Betamethasone

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Betamethasone
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Clinical data
Trade namesCelestone, Eleuphrat, others
AHFS/Drugs.comMonograph
MedlinePlusa682799
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Pregnancy
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Routes of
administration		By mouth, topical, intramuscular
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Legal status
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Pharmacokinetic data
MetabolismLiver CYP3A4
Elimination half-life36-54 hours
ExcretionKidney (in urine)
Identifiers
  • (8S,9R,10S,11S,13S,14S,16S,17R)-9-Fluoro- 11,17-dihydroxy-17-(2-hydroxyacetyl)-10,13,16-trimethyl- 6,7,8,9,10,11,12,13,14,15,16,17-dodecahydro- 3H-cyclopenta[a]phenanthren-3-one
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Chemical and physical data
FormulaC22H29FO5
Molar mass392.467 g·mol−1
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  • InChI=1S/C22H29FO5/c1-12-8-16-15-5-4-13-9-14(25)6-7-19(13,2)21(15,23)17(26)10-20(16,3)22(12,28)18(27)11-24/h6-7,9,12,15-17,24,26,28H,4-5,8,10-11H2,1-3H3/t12-,15-,16-,17-,19-,20-,21-,22-/m0/s1 checkY
  • Key:UREBDLICKHMUKA-DVTGEIKXSA-N checkY
Data page
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Betamethasone is a steroid medication.[3] It is used for a number of diseases including rheumatic disorders such as rheumatoid arthritis and systemic lupus erythematosus, skin diseases such as dermatitis and psoriasis, allergic conditions such as asthma and angioedema, preterm labor to speed the development of the baby's lungs, Crohn's disease, cancers such as leukemia, and along with fludrocortisone for adrenocortical insufficiency, among others.[3] It can be taken by mouth, injected into a muscle, or applied to the skin, typically in cream, lotion, or liquid forms.[3][4]

Serious side effects include an increased risk of infection, muscle weakness, severe allergic reactions, and psychosis.[3] Long-term use may cause adrenal insufficiency.[3] Stopping the medication suddenly following long-term use may be dangerous.[3] The cream commonly results in increased hair growth and skin irritation.[4] Betamethasone belongs to the glucocorticoid class of medication.[3] It is a stereoisomer of dexamethasone, the two compounds differing only in the spatial configuration of the methyl group at position 16 (see steroid nomenclature).[5]

Betamethasone was patented in 1958, and approved for medical use in the United States in 1961.[3][6] It is on the World Health Organization's List of Essential Medicines.[7] It is available as a generic medication.[3] In 2023, it was the 280th most commonly prescribed medication in the United States, with more than 700,000 prescriptions.[8][9]

Medical uses

File:Betnovateonitemntcream.JPG
Betnovate ointment

Betamethasone is a corticosteroid that is available as a pill, by injection, and as an ointment, cream, lotion, gel, or aerosol (spray) for the skin, and a foam for the scalp.[10] When given by injection, anti-inflammatory effects begin in around two hours and last for seven days.[3]

It is used as a topical cream to relieve skin irritation, such as itching and flaking from eczema. It is used as a treatment for local psoriasis, as betamethasone dipropionate and salicylic acid, or as the combination calcipotriol/betamethasone dipropionate.[citation needed] Betamethasone sodium phosphate is used orally and via injection with the same indications as other steroids. Many betamethasone-based pharmaceuticals include the steroid as the valerate ester.[citation needed]

In a randomized controlled trial betamethasone was shown to reduce some of the ataxia (poor coordination) symptoms associated with ataxia telangiectasia (A-T) by 28-31%.[11]

Betamethasone is also used to stimulate fetal maturation of the lungs and cerebral blood vessels.[3]

A cream with 0.05% betamethasone appears effective in treating phimosis in boys,[12] and often averts the need for circumcision.[13][14][15] Longer-term research is needed on this treatment method.[12] This approach has replaced circumcision as the preferred treatment method for some physicians in the British National Health Service.[16][17]

Side effects

Betamethasone crosses the placenta.[3]

When injected into the epidural space or the spine, it may cause serious side effects like loss of vision, stroke, and paralysis.[19]

Pharmacology

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Forms

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Betamethasone is available in a number of compound forms: betamethasone dipropionate (branded as Diprosone, Diprolene, Celestamine, Procort (in Pakistan), and others), betamethasone sodium phosphate (branded as Bentelan in Italy) and betamethasone valerate (branded as Audavate, Betnovate, Celestone, Fucibet, and others).[citation needed] In the United States and Canada, betamethasone is mixed with clotrimazole and sold as Lotrisone and Lotriderm. It is also available in combination with salicylic acid (branded as Diprosalic) for using in psoriatic skin conditions. In some countries, it is also sold mixed with both clotrimazole and gentamicin to add an antibacterial agent to the mix.[citation needed]

Betamethasone sodium phosphate mixed with betamethasone acetate is available in the United States as Celestone Soluspan.[20]

See also

References

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  1. ^ Page Module:Citation/CS1/styles.css has no content."Betamethasone Use During Pregnancy". Drugs.com. 30 December 2019. Retrieved 29 March 2020.
  2. ^ Page Module:Citation/CS1/styles.css has no content."Betamethasone 500 microgram Soluble Tablets - Summary of Product Characteristics (SmPC)". (emc). 5 April 2018. Retrieved 29 March 2020.
  3. ^ a b c d e f g h i j k l Page Module:Citation/CS1/styles.css has no content."Betamethasone". The American Society of Health-System Pharmacists. Archived from the original on 8 December 2015. Retrieved 2 December 2015.
  4. ^ a b Page Module:Citation/CS1/styles.css has no content."Betamethasone topical". The American Society of Health-System Pharmacists. Archived from the original on 8 December 2015. Retrieved 2 December 2015.
  5. ^ Page Module:Citation/CS1/styles.css has no content.Antignac JP, Le Bizec B, Monteau F, Andre F (January 2002). "Differentiation of betamethasone and dexamethasone using liquid chromatography/positive electrospray tandem mass spectrometry and multivariate statistical analysis". Journal of Mass Spectrometry. 37 (1): 69–75. Bibcode:2002JMSp...37...69A. doi:10.1002/jms.260. PMID 11813313.
  6. ^ Page Module:Citation/CS1/styles.css has no content.Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 485. ISBN 978-3-527-60749-5.
  7. ^ Page Module:Citation/CS1/styles.css has no content.World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
  8. ^ Page Module:Citation/CS1/styles.css has no content."The Top 300 of 2023". ClinCalc. Archived from the original on 17 August 2025. Retrieved 17 August 2025.
  9. ^ Page Module:Citation/CS1/styles.css has no content."Betamethasone Drug Usage Statistics, United States, 2014 - 2023". ClinCalc. Retrieved 17 August 2025.
  10. ^ Page Module:Citation/CS1/styles.css has no content."Betamethasone Topical". MedlinePlus. 19 March 2020. Retrieved 29 March 2020.
  11. ^ Page Module:Citation/CS1/styles.css has no content.Zannolli R, Buoni S, Betti G, Salvucci S, Plebani A, Soresina A, et al. (September 2012). "A randomized trial of oral betamethasone to reduce ataxia symptoms in ataxia telangiectasia". Movement Disorders. 27 (10): 1312–1316. doi:10.1002/mds.25126. PMID 22927201. S2CID 23696748.
  12. ^ a b Page Module:Citation/CS1/styles.css has no content.Moreno G, Ramirez C, Corbalán J, Peñaloza B, Morel Marambio M, Pantoja T (January 2024). "Topical corticosteroids for treating phimosis in boys". The Cochrane Database of Systematic Reviews. 1 (1) CD008973. doi:10.1002/14651858.CD008973.pub3. PMC 10809033. PMID 38269441.
  13. ^ Page Module:Citation/CS1/styles.css has no content.Van Howe RS (October 1998). "Cost-effective treatment of phimosis". Pediatrics. 102 (4) E43. doi:10.1542/peds.102.4.e43. PMID 9755280. A review of estimated costs and complications of 3 phimosis treatments.
  14. ^ Page Module:Citation/CS1/styles.css has no content.Esposito C, Centonze A, Alicchio F, Savanelli A, Settimi A (April 2008). "Topical steroid application versus circumcision in pediatric patients with phimosis: a prospective randomized placebo controlled clinical trial". World Journal of Urology. 26 (2). Springer Science and Business Media LLC: 187–190. doi:10.1007/s00345-007-0231-2. PMID 18157674. S2CID 8922151.
  15. ^ Page Module:Citation/CS1/styles.css has no content.Zampieri N, Corroppolo M, Zuin V, Bianchi S, Camoglio FS (April 2007). "Phimosis and topical steroids: new clinical findings". Pediatric Surgery International. 23 (4): 331–335. doi:10.1007/s00383-007-1878-x. PMID 17308904. S2CID 22849471.
  16. ^ Page Module:Citation/CS1/styles.css has no content.Berdeu D, Sauze L, Ha-Vinh P, Blum-Boisgard C (February 2001). "Cost-effectiveness analysis of treatments for phimosis: a comparison of surgical and medicinal approaches and their economic effect". BJU International. 87 (3): 239–244. doi:10.1046/j.1464-410x.2001.02033.x. PMID 11167650. S2CID 2161551.
  17. ^ Page Module:Citation/CS1/styles.css has no content.Chu CC, Chen KC, Diau GY (September 1999). "Topical steroid treatment of phimosis in boys". The Journal of Urology. 162 (3 Pt 1): 861–863. doi:10.1097/00005392-199909010-00078. PMID 10458396.
  18. ^ a b c d e f g Page Module:Citation/CS1/styles.css has no content."betamethasone" (PDF). F.A. Davis. 2017. Archived (PDF) from the original on 8 September 2017. Retrieved 7 March 2017.
  19. ^ Page Module:Citation/CS1/styles.css has no content."FDA Drug Safety Communication: FDA requires label changes to warn of rare but serious neurologic problems after epidural corticosteroid injections for pain". FDA. 23 April 2014. Archived from the original on 11 August 2016. Retrieved 15 August 2016.
  20. ^ Page Module:Citation/CS1/styles.css has no content."Celestone Soluspan- betamethasone acetate and betamethasone sodium phosphate injection, suspension". DailyMed. 18 November 2019. Retrieved 29 March 2020.

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