Drug Detail:Betamethasone (systemic) (monograph) (Celestone soluspan)
Drug Class:
Usual Adult Dose for Dermatological Disorders
Injectable 30 mg/5 mL suspension:
Intralesional treatment: 0.2 mL/cm2 intradermally (do not give subcutaneously) using a tuberculin syringe with a 25 gauge half inch needle
- Use care to make a uniform intradermal depot
Comments:
- Dose requirements are variable; individualize dose based on disease and patient response.
- When a favorable response is achieved, determine maintenance dose by decreasing the dosage in small decrements; use the smallest dose needed for adequate clinical response.
- Withdraw long-term therapy gradually.
Usual Adult Dose for Bursitis
Injectable 30 mg/5 mL suspension:
Acute subdeltoid, subacromial, olecranon, and prepatellar bursitis: 1 mL intrabursal injection
Chronic bursitis: Reduce dosage once acute condition is controlled.
Tenosynovitis and Tendinitis: 3 to 4 local injections, 1 to 2 weeks apart; inject into affected tendon sheaths rather than the tendons themselves
Ganglions of joint capsules and tendon sheaths: 0.5 mL directly into ganglion cyst produced marked lesion size reduction
Comments:
- Several intrabursal injections are usually necessary for acute bursitis and acute exacerbations of chronic bursitis; partial pain relief and increased mobility can be expected after 1 or 2 injections.
- Dose requirements are variable; individualize dose based on disease and patient response.
- When a favorable response is achieved, determine maintenance dose by decreasing the dosage in small decrements; use the smallest dose needed for adequate clinical response.
- Withdraw long-term therapy gradually.
Uses: Adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis, acute and subacute bursitis, acute nonspecific tenosynovitis, epicondylitis, rheumatoid arthritis, and synovitis of osteoarthritis.
Usual Adult Dose for Synovitis
Injectable 30 mg/5 mL suspension:
Acute subdeltoid, subacromial, olecranon, and prepatellar bursitis: 1 mL intrabursal injection
Chronic bursitis: Reduce dosage once acute condition is controlled.
Tenosynovitis and Tendinitis: 3 to 4 local injections, 1 to 2 weeks apart; inject into affected tendon sheaths rather than the tendons themselves
Ganglions of joint capsules and tendon sheaths: 0.5 mL directly into ganglion cyst produced marked lesion size reduction
Comments:
- Several intrabursal injections are usually necessary for acute bursitis and acute exacerbations of chronic bursitis; partial pain relief and increased mobility can be expected after 1 or 2 injections.
- Dose requirements are variable; individualize dose based on disease and patient response.
- When a favorable response is achieved, determine maintenance dose by decreasing the dosage in small decrements; use the smallest dose needed for adequate clinical response.
- Withdraw long-term therapy gradually.
Uses: Adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis, acute and subacute bursitis, acute nonspecific tenosynovitis, epicondylitis, rheumatoid arthritis, and synovitis of osteoarthritis.
Usual Adult Dose for Gouty Arthritis
Injectable 30 mg/5 mL suspension:
Acute gouty arthritis: 0.5 to 1 mL every 3 days to weekly
- A tuberculin syringe with a 25-gauge three quarter inch needle is suitable for most foot injections
Comments:
- Dose requirements are variable; individualize dose based on disease and patient response.
- When a favorable response is achieved, determine maintenance dose by decreasing the dosage in small decrements; use the smallest dose needed for adequate clinical response.
- Withdraw long-term therapy gradually.
Usual Adult Dose for Osteoarthritis
Injectable 30 mg/5 mL suspension: 0.5 to 2 mL intraarticular injection
Very large joint (hip): 1 to 2 mL
Large joint (knee, ankle, shoulder): 1 mL
Medium joint (elbow, wrist): 0.5 to 1 mL
Small joint (metacarpophalangeal, interphalangeal, sternoclavicular, hand, chest): 0.25 to 0.5 mL
Comments:
- Duration of relief varies widely.
- Intraarticular injection relieves pain, soreness, and stiffness; the injection is usually almost painless.
- A portion of the dose is systemically absorbed; consider any concomitant oral or parenteral corticosteroids (especially if high dose) in determining the intraarticular dose.
- Dose requirements are variable; individualize dose based on disease and patient response.
- When a favorable response is achieved, determine maintenance dose by decreasing the dosage in small decrements; use the smallest dose needed for adequate clinical response.
- Withdraw long-term therapy gradually.
Uses: Adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis; acute rheumatic carditis; ankylosing spondylitis; psoriatic arthritis; rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy).
Usual Adult Dose for Rheumatoid Arthritis
Injectable 30 mg/5 mL suspension: 0.5 to 2 mL intraarticular injection
Very large joint (hip): 1 to 2 mL
Large joint (knee, ankle, shoulder): 1 mL
Medium joint (elbow, wrist): 0.5 to 1 mL
Small joint (metacarpophalangeal, interphalangeal, sternoclavicular, hand, chest): 0.25 to 0.5 mL
Comments:
- Duration of relief varies widely.
- Intraarticular injection relieves pain, soreness, and stiffness; the injection is usually almost painless.
- A portion of the dose is systemically absorbed; consider any concomitant oral or parenteral corticosteroids (especially if high dose) in determining the intraarticular dose.
- Dose requirements are variable; individualize dose based on disease and patient response.
- When a favorable response is achieved, determine maintenance dose by decreasing the dosage in small decrements; use the smallest dose needed for adequate clinical response.
- Withdraw long-term therapy gradually.
Uses: Adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis; acute rheumatic carditis; ankylosing spondylitis; psoriatic arthritis; rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy).
Usual Pediatric Dose for Anti-inflammatory
Injectable 30 mg/5 mL suspension:
Initial dose: 0.02 to 0.3 mg/kg/day intramuscularly in 3 or 4 divided doses
Comments:
- Dose requirements are variable; individualize dose based on disease and patient response.
- When a favorable response is achieved, determine maintenance dose by decreasing the dosage in small decrements; use the smallest dose needed for adequate clinical response.
- Withdraw long-term therapy gradually.
- Benzyl alcohol preservative is associated with fatal "Gasping Syndrome" in premature and low birth weight infants; use preservative free formulations for neonates, especially premature infants.
Renal Dose Adjustments
Use with caution.
Liver Dose Adjustments
Data not available
Dose Adjustments
Dose adjustments may be needed for changes in clinical status due to remission or exacerbation of the disease, individual drug responsiveness, and exposure to stress.
Precautions
CONTRAINDICATIONS:
- Hypersensitivity to any of the ingredients
- Intramuscular formulations are contraindicated in idiopathic thrombocytopenic purpura
- Administration of live vaccines is contraindicated in patients on immunosuppressive doses of corticosteroids
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
IV compatibility:
- May combine with 1% or 2% lidocaine hydrochloride (non-parabens formulations) for local anesthesia; add lidocaine into the betamethasone filled syringe and shake briefly - do not inject anesthetic into the betamethasone bottle.
- Avoid diluents with methylparaben, propylparaben, phenol, etc. as flocculation of the steroid may occur.
Patient advice:
- Warn patients not to discontinue this drug abruptly or without medical supervision.
- Seek medical attention for fever or other signs of infection.
- Avoid exposure to chickenpox and measles; if exposed, seek medical attention promptly.
Frequently asked questions
- Is betamethasone the same as hydrocortisone?
- What is Ardosons called in the U.S?
- What is Diprospan used for?
- Can I use the cream on my face?
- How long does it take for betamethasone to work?
- Can betamethasone be used for a yeast infection?
- What causes Plaque Psoriasis?
- Can Enstilar be used on the scalp?
- How do OTC products compare to betamethasone topical?
- What skin conditions can betamethasone be used for?
- Is Enstilar Foam used to treat plaque psoriasis?
- Where should I avoid using betamethasone?
- Is this an antifungal drug?
- How long can you use the cream for?
- Does Luxiq Foam help with hair loss?
