Betamethasone ointment: instructions for use, price, analogues and reviews

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

“Betamethasone – what is it?” - a common question when using betamethasone-containing drugs . Betamethasone is a glucocorticosteroid . It blocks the migration of leukocytes, the release of lysosomal enzymes and anti-inflammatory mediators in the area of inflammation, suppresses phagocytosis , weakens vascular permeability, and stops the development of edema in the inflammatory focus.

Pharmacokinetics

When the cream is applied locally in therapeutic doses, percutaneous absorption into the blood is insignificantly 12-14%. Reaction with blood proteins – 64%. Transformed in the liver.

It is excreted through the kidneys mainly in the form of metabolites , a small part is excreted in bile. The presence of skin damage, inflammation, or the application of occlusive dressings improves the absorption of betamethasone.

Betamethasone 0.05% 30g cream for external use

pharmachologic effect

Glucocorticosteroid for local use.

Composition and release form Betamethasone 0.05% 30g cream for external use

Cream - 1 g:

Active substances: betamethasone dipropionate - 0.643 mg, which corresponds to the content of betamethasone - 0.5 mg;
Excipients: white soft paraffin - 150 mg, cetostearyl alcohol - 72 mg, liquid paraffin - 60 mg, macrogol 20 cetostearyl ether - 22.5 mg, sodium dihydrogen phosphate dihydrate - 3.39 mg, methyl parahydroxybenzoate (methylparaben) - 1 mg, propyl parahydroxybenzoate (propylparaben) - 0.5 mg, sodium hydroxide - in the amount necessary to establish the pH, concentrated phosphoric acid - in the amount necessary to establish the pH, purified water - up to 1 g.

15, 30 or 50 g - aluminum tubes (1) - cardboard packs.

Description of the dosage form

Cream for external use, white or almost white, homogeneous.

Directions for use and doses

The dose is set individually.

When taken orally, the daily dose for adults is 0.25-8 mg, for children - 17-250 mcg/kg. After long-term use, betamethasone should be discontinued gradually, reducing the dose by 250 mcg every 2-3 days.

For intravenous administration (slow jet or drip), a single dose is 4-8 mg, if necessary, it can be increased to 20 mg; The maintenance dose is usually 2-4 mg. A single dose for intramuscular administration is 4-6 mg.

For intra-articular administration and injection directly into the lesion for soft tissue diseases, depending on the size of the joint and the size of the affected area, a single dose is 0.4-6 mg.

Subconjunctival single dose - 2 mg.

For external use, apply a thin layer to the affected area of the skin 2-6 times a day until clinical improvement, then apply 1-2 times a day. When using betamethasone in children, as well as in patients with facial lesions, the course of treatment should not exceed 5 days.

Pharmacodynamics

GKS. Suppresses the functions of leukocytes and tissue macrophages. Limits the migration of leukocytes to the area of inflammation. It disrupts the ability of macrophages to phagocytose, as well as to form interleukin-1. Helps stabilize lysosomal membranes, thereby reducing the concentration of proteolytic enzymes in the area of inflammation. Reduces capillary permeability due to the release of histamine. Suppresses fibroblast activity and collagen formation.

Inhibits the activity of phospholipase A2, which leads to suppression of the synthesis of prostaglandins and leukotrienes. Suppresses the release of COX (mainly COX-2), which also helps to reduce the production of prostaglandins.

Reduces the number of circulating lymphocytes (T- and B-cells), monocytes, eosinophils and basophils due to their movement from the vascular bed into the lymphoid tissue; suppresses the formation of antibodies.

Betamethasone suppresses the pituitary release of ACTH and β-lipotropin, but does not reduce the level of circulating β-endorphin. Inhibits the secretion of TSH and FSH.

When directly applied to blood vessels, it has a vasoconstrictor effect.

Betamethasone has a pronounced dose-dependent effect on the metabolism of carbohydrates, proteins and fats. Stimulates gluconeogenesis, promotes the uptake of amino acids by the liver and kidneys and increases the activity of gluconeogenesis enzymes. In the liver, betamethasone enhances the deposition of glycogen, stimulating the activity of glycogen synthetase and the synthesis of glucose from protein metabolism products. An increase in blood glucose levels activates the release of insulin.

Betamethasone inhibits the uptake of glucose into fat cells, which leads to activation of lipolysis. However, due to increased insulin secretion, lipogenesis is stimulated, which promotes fat accumulation.

Retains sodium ions and water in the body, stimulates the excretion of potassium ions, reduces calcium absorption from the gastrointestinal tract, washes calcium ions from bones, increases calcium excretion by the kidneys.

It has a catabolic effect in lymphoid and connective tissue, muscles, adipose tissue, skin, bone tissue. Osteoporosis and Itsenko-Cushing syndrome are the main factors limiting long-term GCS therapy. As a result of the catabolic effect, growth suppression in children is possible.

In high doses, betamethasone can increase the excitability of brain tissue and help lower the seizure threshold. Stimulates excess production of hydrochloric acid and pepsin in the stomach, which leads to the development of peptic ulcers.

When used systemically, the therapeutic activity of betamethasone is due to anti-inflammatory, antiallergic, immunosuppressive and antiproliferative effects.

When applied externally and locally, the therapeutic activity of betamethasone is due to its anti-inflammatory, antiallergic and antiexudative (due to the vasoconstrictor effect) effect.

Its anti-inflammatory activity is 30 times higher than hydrocortisone, but does not have mineralocorticoid activity. The presence of a fluorine atom in the molecule enhances the anti-inflammatory activity of betamethasone.

Betamethasone in the form of dipropionate is characterized by long-lasting action.

Pharmacokinetics

Plasma protein binding is about 64%, Vd is 84 l. Metabolized in the liver. Metabolites are excreted mainly by the kidneys, a small part - with bile.

When absorbed through the skin, betamethasone is characterized by similar pharmacokinetic properties, both for external and systemic use. Systemic absorption after external use is 12-14%.

When applied topically and externally to intact skin, absorption may be insignificant. The presence of an inflammatory process, as well as the use of an occlusive dressing, can increase the amount of absorption.

Indications for use Betamethasone 0.05% 30g cream for external use

For oral administration: primary or secondary adrenal insufficiency, congenital adrenal hyperplasia, acute (non-purulent) and subacute thyroiditis, hypercalcemia due to tumor disease, rheumatic diseases, collagen diseases, allergic diseases, symptomatic sarcoidosis, Loeffler's syndrome, berylliosis, idiopathic or secondary thrombocytopenia in adults, autoimmune hemolytic anemia, erythroblastopenia (erythrocyte anemia), erythroid hypoplastic anemia, transfusion reactions, palliative therapy of leukemia and lymphoma in adults and acute leukemia in children; ulcerative colitis, Bell's palsy.

For parenteral use: shock (including burn, traumatic, surgical, toxic, cardiogenic, blood transfusion, anaphylactic); allergic reactions (acute, severe forms), anaphylactoid reactions; cerebral edema (including due to a brain tumor or associated with surgery, radiation therapy or head injury), increased intracranial pressure; bronchial asthma (severe form), status asthmaticus; systemic connective tissue diseases (SLE, rheumatoid arthritis); acute adrenal insufficiency, prevention of adrenal insufficiency in patients who have received GCS for a long time; thyrotoxic crisis; acute hepatitis, hepatic coma; poisoning with cauterizing liquids; croup in diphtheria (in combination with appropriate antimicrobial therapy).

For intra-articular administration: rheumatoid arthritis, osteoarthritis, traumatic arthritis, osteochondritis, acute gouty arthritis. Diseases of soft tissues (including bursitis, fibrositis, tendonitis, tenosynovitis, myositis).

For external use: dermatoses, various types of eczema (including atopic, childhood, nummular), Hyde nodular prurigo, simple dermatitis, exfoliative dermatitis, neurodermatitis, solar dermatitis, seborrheic dermatitis, radiation dermatitis, diaper rash, psoriasis (except for extensive plaque psoriasis), skin or anogenital (excluding candidomycosis) itching, discoid lupus erythematosus, as an adjuvant in the complex therapy of generalized erythroderma.

For local use: eye and ear diseases with a pronounced allergic or inflammatory component.

Contraindications

For short-term use for health reasons - hypersensitivity to betamethasone.

For intra-articular injection and injection directly into the lesion: previous arthroplasty, pathological bleeding (endogenous or caused by the use of anticoagulants), intra-articular bone fracture, infectious (septic) inflammatory process in the joint and periarticular infections (including a history), as well as general infectious disease, severe periarticular osteoporosis, absence of signs of inflammation in the joint (“dry” joint, for example, in osteoarthritis without synovitis), severe bone destruction and joint deformation (sharp narrowing of the joint space, ankylosis), joint instability as a result of arthritis, aseptic necrosis of the forming epiphyseal joint of bones.

For external use: rosacea, blackheads and acne vulgaris; primary viral skin infections (including chicken pox).

Application of Betamethasone 0.05% 30g cream for external use during pregnancy and breastfeeding

Use during pregnancy is possible in exceptional cases according to strict indications.

If use is necessary during lactation, breastfeeding should be discontinued.

special instructions

Use with caution in case of parasitic and infectious diseases of a viral, fungal or bacterial nature (currently or recently suffered, including recent contact with a patient) - herpes simplex, herpes zoster (viremic phase), chickenpox, measles, amoebiasis, strongyloidiasis (established or suspected), systemic mycosis; active and latent tuberculosis. Use for severe infectious diseases is permissible only against the background of specific therapy.

Use with caution within 8 weeks before and 2 weeks after vaccination), with lymphadenitis after BCG vaccination, with immunodeficiency conditions (including AIDS or HIV infection).

Use with caution in diseases of the gastrointestinal tract: gastric and duodenal ulcers, esophagitis, gastritis, acute or latent peptic ulcers, recently created intestinal anastomosis, ulcerative colitis with the threat of perforation or abscess formation, diverticulitis.

Use with caution for diseases of the cardiovascular system, incl. after a recent myocardial infarction (in patients with acute and subacute myocardial infarction, the necrotic focus may spread, slowing down the formation of scar tissue and, as a result, rupture of the heart muscle), with decompensated chronic heart failure, arterial hypertension, hyperlipidemia), with endocrine diseases - diabetes mellitus ( including impaired tolerance to carbohydrates), thyrotoxicosis, hypothyroidism, Itsenko-Cushing's disease, with severe chronic renal and/or liver failure, nephrourolithiasis, with hypoalbuminemia and conditions predisposing to its occurrence, with systemic osteoporosis, myasthenia gravis, acute psychosis , obesity (III-IV degree), with poliomyelitis (except for the form of bulbar encephalitis), open- and closed-angle glaucoma, pregnancy, and lactation.

If intra-articular administration is necessary, use with caution in patients with a general severe condition, ineffectiveness (or short duration) of the action of 2 previous administrations (taking into account the individual properties of the corticosteroids used).

When taken orally, it is necessary to monitor blood glucose levels, blood pressure, and water and electrolyte balance. If irritation or symptoms of hypersensitivity to betamethasone occur, treatment should be discontinued and appropriate therapy should be instituted. If a secondary infection occurs, treatment is carried out with appropriate antimicrobial agents.

Not indicated for the treatment of neonatal hyaline membrane disease.

It should not be used externally for the treatment of primary skin lesions with fungal (for example, candidiasis, trichophytosis) and bacterial (for example, impetigo) infections, perianal and anogenital itching.

Side effects Betamethasone 0.05% 30g cream for external use

From the endocrine system: decreased glucose tolerance, steroid diabetes mellitus or manifestation of latent diabetes mellitus, suppression of adrenal function, Itsenko-Cushing syndrome (including moon face, pituitary type obesity, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, myasthenia gravis , striae), delayed sexual development in children.

Metabolism: increased excretion of calcium ions, hypocalcemia, increased body weight, negative nitrogen balance (increased protein breakdown), increased sweating, fluid and sodium ion retention (peripheral edema), hypernatremia, hypokalemic syndrome (including hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue).

From the central nervous system: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, pseudotumor of the cerebellum, headache, convulsions.

From the cardiovascular system: arrhythmias, bradycardia (up to cardiac arrest); development (in predisposed patients) or increased severity of chronic heart failure, ECG changes characteristic of hypokalemia, increased blood pressure, hypercoagulation, thrombosis. In patients with acute and subacute myocardial infarction - the spread of necrosis, slowing down the formation of scar tissue, which can lead to rupture of the heart muscle; with intracranial administration - nosebleeds.

From the digestive system: nausea, vomiting, pancreatitis, steroid ulcer of the stomach and duodenum, erosive esophagitis, bleeding and perforation of the gastrointestinal tract, increased or decreased appetite, flatulence, hiccups. In rare cases, increased activity of liver transaminases and alkaline phosphatase.

From the senses: sudden loss of vision (with parenteral administration in the head, neck, nasal turbinates, scalp, deposition of drug crystals in the vessels of the eye is possible), posterior subcapsular cataract, increased intraocular pressure with possible damage to the optic nerve, tendency to develop secondary bacterial , fungal or viral eye infections, trophic changes in the cornea, exophthalmos.

From the musculoskeletal system: slower growth and ossification processes in children (premature closure of the epiphyseal growth plates), osteoporosis (very rarely - pathological bone fractures, aseptic necrosis of the head of the humerus and femur), rupture of muscle tendons, steroid myopathy, decreased muscle mass (atrophy); with intra-articular administration - increased pain in the joint.

Dermatological reactions: delayed wound healing, petechiae, ecchymosis, skin thinning, hyper- or hypopigmentation, steroid acne, stretch marks, tendency to develop pyoderma and candidiasis.

Allergic reactions: generalized (skin rash, skin itching, anaphylactic shock), local allergic reactions.

Local reactions: with parenteral administration - burning, numbness, pain, paresthesia and infection at the injection site, rarely - necrosis of surrounding tissues, scar formation at the injection site; with intramuscular injection (especially into the deltoid muscle) - atrophy of the skin and subcutaneous tissue.

Other: development or exacerbation of infections (the appearance of this side effect is facilitated by jointly used immunosuppressants and vaccination), leukocyturia, withdrawal syndrome.

With intravenous administration - blood flow to the face, convulsions.

For external use: rarely - itching, hyperemia, burning, dryness, folliculitis, acne, hypopigmentation, perioral dermatitis, allergic dermatitis, skin maceration, secondary infection, skin atrophy, stretch marks, prickly heat. With prolonged use or application to large areas of skin, systemic side effects characteristic of GCS may develop.

Drug interactions

When used simultaneously with cardiac glycosides, their effect is enhanced; with diuretics - potassium excretion increases; with hypoglycemic drugs, oral anticoagulants - weakening of their effect; with NSAIDs - the risk of erosive and ulcerative lesions and bleeding from the gastrointestinal tract increases.

Indications for use

In order to reduce inflammatory phenomena in eczema and dermatitis , including photodermatitis , lichen planus , nodular prurigo , neurodermatitis , discoid lupus erythematosus, pretibial myxedema, necrobiosis lipoidica and erythroderma .
For the treatment of psoriasis in the scalp and other types of psoriasis , except extensive plaque psoriasis .

Contraindications

This drug is prohibited for use in the presence of bacterial, fungal and viral skin lesions, skin symptoms of syphilis , tuberculosis , skin reactions after vaccination, perioral dermatitis , acne , perianal or genital itching, plaque psoriasis, rosacea, varicose veins . Also, the drug is not recommended for use in case of hypersensitivity to Betamethasone or other components of the drug.

Betamethasone

From the endocrine system:

decreased glucose tolerance, steroid diabetes mellitus or manifestation of latent diabetes mellitus, suppression of adrenal function, Itsenko-Cushing syndrome (including moon face, pituitary type obesity, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, myasthenia gravis, stretch marks), delay sexual development in children.

From the side of metabolism:

increased excretion of calcium ions, hypocalcemia, weight gain, negative nitrogen balance (increased protein breakdown), increased sweating, fluid and sodium ion retention (peripheral edema), hypernatremia, hypokalemic syndrome (including hypokalemia, arrhythmia, myalgia or spasm muscles, unusual weakness and fatigue).

From the side of the central nervous system:

delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, pseudotumor of the cerebellum, headache, convulsions.

From the cardiovascular system:

arrhythmias, bradycardia (up to cardiac arrest); development (in predisposed patients) or increased severity of chronic heart failure, ECG changes characteristic of hypokalemia, increased blood pressure, hypercoagulation, thrombosis. In patients with acute and subacute myocardial infarction - the spread of necrosis, slowing down the formation of scar tissue, which can lead to rupture of the heart muscle; with intracranial administration - nosebleeds.

From the digestive system:

nausea, vomiting, pancreatitis, steroid ulcer of the stomach and duodenum, erosive esophagitis, bleeding and perforation of the gastrointestinal tract, increased or decreased appetite, flatulence, hiccups. In rare cases, increased activity of liver transaminases and alkaline phosphatase.

From the senses:

sudden loss of vision (with parenteral administration in the head, neck, nasal turbinates, scalp, deposition of drug crystals in the vessels of the eye is possible), posterior subcapsular cataract, increased intraocular pressure with possible damage to the optic nerve, a tendency to develop secondary bacterial, fungal or viral infections eye, trophic changes in the cornea, exophthalmos.

From the musculoskeletal system:

slower growth and ossification processes in children (premature closure of epiphyseal growth zones), osteoporosis (very rarely - pathological bone fractures, aseptic necrosis of the head of the humerus and femur), rupture of muscle tendons, steroid myopathy, decreased muscle mass (atrophy); with intra-articular administration - increased pain in the joint.

Dermatological reactions

: delayed wound healing, petechiae, ecchymoses, skin thinning, hyper- or hypopigmentation, steroid acne, stretch marks, tendency to develop pyoderma and candidiasis.

Allergic reactions

: generalized (skin rash, skin itching, anaphylactic shock), local allergic reactions.

Local reactions:

with parenteral administration - burning, numbness, pain, paresthesia and infection at the injection site, rarely - necrosis of surrounding tissues, scar formation at the injection site; with intramuscular injection (especially into the deltoid muscle) - atrophy of the skin and subcutaneous tissue.

Other:

development or exacerbation of infections (the appearance of this side effect is facilitated by jointly used immunosuppressants and vaccination), leukocyturia, withdrawal syndrome.

With intravenous administration - blood flow to the face, convulsions.

For external use:

rarely - itching, hyperemia, burning, dryness, folliculitis, acne, hypopigmentation, perioral dermatitis, allergic dermatitis, skin maceration, secondary infection, skin atrophy, stretch marks, prickly heat. With long-term use or application to large areas of skin, systemic side effects characteristic of GCS may develop.

Side effects

Skin reactions: with prolonged treatment, sensations of itching , burning, dryness, and irritation may occur at the site of frequent use of the drug. , folliculitis, acne, hypertrichosis, hypopigmentation, perioral dermatitis, hyperpigmentation, contact dermatitis, secondary infection, skin maceration, skin atrophy, miliaria, stretch marks and develop .
Systemic reactions: Itsenko-Cushing syndrome , decreased tolerance to carbohydrates, suppression of adrenal function. In children, suppression of adrenal function is manifested by increased intracranial pressure, growth retardation, decreased body weight, decreased cortisol in the blood, bulging fontanel, headache and swelling of the optic nerve.

Betamethasonum

From the endocrine system:

From the side of metabolism:

From the side of the central nervous system:

From the cardiovascular system:

From the digestive system:

From the senses:

From the musculoskeletal system:

Dermatological reactions:

delayed wound healing, petechiae, ecchymosis, skin thinning, hyper- or hypopigmentation, steroid acne, stretch marks, tendency to develop pyoderma and candidiasis.

Allergic reactions:

generalized (skin rash, skin itching, anaphylactic shock), local allergic reactions.

Local reactions:

Other:

development or exacerbation of infections (the appearance of this side effect is facilitated by jointly used immunosuppressants and vaccination), leukocyturia, withdrawal syndrome.

When administered intravenously

- blood to the face, convulsions.

For external use:

rarely - itching, hyperemia, burning, dryness, folliculitis, acne, hypopigmentation, perioral dermatitis, allergic dermatitis, skin maceration, secondary infection, skin atrophy, stretch marks, prickly heat. With prolonged use or application to large areas of the skin, systemic side effects characteristic of glucocorticosteroids may develop.

Betamethasone cream and ointment, instructions for use (Method and dosage)

The cream is used locally. The drug dosage regimen is developed individually.

The cream should be applied to the affected area of the skin in a thin layer twice a day, gently rubbing. After signs of improvement appear, the frequency of use can be reduced to once a day. The duration of treatment is determined by the speed of disappearance of the inflammatory process, cleansing of the skin and cessation of itching. Also, the duration of the course of therapy depends on the severity and type of disease. Usually the course of treatment lasts 1-2 weeks. There should be a break of at least three weeks between repeated treatment cycles.

The course of therapy in children and patients with facial skin lesions is no more than 5 days.

Betamethasone solution for injection 4 mg/ml 1 ml No. 5

Corticosteroids should be prescribed with caution to patients who have recently had a myocardial infarction due to the risk of myocardial rupture.

Due to insufficient data regarding the use of corticosteroids to treat head injury or stroke, they should not be used in these conditions.

Severe neurological deficits, some fatal, have been reported following epidural corticosteroid injections. There have also been reports of spinal cord infarction, paraplegia, quadriplegia, cortical blindness and stroke. These serious neurological disorders were observed regardless of the use of fluoroscopy. Because the safety and effectiveness of epidural administration have not been established, corticosteroids are not recommended for epidural use.

Injections should be administered deeply only into large muscle masses to avoid local tissue atrophy.

When administered into soft tissue at sites of injury and intra-articularly, both local and systemic effects of corticosteroids may occur.

It is necessary to examine the intra-articular fluid to exclude a septic process. Local injections into a previously infected joint should be avoided. A noticeable increase in pain and local swelling, further restriction of joint movement, fever and malaise are signs of septic arthritis. If the diagnosis of sepsis is confirmed, appropriate antimicrobial therapy should be prescribed.

Corticosteroids should not be injected into unstable joints, areas of inflammation, or intervertebral spaces. Repeated injections into joints for osteoarthritis may increase joint destruction. Injecting corticosteroids directly into the tendon should be avoided as this may cause delayed tendon rupture.

After intra-articular betamethasone therapy, the patient should avoid putting too much stress on the joint in which symptoms have been relieved.

Since there have been isolated cases of anaphylactic reactions in patients receiving parenteral therapy with betamethasone, safety precautions should be taken before prescribing the drug, especially in patients with a history of allergies to any drug.

When using corticosteroid therapy for a long time, all potential benefits and risks should be considered before switching from parenteral to oral use.

Changes in the dosage regimen are possible according to the course of the disease during remission or exacerbation, the patient's response to therapy, negative changes in the patient's emotional and physical state, such as severe infection, surgery or trauma. After completing a long or intensive course of treatment with glucocorticosteroids, constant monitoring of the patient's condition throughout the year is necessary.

Corticosteroids may aggravate systemic fungal infections and should not be used in the presence of infections requiring antifungal treatment.

Corticosteroids may mask signs of infections, or new infections may occur while using corticosteroids. When using corticosteroids, the body's resistance and ability to localize the infection are reduced.

With long-term use, posterior subcapsular cataracts (especially in children), glaucoma with possible damage to the optic nerve, and an increased risk of developing secondary fungal or viral eye infections may occur. An ophthalmological examination should be performed periodically, especially in patients undergoing long-term therapy (more than 6 weeks).

The use of medium and large doses of corticosteroids can cause increased blood pressure, salt and fluid retention, and increased potassium excretion. These effects are less likely when using synthetic derivatives (but not in high doses). However, it may be necessary to follow a low-salt diet and take potassium supplements. All corticosteroids increase calcium excretion.

Patients should not be vaccinated against varicella while receiving corticosteroids. Patients receiving corticosteroids, especially high doses, should not be vaccinated against other infections due to the risk of developing neurological complications and a decreased immune response. But immunization is possible in patients receiving corticosteroid replacement therapy, such as Addison's disease.

Patients receiving immunosuppressive doses of corticosteroids should avoid contact with patients with chickenpox and measles. This is especially important for children.

For active tuberculosis, corticosteroid therapy should be limited to cases of fulminant or disseminated tuberculosis, in which a corticosteroid is used only in conjunction with antituberculosis therapy. Patients with latent tuberculosis or those who are reactive to tuberculin and receiving corticosteroids should be under medical supervision, as reactivation of the disease is possible. During long-term corticosteroid therapy, patients should receive chemoprophylaxis. If chemotherapy includes the use of rifampicin, its enhancing effect on the metabolic hepatic clearance of corticosteroids should be considered; It may be necessary to adjust the dose of the corticosteroid.

To control the condition during treatment, the lowest dose of corticosteroid should be used, and if possible, the dose should be reduced gradually.

Due to very rapid withdrawal of the corticosteroid, secondary drug-induced adrenal insufficiency may occur, which can be minimized by gradually reducing the dose of the drug. This relative deficiency may persist for several months after discontinuation of therapy. If during this period the patient experiences a stressful situation, the use of corticosteroids must be reinstated. If the patient is already receiving corticosteroids, the dosage may need to be increased. Due to the possible impairment of mineralocorticosteroid secretion, salt and/or mineralocorticoids should be used concomitantly. Dose reductions should be made under strict medical supervision, and sometimes it is necessary to monitor the patient's condition for a period of up to one year after stopping long-term treatment or using increased doses.

For diabetic patients, betamethasone can only be used for a short period and only under strict medical supervision, given its glucocorticoid properties (transformation of proteins into glucose).

The effect of the drug is enhanced in persons with hypothyroidism and cirrhosis of the liver.

The drug should be prescribed with caution for ocular herpes zoster due to possible perforation of the cornea.

With corticosteroid therapy, mental disorders may occur (especially in patients with emotional instability or a tendency to psychosis).

The drug should be used with caution in nonspecific ulcerative colitis with the threat of perforation, abscess or other purulent infection, diverticulitis, intestinal anastomosis, gastric and duodenal ulcers, renal failure, arterial hypertension, osteoporosis, myasthenia gravis, glaucoma, acute psychoses, viral and bacterial infections, growth retardation, tuberculosis, Cushing's syndrome, diabetes, heart failure, in case of difficult to treat cases of epilepsy, tendency to thromboembolism or thrombophlebitis, during pregnancy.

Complications of treatment with glucocorticosteroids depend on the dose and duration of treatment, so it is necessary to consider the risk/benefit ratio for each patient.

In some patients, corticosteroids may cause a decrease in sperm count and motility.

The total amount of sodium in 1 ml of solution is 0.06 mmol, that is, the drug is practically free of sodium.

Strict adherence to aseptic rules is mandatory when using the drug.

special instructions

The drug is not used in ophthalmology. Do not allow the drug to come into contact with the eyes or skin of the eyelids, as this can lead to the development of cataracts, glaucoma , fungal and herpetic infections.

In patients with psoriasis , the use of Betamethasone may worsen the course of this disease.

The armpits and groin area are more prone to stretch marks . The use of the product in these areas should not be prolonged.

When superinfection additional use of antifungal or antibacterial drugs , depending on the etiology.

It is not recommended to use the cream on the scalp.

Analogs

Level 4 ATC code matches:
Gistan-N

Sinalar

Avecourt

Mesoderm

Momederm

Betazon

Silkaren

Elokom

Flucinar

Sinaflan

Celestoderm

Cutivate

Advantan

Beloderm

Mometasone Furoate

Uniderm

Momat

Betamethasone analogs: Akriderm, Betazon, Beloderm Express, Betamethasone valerate, Betliben, Betamethasone dipropionate, Soderm, Celestoderm-V.

Betamethasone price, where to buy

The price of Betamethasone ointment in Russia starts from 115 rubles, in Ukraine the price averages 20-23 hryvnia.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine

ZdravCity

Betamethasone ointment d/nar.
approx. 0.05% tube 30g PAO Biosintez 94 RUR order
Betamethasone-Vertex ointment for external use 0.05% 30gVertex AO
160 rub. order
Betamethasone-Vertex cream for external use 0.05% tube 30gVertex AO
162 RUR order

Pharmacy24

Betamethasone-Darnitsa 15g cream PrAT" Pharmaceutical company "Darnitsa", Ukraine
32 UAH. order
Betamethasone 15 g cream PAT "Kievmedpreparat", Ukraine
31 UAH order