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RESPIRATORY SYSTEM › DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES, INHALANTS › Glucocorticoids
betamethasone
R03BA04
Forms & Strengths
- Inhalation aerosol: 100 mcg/actuation
- Oral syrup: 0.6 mg/5 mL
- Oral tablets: 0.6 mg
- Injection solution: 3 mg/mL, 6 mg/mL
Adult Dosing
- Asthma (Inhalation): 200 to 800 mcg twice daily
- Systemic inflammation (Oral/IV/IM): 0.6 to 7.2 mg daily in divided doses depending on disease severity
- Bursitis/tendinitis (Intrabursal/intra-articular): 0.4 to 6 mg depending on joint size
Pediatric Dosing
- Asthma (Inhalation, children >6 years): 100 to 200 mcg twice daily
- Systemic inflammation (Oral/IV): 0.03 to 0.15 mg/kg/day divided every 6 to 12 hours
Indications
- Bronchial asthma
- Severe allergic and inflammatory conditions
- Rheumatologic disorders
- Fetal lung maturation (antenatal administration)
Mechanism of Action
- Potent glucocorticoid with high anti-inflammatory and immunosuppressive potency
- Binds to cytosolic glucocorticoid receptors, modulating gene transcription, inhibiting leukocyte infiltration, and suppressing inflammatory cytokine production
Contraindications
- Systemic fungal infections
- Hypersensitivity to betamethasone or other corticosteroids
- Administration of live or live-attenuated vaccines while on immunosuppressive doses
Adverse Reactions
- Fluid retention, hypertension, and weight gain
- Hyperglycemia and impaired glucose tolerance
- Immunosuppression and increased risk of secondary infections
- Hypothalamic-pituitary-adrenal (HPA) axis suppression
- Osteoporosis and increased fracture risk with long-term use
- Mood changes, insomnia, and psychiatric disturbances
Drug Interactions
- CYP3A4 inducers (e.g., rifampin, carbamazepine) decrease betamethasone plasma concentrations
- CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) increase betamethasone exposure
- Nonsteroidal anti-inflammatory drugs (NSAIDs) increase risk of gastrointestinal ulceration
- Diuretics (e.g., furosemide, thiazides) enhance potassium-wasting effects
- Antidiabetic agents: corticosteroids antagonize hypoglycemic effects, requiring dosage adjustment
Curated Content: Needs Vetting Before Put to Clinical Use