betamethasone dipropionate, Diprolene; Diprolene AF; (Diprosone, Alphatrex have been discontinued)

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Pharmacy Author:

Omudhome Ogbru, PharmD

Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

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Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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GENERIC NAME: betamethasone dipropionate

BRAND NAME: Diprolene; Diprolene AF; (Diprosone and Alphatrex have been discontinued)

DRUG CLASS AND MECHANISM: Betamethasone is a synthetic (man-made) corticosteroid that is used topically (on the skin). Betamethasone mimics the action of cortisol (hydrocortisone), the naturally-occurring steroid produced in the body by the adrenal glands. Corticosteroids have potent anti-inflammatory actions and also suppress the immune response. Corticosteroids have many effects on the body, but they most often are used for their potent anti-inflammatory effects, particularly in those conditions in which the immune system plays an important role. The FDA approved betamethasone in July 1983.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Cream, ointment, lotion: 0.05%

STORAGE: All preparations should be kept between 15 and 30 C (59-86 F). Lotion should be shaken before each use.

PRESCRIBED FOR: Betamethasone is used for the relief of itching and inflammation associated with a wide variety of skin conditions in patients 13 years of age or older. Examples include allergic dermatitis, atopic dermatitis, contact dermatitis, and plaque psoriasis.

DOSING:

• A thin strip of betamethasone cream or ointment is applied gently to the affected area once or twice daily.
• A few drops of the lotion is applied to the affected area once or twice daily.
• The lotion should be massaged gently until it disappears.

Large doses and prolonged use of betamethasone may cause large amounts to be absorbed into the body and suppress production of cortisol by the adrenal glands. Therefore, the lotion should not be used for longer than two weeks, and not more than 50 ml should be used per week. The augmented cream or ointment should be limited to 45 grams per week. Betamethasone should not be used with occlusive dressings because occlusive dressings increase absorption into the body.

DRUG INTERACTIONS: Combining topical steroids with topical anthralin may increase psoriasis symptoms. Therefore, topical steroids should be discontinued 1 week before starting anthralins.

PREGNANCY: Use of betamethasone in pregnant women has not been studied. When corticosteroids are given systemically (orally, intramuscularly or intravenously) to pregnant animals fetal abnormalities occur.

NURSING MOTHERS: It is not known if betamethasone is secreted in breast milk. Corticosteroids absorbed into the body may appear in breast milk and may cause harmful effects in breast fed infants.

SIDE EFFECTS: The most commonly-noted side effects of betamethasone are burning at the area of application, itching, irritation, and dryness.

Topical application of corticosteroids may suppress the body's production of cortisol. If suppression has occurred for a long enough period of time, discontinuing the potent corticosteroid can be associated with symptoms of cortisol deficiency. (It takes the adrenal glands some time before they can begin producing cortisol again.) Absorption of potent corticosteroids can increase the glucose concentration in the blood (especially worrisome in people with diabetes) and cause symptoms of steroid excess (weight gain, redistribution of fat stores, and psychiatric problems). The suppression of inflammation and the immune response caused by steroid excess also allows infections to occur more easily.

REFERENCE: AHFS Drug Information. Prescribing Information for Diprolene

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