Generic Name: betamethasone

Brand Names: Celestone, Celestone Soluspan

Drug Class: Corticosteroids

What is betamethasone, and what is it used for?

Betamethasone is a synthetic steroid medication used to treat inflammation from disorders of many organs. Betamethasone is a corticosteroid analog drug with chemical structure similar to the naturally occurring corticosteroid produced by the cortical region of the adrenal gland.

Betamethasone works in the following ways to control inflammation:

  • Controls the rate of protein synthesis
  • Prevents migration and aggregation of polymorphonuclear leukocytes (PMN), types of white cells such as neutrophils, eosinophils and basophils that release inflammatory substances
  • Inhibits pro-inflammatory signals and promotes anti-inflammatory signals
  • Reduces capillary permeability to prevent the leakage of inflammatory cells and proteins (cytokines) into the inflammation site
  • Stabilizes the membranes of cells, and lysosomes, the organelles inside cells that contain digestive enzymes
  • Prevents migration of fibroblasts, cells that form extracellular matrix, the supportive structure of tissue, and prevents scar tissue formation

Systemic betamethasone is administered orally or as injections into the skin (intradermal), muscle (intramuscular), joints (intra-articular) and skin lesions (intralesional) and is also used as a topical application to treat inflammatory skin conditions. Betamethasone is used to treat inflammation in the following conditions:

Warnings

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What are the side effects of betamethasone?

Common side effects of betamethasone include:

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

What are the dosages of betamethasone?

Injectable Suspension

  • 6 mg/ml

Oral Solution

  • 0.6 mg/5 ml

Adult

Endocrine Disorders

  • 0.6-7.2 mg orally divided twice daily/four times daily or 0.6-9 mg/day intramuscularly each day divided twice daily

Inflammatory Conditions

  • 0.6-7.2 mg orally divided twice daily/four times daily or 0.6-9 mg/day intramuscularly each day divided twice daily

Tenosynovitis, Peritendinitis, Bursitis (except on the foot)

  • 3-6 mg (0.5-1 mL) intrabursal once; for acute exacerbations or chronic conditions may require several injections; for repeat injections may use reduced doses

Dermatologic

  • 1.2 mg/cm² (0.2 mL/cm²) intralesional once; not to exceed 6 mg (1 mL) per week

Multiple Sclerosis

  • 30 mg/day IM for 1 week; then 12 mg every other day for 1 week

Rheumatoid Arthritis/Osteoarthritis

  • Intrabursal, intra-articular, intradermal: 0.25-2 mL (3 mg-12 mg)
  • Intralesional: (6 mg/mL)
  • Very large joints: 1-2 mL (6-12 mg)
  • Large joints: 1 mL (6 mg)
  • Medium joints: 0.5 - 1 mL (3-6 mg)
  • Small joints: 0.25-0.5 mL (1.5-3 mg)

Pediatric

Inflammatory conditions

  • Children under 12 years old: 0.0175-0.25 mg/kg/day intramuscular/orally divided every 6-12 hours
  • Children over 12 years old: As in adults

Adrenal Insufficiency

  • Children under 12 years old: 0.0175-0.25 mg/kg/day divided every 6-12 hours intramuscularly/orally; use the lowest dose as an initial dose
  • Children over 12 years old: As in adults; use the lowest dose as an initial dose

Administration

  • Dosage requirements are variable and must be individualized on the basis of the disease under treatment and the response of the patient.

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Overdose

  • Acute overdose is treated with supportive and symptomatic therapy.
  • For chronic overdosage in the face of severe disease requiring continuous steroid therapy, corticosteroid dosage may be temporarily reduced, or alternate treatment introduced.

What drugs interact with betamethasone?

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

Interactions of betamethasone include:

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

Pregnancy and breastfeeding

  • Betamethasone should be used in pregnancy only if potential benefits outweigh potential risks to the fetus.
  • Use with caution in breastfeeding women; systemically administered corticosteroids enter breast milk and can suppress growth, interfere with natural (endogenous) corticosteroid production, or cause other effects.

What else should I know about betamethasone?

  • High doses of betamethasone for prolonged periods of time can cause adrenal suppression
  • Prolonged use of corticosteroids may increase incidence of secondary infections
  • Betamethasone can cause blood clotting (thromboembolic) disorders
  • High-dose corticosteroids can cause muscle damage (myopathy)
  • Occurrence of Kaposi sarcoma, a type of cancer, is associated with prolonged corticosteroid treatment
  • Seizures have been reported in patients with history of seizure disorders
  • Patients on corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated
  • Latent tuberculosis may be reactivated (patients with positive tuberculin test should be monitored). Restrict the use of corticosteroids in active tuberculosis to cases of fulminating or disseminated tuberculosis
  • Prolonged corticosteroid use may result in eye conditions such as elevated intraocular pressure, glaucoma, or cataracts
  • Betamethasone use can delay wound healing
  • High dose corticosteroids are associated with increased bone loss and must be used with caution in patients at higher risk for osteoporosis (post-menopausal women)

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Summary

Betamethasone is a synthetic steroid taken as an oral medication, injections into the skin, or a topical cream, and is used to treat inflammation from various disorders, including skin conditions, asthma, ulcerative colitis, arthritis, and others. Common side effects include allergic reactions (swelling), acne, hives, itching, irregular heart rhythms (arrhythmia), heart enlargement, fainting, fluid in the lungs (pulmonary edema), blood clot blockage in a blood vessel (thromboembolism), vein inflammation with blood clots (thrombophlebitis), and others. Consult your doctor before taking if pregnant or breastfeeding.

Treatment & Diagnosis

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Medically Reviewed on 3/10/2022
References
https://www.rxlist.com/consumer_betamethasone_celestone_betaject/drugs-condition.htm

https://reference.medscape.com/drug/celestone-soluspan-betamethasone-342740#0

https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/014602s047lbl.pdf

https://www.accessdata.fda.gov/drugsatfda_docs/label/2006/014215s009s015lbl.pdf