Composition
Inj: Per ml: 4 mg Betamethasone as the sodium phosphate ester. Tab: 0.5 mg Betamethasone as the sodium phosphate ester.
Indications & Dosage
Severe asthma, allergic conditions, rheumatoid arthritis, collagen diseases: ORAL: Adults: 0.5-5 mg daily, reduce for maintenance to minimum effective dose. BY IV INJ: Adult: 4-20 mg IV repeated three or four times daily if required. Suppression of inflammatory and allergic disorders, congenital adrenal hyperplasia: BY IV INJ OR INF: Children 1 mth-1 yr: Initially 1 mg repeated up to 4 times in 24 hr according to response; 1-6 yrs: initially 2 mg repeated up to 4 times in 24 hr according to response; 6-12 yrs: initially 4 mg repeated up to 4 times in 24 hr according to response; 12-18 yrs: initially 4-20 mg repeated up to 4 times in 24 hr according to response.
Administration
A tuberculin syringe with a 25-gauge, 3/4-inch needle is suitable for most injection into the foot. Intra-articular injection: Intra-articular injection is well tolerated in joints and peri-articular tissues. There is virtually no pain on injection, and the secondary flare' that sometimes occurs a few hours after intra-articular injection of corticosteroids has not been reported with betamethasone sodium phosphate. Intradermal injection: Intralesional treatment should use a tuberculin syringe with a 25-gauge, 1/2-inch needle.
Stability
Store between 2C-25C. Protect from light.
Contraindications
Systemic fungal infections unless specific anti-infective therapy is used, head injury, stroke.
Precautions
Active infections not controlled by antibiotics, latent or active amoebiasis, history of TB, septicaemia, symptoms may be masked, avoid or maintain extreme cautions in chickenpox, measles, psychiatric disorders, renal impairment, hepatic.failure, cirrhosis, active peptic ulcer, myasthenia gravis, previous steroid myopathy, osteoporosis, epilepsy, hypothyroidism, diabetes, adrenal suppression, hypertension, recent myocardial infarction, congestive heart failure,thromboembolic disorders, glaucoma, corneal perforation. Withdraw gradually, withdrawal symp-toms may include fever, myalgia, arthralgia, rhinitis, itchy skin nodules and weight loss.
Interactions
Live vaccines or other vaccines, anticoagulants, hypoglycaemia agents, antihypertensives, diuretics, erythromycin, rifamycin, amphotericin, azole antifungals, ritonavir, cyclosporin, cardiac glycosides, Oestrogens including oral contraceptives, somatropin, Carbamazepine, phenytoin, primidone, barbiturates, muscle relaxants, NSAIDs, salicylates, sympathomimetics, mifepristone, methotrexate, theophylline, aprepitant.
Pregnancy
Caution advised
Lactation
Caution advised
Side Effects
Increased susceptibility and severity to infection, endocrine irregularities including menstrual problems, Cushingoid state, adrenal suppression, growth suppression in children, fluid/electrolyte disturbance, hypertension, negative protein, nitrogen and calcium balance, myopathy, tendon rupture, osteoporosis, osteonecrosis and fractures, impaired wound healing, sweating, hirsutism, striae, telangiectasia, acne,GIdisturbance, peptic ulceration, acute pancreatitis, candidiasis,psychiatric effects, neurological effects, insomnia, diabetes, impaired glucose tolerance, weight gain, increased appetite, ocular disturbances including cataracts, raised intraocular pressure, optic nerve damage, corneal changes, glaucoma, thromboembolism, leukocytosis.