Medications and Drugs

GENERIC NAME: betamethasone dipropionate

BRAND NAME: Diprosone; Diprolene

DRUG CLASS AND MECHANISM: Betamethasone dipropionate is a synthetic glucocorticoid that is used topically on the skin. (The naturally-occurring glucocorticoid is cortisol or hydrocortisone which is produced by the adrenal gland.) Glucocorticoids have potent anti-inflammatory actions and also suppresses the immune response.

PRESCRIPTION: yes

GENERIC AVAILABLE: no

PREPARATIONS: Cream (0.05%), Ointment (0.05%), Topical aerosol (0.1%) Topical lotion (0.05%); Augmented Gel, Cream, Ointment, or Lotion (0.05%; Diprolene). The augmented formulation (Diprolene) is a highly potent form of betamethasone dipropionate which can suppress the production of hydrocortisone by the body under several circumstances. Such circumstances include application for 7 days or longer, to broken skin, to a large part of the body, and in children.

STORAGE: All preparations should be kept between 20 and 30°C (36-86°F). Lotion should be shaken before each use.

PRESCRIBED FOR: Betamethasone dipropionate is used for the relief of itching and inflammation associated with a wide variety of skin conditions.

DOSING: A thin strip of betamethasone dipropionate 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. The augmented 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.

DRUG INTERACTIONS: There are no known drug interactions with topical betamethasone dipropionate.

PREGNANCY: When glucocorticoids are given systemically (orally, intramuscularly or intravenously) to pregnant animals, fetal abnormalities occur. Following application to the skin, a small amount of betamethasone dipropionate is absorbed into the blood and is distributed systemically to the rest of the body. In fact, fetal abnormalities have been noted when potent glucocorticoids are applied to the skin of pregnant animals though betamethasone dipropionate specifically has not been studied in animals. Furthermore, there is no data on the use of betamethasone dipropionate in pregnant women. The use of betamethasone dipropionate during pregnancy, therefore, should be carefully considered with the potential risk weighed against the possible benefit.

NURSING MOTHERS: It is not known if betamethasone dipropionate is secreted in breast milk.

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

Topical application of glucocorticoids may suppress the body's production of cortisol. This is especially true for potent products such as the augmented formulation of betamethasone dipropionate (Diprolene). If suppression has occurred for a long enough period of time, discontinuing the potent glucocorticoid can be associated with symptoms of glucocorticoid deficiency. (It takes the adrenal glands some time before they can begin producing glucocorticoids again.)

Absorption of potent glucocorticoids can increase the glucose concentration in the blood (this is especially worrisome in diabetics) and cause symptoms of glucocorticoid excess (weight gain, redistribution of fat stores, and psychiatric problems). The suppression of inflammation and the immune response caused by glucocorticoid excess also allows infections to occur more easily.

Reference: FDA Prescribing Information

Last Editorial Review: 4/4/1999

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