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]
Quick Facts Clinical data, Trade names ...
Betamethasone |
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Trade names | Celestone, Eleuphrat, others |
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AHFS/Drugs.com | Monograph |
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MedlinePlus | a682799 |
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License data |
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Pregnancy category | |
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Routes of administration | By mouth, topical, intramuscular |
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ATC code | |
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Legal status |
- AU: S4 (Prescription only)
- UK: POM (Prescription only)[2]
- US: ℞-only
- In general: ℞ (Prescription only)
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Metabolism | Liver CYP3A4 |
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Elimination half-life | 36-54 hours |
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Excretion | Kidney (in urine) |
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(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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UNII | |
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CompTox Dashboard (EPA) | |
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ECHA InfoCard | 100.006.206 |
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Formula | C22H29FO5 |
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Molar mass | 392.467 g·mol−1 |
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3D model (JSmol) | |
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O=C(CO)[C@]3(O)[C@]2(C[C@H](O)[C@]4(F)[C@@]/1(\C(=C/C(=O)\C=C\1)CC[C@H]4[C@@H]2C[C@@H]3C)C)C
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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 YKey:UREBDLICKHMUKA-DVTGEIKXSA-N Y
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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] The cream and ointment are on the World Health Organization's List of Essential Medicines.[7] It is available as a generic medication.[3] In 2021, it was the 251st most commonly prescribed medication in the United States, with more than 1 million prescriptions.[8][9]
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 lung maturation in order to prevent infant respiratory distress syndrome (IRDS) and to decrease the incidence and mortality from intracranial hemorrhage in premature infants.[original research?]
A cream with 0.05% betamethasone appears effective in treating phimosis in boys,[12][needs update] and often averts the need for circumcision.[13][14][15] It has replaced circumcision as the preferred treatment method for some physicians in the British National Health Service.[16][17]
Prolonged use of this medicine on extensive areas of skin, broken or raw skin, skin folds, or underneath airtight dressings may on rare occasions result in enough corticosteroid being absorbed to have side effects on other parts of the body; for example, by causing a decrease in the production of natural hormones by the adrenal glands.[original research?]
Betamethasone is also used prior to delivery of a preterm baby to help prepare the lungs for breathing. However, because betamethasone crosses the placenta, which is required for its beneficial effects, it may also be associated with complications, such as hypoglycemia and leukocytosis in newborns exposed in utero.[original research?]
When injected into the epidural space or the spine, it may cause serious side effects like loss of vision, stroke, and paralysis.[19]
| This section relies largely or entirely on a single source. (November 2023) |
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]
"Betamethasone". The American Society of Health-System Pharmacists. Archived from the original on 8 December 2015. Retrieved 2 December 2015. 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. World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO. 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. 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. "betamethasone" (PDF). F.A. Davis. 2017. Archived (PDF) from the original on 8 September 2017. Retrieved 7 March 2017.