Betamethasone

Summary

Betamethasone is a synthetic glucocorticoid hormone. Glucocorticoids such as betamethasone primarily have an anti-inflammatory and immunosuppressive effect. This molecule is mostly used locally as a cream or injection.

Molecule Names:
Betamethasone, Betamethasone, Betamethasonum PhEuro.
Notes: There are several betamethasone salts (eg betamethasone acetate, betamethasone dipropion)

Molecule:
22 H 29 FO 5

Half-life:
6 hours

Local (vs. systemic) application:
When applied locally to the skin, only between 2% and 40% of betamethasone is available systemically1.

Effects:
The effects are mainly anti-inflammatory and immunosuppressive.
Glucocorticoids bind to specific receptors on cells and turn on or off certain genes. This leads to changes in protein synthesis. These effects also lead to changes in carbohydrate and fat synthesis. These changes can lead to various side effects (see below), which can be serious, especially in the case of medium and long-term treatment.

Indications:
Indications for betamethasone include specific diseases or dermatological conditions:
– Eczema (of various types and locations)
– Psoriasis (psoriasis vulgaris, avoid application to the face and genitals)
– Gout (especially in injectable form)
– Sunburn
– Allergic reactions
– Various rheumatoid diseases: eg rheumatoid arthritis, arthritis or osteoarthritis (e.g. knee injection)
– Skin lesions such as scleroderma (as local infiltration)
– Carpal tunnel syndrome
– Prevention of respiratory distress syndrome in newborns (intern use)

Side effects:

Side effects vary depending on the dosage and duration of treatment.

Side effects related to cutaneous use (eg cream):
Local irritation, atrophy, allergic reactions. In case of prolonged application in the eye area, eye problems may occur (eg glaucoma, cataracts).

For a complete list of skin side effects, read the package leaflet.
Side effects related to intra-articular or intra-layer use:
Synovitis (post-injection), infectious arthritis, joint capsule disorders, skin atrophy, subcutaneous fat necrosis. For a complete list of side effects, read the package leaflet.
Side effects of systemic use (internal use):
Short-term therapy (up to 10 days) is generally well tolerated.
In case of particularly high long-term use of betamethasone, a Cushing’s syndrome may occur. This syndrome is characterized by weight gain, facial changes, hypertension, edema, diabetes, depression and osteoporosis.
Glucocorticoids like betamethasone can lead to other side effects like glaucoma, cataracts, aseptic bone necrosis, slow wound healing, weakened immune system (resulting in a higher risk of infectious diseases), pancreatitis, Pseudotumor cerebri , blood count changes. For a complete list of side effects, read the package leaflet.

Contraindications
There are many contraindications to glucocorticoids such as betamethasone for internal use:
– Hypersensitivity
– Gastrointestinal ulcers
– Severe osteoporosis
– Diabetes
– Severe arterial hypertension
– Viral infections, systemic infections
– Vaccination with live vaccines
– Psychiatric illnesses in the patient’s history
– Systemic fungal infections
Caution also in case of renal or hepatic insufficiency.
For a complete list, please read the package insert and seek expert advice.
Betamethasone contraindications for internal (skin) use include
– Skin ulcers
– Infectious skin diseases
Contraindications to betamethasone for intra-articular use include
– Infections in or around the joint
– Bacteremia
– Fractures
– Prosthetic joints

Interactions
Oral glucocorticoids such as betamethasone have the potential for interactions. It is believed that some antidiabetic drugs, drugs to lower blood pressure or drugs with a role in clotting can lead to interactions with glucocorticoids.
Ask your pharmacist or doctor for advice about interactions, especially for topical use.

Betamethasone dosage forms:
Betamethasone is often available as pills, injectable medication, scalp application, cream, lotion, ointment, gel, solution, patch, and eye ointment2.
Notes:
– Betamethasone was approved by the US FDA in 1965. Betamethasone, like other glucocorticoids such as dexamethasone, is off-patent and therefore can be sold worldwide as a generic drug, often at low prices.
– There are several betamethasone molecules or salts, all considered highly effective corticosteroids. This means that they must be used in a targeted manner and with some restriction (beware of long-term therapy).
– The dermal absorption of betamethasone is greater in children than in adults, therefore caution is recommended.
Alternatives (other corticosteroids):
Alternatives to betamethasone for topical use (eg, cream) include other corticosteroids such as fluocinonide, halcinoid, mometasone, or prednicarbate3 .
In local injection, dexamethasone is an alternative to betamethasone.
In systemic use (eg, as a tablet), prednisone is a reliable alternative to betamethasone.

Sources and References: 
Sources: 
Pharmawiki.ch
References and Literature:
“100 wichtige Medikamente” – Infomed (2020).

Jeanne Kenney
 | Website

I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

Leave a Reply

Your email address will not be published. Required fields are marked *