Betamethasone

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Betamethasone
Systematic (IUPAC) name
(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
Identifiers
CAS number	378-44-9
ATC code	A07EA04 C05AA05 D07AC01 D07XC01 H02AB01 R01AD06 R03BA04 S01BA06 S01CB04 S02BA07 S03BA03
PubChem	9782
DrugBank	APRD00513
ChemSpider	9399
Chemical data
Formula	C22H29FO5
Mol. mass	392.461
Pharmacokinetic data
Bioavailability	?
Metabolism	hepatic CYP3A4
Half life	5.6 hours
Excretion	?
Therapeutic considerations
Pregnancy cat.	C(US)
Legal status	℞ Prescription only
Routes	oral or topical

Betamethasone is a moderately potent glucocorticoid steroid with anti-inflammatory and immunosuppressive properties. Unlike other drugs with these effects, betamethasone does not cause water retention. It is applied as a topical cream, ointment, foam, lotion or gel to treat itching (e.g. from eczema). Betamethasone sodium phosphate is sometimes prescribed as an intramuscular injection (I.M) for itching from various ailments including allergic reactions to poison ivy and similar plants.

The compound is available as a number of ester derivatives: Dipropionate (branded as Diprosone, Diprolene and others), Sodium Phosphate and Valerate (branded as Betnovate, Celestone and others). In the United States and Canada, Betamethasone is mixed with Clotrimazole and sold as Lotrisone.

Indications

Betamethasone is a corticosteroid used to stimulate fetal lung maturation, and to decrease the incidence and mortality from intracranial hemorrhage in premature infants.

It is also used as a topical cream to relieve skin irritation. The tablet form, available in Japan, eradicates eczematous rash within 24 hours, far more rapidly than the ointment.

0.05% Betamethasone cream appears effective in treating phimosis in boys, and often averts the need for circumcision.

Betamethasone sodium phosphate is used orally and via injection with the same indications as other steroids.

Betamethasone Dipropionate and Salicylic Acid can be used as a treatment for Local Psoriasis.

Side effects

The side effects of Betamethasone (as every glucocorticoid) are very severe: diabetes mellitus type 2, insulin resistance, hypogonadism, osteoporosis, depression.

Fetal risk

As it crosses the placenta, which is required for its beneficial effects, it may also be associated with complications, such as hypoglycemia and leucocytosis in newborns exposed in utero.

Notes

While betamethasone is commonly applied topically to treat skin inflammation, persistent application of large quantities may result in a more severe rebound inflammation when the medication is withdrawn, sometimes called "Betnovate face".

A tube of 'Betnovate ointment' cream and its box.

External links

• "Betamethasone". safefetus.com. http://www.safefetus.com/DrugDetail.asp?DrugId=709&TradeName=Betaval&TradeId=775. 
• "Betamethasone". Pharmacy Services. Medical University of South Carolina. http://www.musc.edu/pharmacyservices/Drugs/B/Betamethasone.htm. 

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