Betamethasone

Reviewed on 8/19/2021

What Is Betamethasone and How Does It Work?

Betamethasone is a prescription medication use to treat conditions such as allergic reactions, dermatologic disease, endocrine disorders, gastrointestinal disease, hematologic disorders, neoplastic disease, ophthalmic diseases, renal diseases, rheumatic disorders, and disorders affecting the nervous system.

  • Betamethasone is available under the following different brand names: Celestone, Celestone Soluspan, Betaject, and Betamethasone IM/PO.

What Are Dosages of Betamethasone?

Dosages of Betamethasone:

Adult and Pediatric Dosages:

Injectable Suspension

  • 6 mg/ml

Oral Solution

  • 0.6 mg/5 ml

Dosage Considerations – Should be Given as Follows:

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

Adult Dosage:

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

Pediatric Dosage:

  • 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

Rheumatoid Arthritis/Osteoarthritis

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

Adrenal Insufficiency

Pediatric only

  • 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

  • Base dosage on severity of disease and patient response

Other Indications and Uses

QUESTION

Ringworm is caused by a fungus. See Answer

What Are Side Effects Associated with Using Betamethasone?

Common side effects of betamethasone include:

  • abdominal bloating
  • abdominal fat deposits
  • abnormal hair growth
  • abscess
  • acne
  • adrenal suppression
  • blindness
  • blot clots
  • blurred vision
  • bowel/bladder dysfunction
  • break in the stomach lining
  • brittle bones/fractures
  • bulging of the eyes
  • calcium deposits in the skin
  • cardiac arrest
  • cataracts
  • cell death of bone components
  • changes in the skin layers (cutaneous and subcutaneous atrophy)
  • circulatory collapse
  • congestive heart failure
  • contact allergy
  • convulsions (seizures)
  • Cushingoid state
  • darkening of the skin
  • decreased carbohydrate tolerance
  • decreased glucose tolerance
  • decreased resistance to infection
  • delayed wound healing
  • depression
  • diabetes mellitus
  • difficulty falling asleep
  • discoloring of the skin
  • dizziness
  • dry scaly skin
  • elevation of serum liver enzyme levels
  • emotional instability
  • enlarged heart
  • enlarged liver
  • excess spinal fluid within the skull (on withdrawal)
  • fainting
  • fast heart rate
  • fat embolism
  • feeling unwell (malaise)
  • fluid in the lungs
  • fluid retention
  • fluid/electrolyte disturbances
  • glaucoma
  • headache
  • heart attack (myocardial infarction)
  • hiccups
  • high blood pressure (hypertension)
  • hives
  • increased appetite
  • increased pressure in the eye
  • increased requirements for insulin
  • increased sweating
  • increased/decreased sperm count
  • indigestion
  • inflammation of veins/blood vessels
  • inflammation of nerves
  • inflammation of the membrane covering the brain
  • intense excitement
  • irregular heartbeats
  • itching
  • joint pain and loss of sensation in foot and ankle
  • loss of muscle mass
  • loss of skin color
  • low blood potassium with increased pH
  • male-pattern hair growth in women
  • mood swings
  • moon face or round appearance due to fat deposits
  • muscle disease
  • muscle weakness
  • nausea
  • nervousness
  • numbness and tingling
  • oral hypoglycemic adrenocortical and pituitary unresponsiveness
  • pain
  • pancreatitis
  • partial paralysis/paralysis of the legs
  • perforation of the intestine
  • personality changes
  • post-injection flare (heat, redness, swelling, and pain)
  • potassium loss
  • psychotic disorders
  • rash
  • round spots on the skin
  • sensory disturbances
  • severe allergic reaction (anaphylactic reaction)
  • skin dryness (topical)
  • skin redness (topical)
  • skin swelling
  • slow heart rate
  • sodium retention
  • spinning sensation (vertigo)
  • stretchmarks
  • sugar in the urine
  • suppressed reactions to skin tests
  • suppression of growth in children
  • swelling
  • tendon rupture
  • thin fragile skin
  • thinning scalp hair
  • ulcerative esophagitis
  • vertebral compression fracture
  • weight gain

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

What Other Drugs Interact with Betamethasone?

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

Interactions of betamethasone include:

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more information about this medicine.

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What Are Warnings and Precautions for Betamethasone?

Warnings

This medication contains betamethasone. Do not take Celestone, Celestone Soluspan, Betaject, or Betamethasone Intramuscular/Oral if you are allergic to betamethasone or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

  • Systemic fungal infection
  • Hypersensitivity to betamethasone
  • Traumatic brain injury (high doses)
  • Untreated serious infections
  • Administration of live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids

Effects of Drug Abuse

  • None

Short-Term Effects

  • See "What Are Side Effects Associated with Using Betamethasone?"

Long-Term Effects

  • See "What Are Side Effects Associated with Using Betamethasone?"

Cautions

  • Cirrhosis, ocular herpes simplex, hypertension, diverticulitis, hypothyroidism, myasthenia gravi, peptic ulcer disease, osteoporosis, ulcerative colitis, psychotic tendencies, untreated systemic infections, renal insufficiency, and pregnancy
  • Not effective in the treatment of respiratory distress syndrome in premature neonates
  • Minimal sodium retention activity: however, may increase with high doses
  • If used to treat adrenocortical insufficiency should also use mineralocorticoid
  • Thromboembolic disorders
  • Myopathy
  • Delayed wound healing
  • Patients receiving corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated
  • Latent tuberculosis may be reactivated (monitor patients with positive tuberculin test)
  • Some suggestions of slightly increased cleft palate risk if corticosteroids are used in pregnancy, but not fully substantiated
  • Prolonged corticosteroid use may result in elevated pressure in the eye, glaucoma, and/or cataracts
  • Killed or inactivated vaccines may be administered; however, the response to such vaccines cannot be predicted
  • Immunization procedures may be undertaken in patients who are receiving corticosteroids as replacement therapy in physiologic doses (Addison's disease)
  • Epidural injection:
    • Serious neurologic events, some resulting in death, have been reported with epidural injection
    • Specific events reported include, but are not limited to, spinal cord infarction, paraplegia, quadriplegia, cortical blindness, and stroke
    • These serious neurologic events have been reported with and without the use of fluoroscopy
    • The safety and effectiveness of epidural administration of corticosteroids have not been established, and corticosteroids are not approved for this use

Pregnancy and Lactation

  • Use betamethasone during pregnancy with caution if the benefits outweigh the risks. Animal studies show risk and human studies are not available, or neither animal nor human studies were done.
  • If breastfeeding, systemically administered corticosteroids enter the breast milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other effects; use with caution if breastfeeding. Consult your doctor.
References
Medscape. Betamethasone.
https://reference.medscape.com/drug/celestone-soluspan-betamethasone-342740#0
RxList. Celestone Soluspan.
https://www.rxlist.com/celestone-soluspan-drug.htm#side_effects_interactions

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