use Celestone Soluspan for intraarticular, IM, and intralesional injection. The preparation is not intended for IV use.
Do not mix with diluents containing preservatives (e.g., parabens, phenol).
- Use 1% or 2% lidocaine hydrochloride if prescribed. Withdraw betamethasone mixture first, then lidocaine; shake
PREPARE: Direct: Give by direct IV undiluted or further diluted in D5W or NS.
ADMINISTER: Direct: Give at a rate of 1 dose/min. IV Infusion: Give at a rate determined by the total amount of IV fluid.
INCOMPATIBILITIES Solution/additive: Unknown. Y-site: Unknown.
Adverse Effects (≥1%) Body as a Whole:
Hypersensitivity or anaphylactoid reactions; aggravation or masking of infections
, weight gain, obesity
. Most adverse effects are dose and treatment duration dependent. CNS:
Vertigo, headache, nystagmus, ataxia (rare), increased intracranial pressure with papilledema (usually after discontinuation
of medication), mental disturbances, aggravation of preexisting psychiatric conditions, insomnia
Hypertension; syncopal episodes, thrombophlebitis, thromboembolism or fat embolism, palpitation, tachycardia, necrotizing
angiitis; CHF. Endocrine:
Suppressed linear growth in children, decreased glucose tolerance; hyperglycemia, manifestations of latent diabetes
hypocorticism; amenorrhea and other menstrual difficulties. Special Senses:
Posterior subcapsular cataracts (especially in children), glaucoma
, exophthalmos, increased intraocular pressure with optic
nerve damage, perforation of the globe, fungal infection
of the cornea, decreased or blurred vision. Metabolic:
Hypocalcemia; sodium and fluid retention;
hypokalemia and hypokalemic alkalosis; negative nitrogen balance. GI: Nausea,
increased appetite, ulcerative esophagitis, pancreatitis
, abdominal distention, peptic ulcer
with perforation and hemorrhage,
melena; decreased serum
concentration of vitamins A and C. Hematologic: Thrombocytopenia
Osteoporosis, compression fractures, muscle wasting and weakness, tendon rupture, aseptic necrosis of femoral and humeral
heads (all resulting from long-term use). Skin:
Skin thinning and atrophy, acne, impaired wound healing;
petechiae, ecchymosis, easy bruising; suppression of skin test reaction; hypopigmentation or hyperpigmentation, hirsutism,
acneiform eruptions, subcutaneous
fat atrophy; allergic dermatitis, urticaria, angioneurotic edema, increased sweating. Urogenital:
Increased or decreased motility and number of sperm; urinary frequency and urgency, enuresis. With parenteral therapy, IV site:
Pain, irritation, necrosis, atrophy, sterile abscess; Charcot-like arthropathy following intraarticular use; burning and
tingling in perineal area (after IV
Diagnostic Test Interference
May increase serum cholesterol, blood glucose, serum sodium, uric acid (in acute leukemia) and calcium (in bone metastasis). It may decrease serum calcium, potassium, PBI, thyroxin (T4), triiodothyronine (T3) and reduce thyroid I 131 uptake. It increases urine glucose level and calcium excretion; decreases urine 17-OHCS and 17-KS levels. May produce false-negative results with nitroblue tetrazolium test for systemic bacterial infection and may suppress reactions to skin tests.
Interactions Drug: barbiturates
, phenytoin, rifampin
may reduce pharmacologic effect of betamethasone by increasing its metabolism
Assessment & Drug Effects
- Assess therapeutic effectiveness. Response following intraarticular, intralesional, or intrasynovial administration occurs
within a few hours and persists for 14 wk. Following IM administration response occurs in 23 h and persists
for 37 d.
Patient & Family Education
- Monitor weight at least weekly.
- Discontinue slowly after systemic use of ≥1 wk. Abrupt withdrawal, especially
following high doses or prolonged use, can cause dizziness, nausea, vomiting, fever, muscle and joint pain, weakness.