Betamethasone dipropionate cream and ointment are indicated for the relief of inflammatory and pruritic symptoms associated with severe or resistant corticosteroid-responsive dermatoses. These conditions include:

• Atopic eczema
• Nummular eczema
• Contact dermatitis
• Neurodermatitis
• Anogenital and senile pruritus
• Lichen planus
• Psoriasis

Betamethasone dipropionate is a topical corticosteroid with anti-inflammatory, antipruritic, and vasoconstrictive properties. It stimulates the production of peptides known as lipocortins, which inhibit phospholipase A2—an enzyme responsible for breaking down leukocyte lysosomal membranes and releasing arachidonic acid. By blocking this pathway, it reduces the formation and release of inflammatory mediators such as prostaglandins, kinins, and histamine.

Pharmacokinetics: Betamethasone dipropionate may be absorbed through intact skin. Once absorbed, corticosteroids bind to plasma proteins to varying extents. They are primarily metabolized in the liver and excreted via the kidneys.

Apply a thin film once or twice daily to cover completely the affected area. Patients with chronic psoriasis who have achieved at least a marked improvement in their psoriatic lesion (i.e., approximately 80% improvement) with Betamethasone Dipropionate may be maintained in remission with a pulse dosing regimen consisting of three consecutive applications of up to 3.5 g each of Betamethasone Dipropionate cream and ointment, twelve hours apart (e.g., morning, evening, following morning) to the previously affected areas once each week. For this purpose, Betamethasone Dipropionate cream and ointment should be applied to the lesion sites previously affected and treated. Patients on this pulse dose regimen who relapse should be reverted back to the conventional dosing regimen.

There is no evidence of any known interactions.

Contraindicated in patients with hypersensitivity to betamethasone dipropionate, other corticosteroids, or any component of the formulation. As with other topical corticosteroids, it should not be used in viral skin infections such as vaccinia, varicella, or herpes simplex. It is also contraindicated in cutaneous tuberculosis, acne rosacea, fungal skin infections (e.g., moniliasis), perioral dermatitis, and ulcerative skin conditions.

The most commonly reported adverse effects of betamethasone dipropionate include mild to moderate transient burning or stinging, dry skin, pruritus, irritation, and folliculitis. Less frequently reported reactions include tingling, a prickling sensation, skin tightness or cracking, a feeling of warmth, lamellar or perilesional scaling, follicular rash, skin atrophy, erythema, urticaria, vesiculation, telangiectasia, acneiform eruptions, and hyperaesthesia.

With the ointment pulse-dose regimen, mild intermittent hypertension and paraesthesia have been reported. Additional local adverse reactions associated with topical corticosteroids may include itching, hypertrichosis, hypopigmentation, perioral dermatitis, allergic contact dermatitis, skin maceration, secondary infection, striae, miliaria, and worsening of untreated infections.

Betamethasone dipropionate should not be applied in or around the eyes due to the potential risk of glaucoma and cataract formation. If irritation or sensitization occurs during treatment, the medication should be discontinued and appropriate therapy initiated. In cases of concurrent infection, suitable antifungal or antibacterial treatment should be administered. If there is no prompt clinical improvement, betamethasone dipropionate should be stopped until the infection is adequately controlled.

As corticosteroids can be absorbed through the skin, prolonged or extensive topical use may result in systemic effects, which should be considered during treatment. This product is not intended for use under occlusive dressings, as occlusion increases systemic absorption. In infants, diapers may act as occlusive dressings and enhance absorption. Appropriate precautions should be taken when using topical corticosteroids in patients with stasis dermatitis or other conditions associated with impaired circulation. Prolonged use may lead to striae or atrophy of the skin and subcutaneous tissue; if these occur, treatment should be discontinued.

Acute overdose with the ointment is unlikely and is not expected to result in a life-threatening condition. However, the ointment should not be used beyond the prescribed duration of treatment.

Corticosteroid.

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