Betamethasone is indicated for-

• Control of inflammatory and allergic conditions including rheumatoid arthritis, rheumatoid carditis, severe hypersensitivity reactions, bronchial asthma, and inflammatory skin diseases;
• congenital adrenal hyperplasia;
• ulcerative conditions of the ear, eye, nose, and oral cavity.

Corticosteroids exert their effects by binding to glucocorticoid receptors, where they suppress pro-inflammatory pathways and enhance anti-inflammatory responses. Betamethasone phosphate has a short duration of action because it is rapidly hydrolyzed to betamethasone. Corticosteroids generally have a wide therapeutic range, as treatment doses may exceed the body’s normal physiological production. Patients receiving corticosteroid therapy should be advised about the potential for hypothalamic-pituitary-adrenal (HPA) axis suppression and an increased risk of infections.

The lowest dosage that will produce an acceptable result should be used.

Adult Dosage: Usual range 0.5-5 mg daily. The dose used will depend upon the disease, its severity, and the clinical response obtained. The following regimens are for guidance only. Divided dosage is usually employed.

Short-term treatment: 2 to 3 mg daily for the first few days, subsequently reducing the daily dosage by 0.25 or 0.50 mg every two to five days, depending upon the response.

Rheumatoid arthritis: 0.5 to 2 mg daily. For maintenance therapy the lowest effective dosage is used.

Child Dosage: A proportion of the adult dosage may be used (e.g. 75% at twelve years, 50% at seven years and 25% at one year) but clinical factors must be given due consideration. Or as directed by the physician.

Use in elderly: The common adverse effects of systemic corticosteroids may be associated with more serious consequences in old age. Close clinical supervision is required to avoid life-threatening reactions.

Steroids may decrease the effectiveness of anticholinesterases and non-steroidal anti-inflammatory drugs (NSAIDs). Drugs such as rifampicin, rifabutin, carbamazepine, phenobarbitone, phenytoin, primidone, aminoglutethimide, and ephedrine can increase the metabolism of corticosteroids, potentially reducing their therapeutic efficacy.

Contraindicated in patients with systemic infections unless appropriate anti-infective therapy is being administered. Also contraindicated in individuals with known hypersensitivity to any component of the tablets.

Adverse effects may include diabetes, osteoporosis (particularly in the elderly), proximal muscle wasting (myopathy), amenorrhoea, and weight gain. High doses of corticosteroids can lead to Cushing’s syndrome, characterized by features such as moon face, striae, and acne; these effects are generally reversible upon discontinuation of therapy. In children, corticosteroid use may cause growth suppression.

Pregnancy Category C. This medication should be used during pregnancy only if the anticipated benefits justify the potential risks to the fetus. There are no available data regarding its use in breastfeeding mothers.

Special caution is advised when prescribing systemic corticosteroids to patients with a recent myocardial infarction, hypothyroidism, osteoporosis, hypertension, or congestive heart failure. Care is also required in individuals with diabetes mellitus, a history of active tuberculosis, glaucoma (or a family history of glaucoma), previous corticosteroid-induced myopathy, hepatic impairment, renal insufficiency, epilepsy, or peptic ulcer disease.

Corticosteroid.

Store at temperatures below 30°C, protected from light and moisture. Keep out of reach of children.