Home Drug Guide Betamethasone Sodium Phosphate

Drug Guide

Generic Name

Betamethasone Sodium Phosphate

Brand Names Celestone

Classification

Therapeutic: Anti-inflammatory, corticosteroid

Pharmacological: Glucocorticoid

FDA Approved Indications

Management of allergic conditions, dermatologic conditions, rheumatic disorders, flares of chronic respiratory illnesses, adrenal insufficiency, and cerebral edema

Mechanism of Action

Betamethasone suppresses inflammation and modifies the immune response by inhibiting multiple pro-inflammatory mediators and cytokines, leading to decreased edema, fibrosis, and immune cell infiltration.

Dosage and Administration

Adult: Dosage varies depending on the condition; typically 0.6 mg/kg administered IM or IV, possibly repeated daily or as needed.

Pediatric: Doses are weight-based; usually 0.1-0.2 mg/kg per day, administered IM, IV, or orally.

Geriatric: Dose adjustments based on renal function and comorbidities are recommended; start at lower end of dosing range.

Renal Impairment: Use with caution; monitor for increased effects and toxicity.

Hepatic Impairment: Adjust dose as needed; monitor for altered drug metabolism.

Pharmacokinetics

Absorption: Rapid absorption after IM or IV administration.

Distribution: Widely distributed in body tissues; crosses the placenta and enters breast milk.

Metabolism: Primarily hepatic metabolism via CYP3A4.

Excretion: Excreted mainly in urine as metabolites.

Half Life: Approximately 36-54 hours.

Contraindications

Fungal infections

Precautions

Use with caution in patients with systemic infections, peptic ulcer, osteoporosis, surgery or trauma, and patients with mental health disorders. Monitor glucose in diabetics. Avoid live vaccines during therapy.

Adverse Reactions - Common

Fluid retention, edema (Common)
Increased appetite (Common)
Insomnia (Common)

Adverse Reactions - Serious

Adrenal suppression (Rare)
Hypothyroidism or hyperglycemia (Rare)
Osteoporosis (Rare)
Infections due to immunosuppression (Rare)

Drug-Drug Interactions

NSAIDs increasing risk of GI bleeding
Vaccines: live vaccines contraindicated during therapy
CYP3A4 inhibitors (e.g., ketoconazole) may increase steroid levels

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of infection, blood glucose levels, electrolyte imbalances, and signs of adrenal suppression.

Diagnoses:

Risk for infection
Imbalanced nutrition: less than body requirements
Risk for osteoporosis

Implementation: Administer with food or milk to reduce GI upset. Taper dose gradually if used long-term.

Evaluation: Assess for resolution of symptoms, monitor blood glucose, and watch for adverse effects.

Patient/Family Teaching

Do not stop medication abruptly.
Report signs of infection or unusual symptoms.
Avoid live vaccines during therapy.
Follow dosing schedule precisely.

Special Considerations

Black Box Warnings:

Potential for immune suppression leading to increased susceptibility to infections, including tuberculosis.
Use with caution in pediatrics and chronic use may cause growth retardation.

Genetic Factors: Limited data on genetic differences affecting metabolism.

Lab Test Interference: May increase serum glucose, sodium, and potash; may decrease potassium levels.

Overdose Management

Signs/Symptoms: Symptoms of steroid overdose include hyperglycemia, edema, hypertension, and acute adrenal suppression.

Treatment: Discontinue medication gradually; supportive care as needed; no specific antagonist.

Storage and Handling

Storage: Store at room temperature away from light and moisture.

Stability: Stable for 2-3 years when stored properly.