Generic Name and Formulations:
Betamethasone acetate 3mg/mL; for IM, intra-articular or intralesional inj.
Various generic manufacturers
Steroid-responsive disorders when oral therapy not feasible.
See literature. Individualize. Titrate to lowest effective dose. Usual range: 0.25–9mg/day.
See literature. Individualize. Titrate to lowest effective dose. Initially 0.02–0.3mg/kg/day in 3 or 4 divided doses.
IM inj with idiopathic thrombocytopenic purpura.
Avoid IV administration. Not for treating traumatic brain injury or optic neuritis. Concomitant systemic fungal infections, active ocular herpes simplex, cerebral malaria, live vaccines: not recommended. Latent or active amebiasis. Strongyloides infection. Tuberculosis. If exposed to chickenpox or measles, consider prophylactic passive immune therapy. CHF. Recent MI. Hypertension. Renal insufficiency. Peptic ulcers. Diverticulitis. Intestinal anastomoses. Ulcerative colitis. Cirrhosis. Unstable or infected joints. Postmenopausal women (osteoporosis risk). Supplement with additional steroids in physiologic stress. Emotional instability. Psychotic tendencies. Myasthenia gravis. Avoid abrupt cessation. Monitor thyroid, weight, growth, fluid, electrolyte balance and intraocular pressure (w. therapy >6weeks). Pregnancy (Cat.C). Nursing mothers.
Potentiated by CYP3A4 inhibitors (eg, ketoconazole, macrolides), cyclosporine, estrogens. Antagonized by CYP3A4 inducers (eg, barbiturates, phenytoin, carbamazepine, rifampin). May potentiate cyclosporine (seizure risk). May antagonize anticoagulants (monitor), isoniazid, other CYP3A4 substrates (eg, indinavir, erythromycin). Increased risk of arrhythmias with digitalis. May need to adjust dose of antidiabetic agents. Increased GI effects with aspirin. Monitor for hypokalemia with potassium-depleting drugs (eg, amphotericin B, diuretics). Concomitant neuromuscular blocking agents; increased risk of myopathy. Withdraw anticholinesterase agents at least 24hrs before initiating corticosteroid therapy. Aminoglutethimide may lead to loss of corticosteroid-induced adrenal suppression. May suppress reactions to skin tests.
HPA axis suppression, masks infection, increased susceptibility to infection, glaucoma, cataracts, secondary infections, hypokalemia, hypocalcemia, hypernatremia, hypertension, psychic disorders, myopathy, osteoporosis, peptic ulcer, dermal atrophy, increased intracranial pressure, carbohydrate and glucose intolerance, inj site reactions; Kaposi's sarcoma, anaphylactoid reactions.
Formerly known under the brand name Celestone.
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