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ALIMENTARY TRACT AND METABOLISM › ANTIDIARRHEALS, INTESTINAL ANTIINFLAMMATORY/ANTIINFECTIVE AGENTS › INTESTINAL ANTIINFLAMMATORY AGENTS › Corticosteroids acting locally
betamethasone
A07EA04
Forms & Strengths
- Enema: 0.05% (as sodium phosphate)
- Suppositories: 1 mg
- Oral tablet: 0.6 mg, 1 mg
- Oral syrup: 0.6 mg/5 mL
Adult Dosing
- Ulcerative colitis (rectal): 5 mg (as sodium phosphate) nightly for 2 to 4 weeks
- Corticosteroid-responsive conditions (oral): 0.6 mg to 7.2 mg daily in divided doses, adjusted based on response
Pediatric Dosing
- Safety and efficacy in pediatric patients for rectal formulations not established
- Oral: 0.017 mg/kg to 0.25 mg/kg daily in divided doses every 6 to 8 hours
Indications
- Induction of remission in ulcerative colitis (rectal administration)
- Adjunctive treatment of severe corticosteroid-responsive inflammatory conditions
Mechanism of Action
- Synthetic glucocorticoid with potent anti-inflammatory, immunosuppressive, and antiproliferative properties
- Binds to glucocorticoid receptors, inhibiting inflammatory cytokine production and leukocyte infiltration
Contraindications
- Systemic fungal infections
- Known hypersensitivity to betamethasone or components
- Administration of live or live-attenuated vaccines while on immunosuppressive doses
Adverse Reactions
- Local rectal irritation (with enema/suppository use)
- Systemic absorption risks: adrenal suppression, Cushingoid features, hyperglycemia, hypertension
- Osteoporosis, increased infection susceptibility, psychiatric disturbances with prolonged systemic exposure
Drug Interactions
- CYP3A4 inducers (e.g., rifampin, carbamazepine) decrease betamethasone concentrations
- CYP3A4 inhibitors (e.g., ketoconazole) increase systemic exposure risks
- NSAIDs increase risk of gastrointestinal ulceration
- Antidiabetic agents: glucocorticoids antagonize hypoglycemic effects
Curated Content: Needs Vetting Before Put to Clinical Use