indication

Topical use (cream, lotion and ointment): for relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses
Topical use (foam): relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses of the scalp
Systemic use: for the treatment of edocrine disorders, rheumatic disorders, collagen diseases, dermatological diseases, allergic states, ophthalmic diseases, respiratory diseases, hematologic disorders, neoplastic diseases, edematous states, gastrointestinal diseases, tuberculous meningitis and trichinosis.

pharmacology

Betamethasone and its derivatives, betamethasone sodium phosphate and betamethasone acetate, are synthetic glucocorticoids. Used for its antiinflammatory or immunosuppressive properties, betamethasone is combined with a mineralocorticoid to manage adrenal insufficiency and is used in the form of betamethasone benzoate, betamethasone dipropionate, or betamethasone valerate for the treatment of inflammation due to corticosteroid-responsive dermatoses. Betamethasone and clotrimazole are used together to treat cutaneous tinea infections.

mechanism of action

Betamethasone is a glucocorticoid receptor agonist. This leads to changes in genetic expression once this complex binds to the GRE. The antiinflammatory actions of corticosteroids are thought to involve lipocortins, phospholipase A2 inhibitory proteins which, through inhibition arachidonic acid, control the biosynthesis of prostaglandins and leukotrienes. The immune system is suppressed by corticosteroids due to a decrease in the function of the lymphatic system, a reduction in immunoglobulin and complement concentrations, the precipitation of lymphocytopenia, and interference with antigen-antibody binding. Betamethasone binds to plasma transcortin, and it becomes active when it is not bound to transcortin.

toxicity

Symptoms of overdose include burning, itching, irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of the skin, secondary infection, skin atrophy, striae, and miliaria.

biotransformation

Hepatic

absorption

Minimal if applied topically.

half life

5.6 hours

drug interactions

Acenocoumarol: The corticosteroid, betamethasone, alters the anticoagulant effect, acenocoumarol.

Acetylsalicylic acid: The corticosteroid, betamethasone, may decrease the effect of the salicylate, acetylsalicylic acid.

Ambenonium: The corticosteroid, betamethasone, may decrease the effect of the anticholinesterase, ambenonium.

Amobarbital: The barbiturate, amobarbital, may decrease the effect of the corticosteroid, betamethasone.

Anisindione: The corticosteroid, betamethasone, alters the anticoagulant effect of anisindione.

Aprobarbital: The barbiturate, aprobarbital, may decrease the effect of the corticosteroid, betamethasone.

Bismuth Subsalicylate: The corticosteroid, betamethasone, may decrease the effect of the salicylate, bismuth subsalicylate.

Butabarbital: The barbiturate, butabarbital, may decrease the effect of the corticosteroid, betamethasone.

Butalbital: The barbiturate, butalbital, may decrease the effect of the corticosteroid, betamethasone.

Butethal: The barbiturate, butethal, may decrease the effect of the corticosteroid, betamethasone.

Dicumarol: The corticosteroid, betamethasone, alters the anticoagulant effect of dicumarol.

Dihydroquinidine barbiturate: The barbiturate, dihydroquinidine barbiturate, may decrease the effect of the corticosteroid, betamethasone.

Edrophonium: The corticosteroid, betamethasone, may decrease the effect of the anticholinesterase, edrophonium.

Ethotoin: The enzyme inducer, ethotoin, may decrease the effect of the corticosteroid, betamethasone.

Fosphenytoin: The enzyme inducer, fosphenytoin, may decrease the effect of the corticosteroid, betamethasone.

Heptabarbital: The barbiturate, heptabarbital, may decrease the effect of the corticosteroid, betamethasone.

Hexobarbital: The barbiturate, hexobarbital, may decrease the effect of the corticosteroid, betamethasone.

Magnesium salicylate: The corticosteroid, betamethasone, may decrease the effect of magnesium salicylate.

Mephenytoin: The enzyme inducer, mephenytoin, may decrease the effect of the corticosteroid, betamethasone.

Methohexital: The barbiturate, methohexital, may decrease the effect of the corticosteroid, betamethasone.

Methylphenobarbital: The barbiturate, methylphenobarbital, may decrease the effect of the corticosteroid, betamethasone.

Midodrine: Increased arterial pressure

Pentobarbital: The barbiturate, pentobarbital, may decrease the effect of the corticosteroid, betamethasone.

Phenobarbital: The barbiturate, phenobarbital, may decrease the effect of the corticosteroid, betamethasone.

Phenytoin: The enzyme inducer, phenytoin, may decrease the effect of the corticosteroid, betamethasone.

Primidone: The barbiturate, primidone, may decrease the effect of the corticosteroid, betamethasone.

Pyridostigmine: The corticosteroid, betamethasone, may decrease the effect of the anticholinesterase, pyridostigmine.

Quinidine barbiturate: The barbiturate, quinidine barbiturate, may decrease the effect of the corticosteroid, betamethasone.

Rifampin: The enzyme inducer, rifampin, may decrease the effect of the corticosteroid, betamethasone.

Salicylate-sodium: The corticosteroid, betamethasone, may decrease the effect of the salicylate, salicylate-sodium.

Salsalate: The corticosteroid, betamethasone, may decrease the effect of the salicylate, salsalate.

Secobarbital: The barbiturate, secobarbital, may decrease the effect of the corticosteroid, betamethasone.

Tacrine: Tacrine and Betamethasone may independently exacerbate muscle weakness in myasthenia gravis patients. Monitor for additive muscle weakness effects.

Talbutal: The barbiturate, talbutal, may decrease the effect of the corticosteroid, betamethasone.

Trastuzumab: Trastuzumab may increase the risk of neutropenia and anemia. Monitor closely for signs and symptoms of adverse events.

Trisalicylate-choline: The corticosteroid, betamethasone, may decrease the effect of the salicylate, trisalicylate-choline.

Vecuronium: Vecuronium may increase the adverse neuromuscular effects of systemic corticosteroids, such as Betamethasone. Monitor for increased muscle weakness and signs of polyneuropathies and myopathy.

Warfarin: The corticosteroid, betamethasone, alters the anticoagulant effect of warfarin.