Home Drug Guide Betamethasone Dipropionate

Drug Guide

Generic Name

Betamethasone Dipropionate

Brand Names Diprosone, Diprolene, Alphatrex, Diprolene Af, Sernivo

Classification

Therapeutic: Anti-inflammatory, corticosteroid

Pharmacological: Glucocorticoid

FDA Approved Indications

Inflammatory skin conditions (eczema, psoriasis, dermatitis)
Itching and swelling associated with these conditions

Mechanism of Action

Betamethasone Dipropionate binds to glucocorticoid receptors, leading to modulation of gene expression that results in anti-inflammatory, immunosuppressive, and antiproliferative effects on skin cells.

Dosage and Administration

Adult: Apply a thin layer to affected skin once daily, as directed by physician.

Pediatric: Use with caution; consult specific guidelines. Usually similar application as adults, but monitor for systemic effects.

Geriatric: Use with caution; reduced clearance may occur, monitor for adverse effects.

Renal Impairment: No specific dosage adjustments necessary.

Hepatic Impairment: No specific dosage adjustments necessary.

Pharmacokinetics

Absorption: Minimal systemic absorption when used topically, but absorption can increase with prolonged use or application to large surface areas.

Distribution: Low plasma protein binding when absorbed systemically.

Metabolism: Metabolized in the liver via hepatic enzymes.

Excretion: Excreted primarily in urine.

Half Life: Approximately 36-54 hours when absorbed systemically.

Contraindications

Hypersensitivity to betamethasone dipropionate or other corticosteroids.

Precautions

Use with caution in skin infections, including tuberculosis or fungal infections. Avoid applying to broken or ulcerated skin. Prolonged use may lead to skin atrophy, systemic absorption, and hypothalamic-pituitary-adrenal (HPA) axis suppression.
Pregnancy category C; use only if potential benefits justify risks. Breastfeeding considerations: small amounts may pass into breast milk.

Adverse Reactions - Common

Skin itching, burning, irritation (Common)
Skin atrophy, striae, telangiectasia (Less common)

Adverse Reactions - Serious

Hypopigmentation, systemic corticosteroid effects (hyperglycemia, Cushingoid features), adrenal suppression (Rare, with extensive or prolonged use)

Drug-Drug Interactions

Potent CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) may increase systemic corticosteroid levels.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor skin condition for improvement or adverse effects. Assess for signs of systemic absorption or HPA suppression during prolonged therapy.

Diagnoses:

Risk for skin atrophy, infection, or systemic corticosteroid effects.

Implementation: Apply as prescribed, avoid occlusion unless directed. Use the lowest effective dose for the shortest duration.

Evaluation: Verify resolution of skin inflammation, monitor for adverse effects, and adjust therapy accordingly.

Patient/Family Teaching

Use medication exactly as prescribed. Do not cover the treated area with occlusive bandages unless instructed.
Report signs of skin thinning, new infections, or systemic symptoms.
Avoid applying to face, groin, or underarms unless directed.

Special Considerations

Black Box Warnings:

Prolonged use of topical corticosteroids can lead to systemic absorption resulting in HPA suppression, especially in children.
Use caution in fragile skin areas.

Genetic Factors: Variations in glucocorticoid receptor sensitivity may affect response.

Lab Test Interference: May increase blood glucose levels during systemic absorption.

Overdose Management

Signs/Symptoms: Features of systemic corticosteroid excess, such as Cushing syndrome, hyperglycemia.

Treatment: Discontinue corticosteroid use gradually to prevent adrenal insufficiency. Supportive therapy as needed.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F). Keep away from heat and flame.

Stability: Stable until expiration date given on package.