Betamethasone

Pharmacological properties

Betamethasone, a synthetic glucocorticoid for external use, exhibits high glucocorticoid activity and minimal mineralocorticoid effect. It has anti-inflammatory, anti-allergic and vasoconstrictive effects. due to this, it is used to treat dermatoses sensitive to the action of corticosteroids.

Pharmacokinetics When applied topically, betamethasone may be slightly absorbed by normal intact skin, systemic absorption of corticosteroids is expected only under adverse conditions (long-term treatment, occlusive dressing). After penetration into the skin, the pharmacokinetics profile of local corticosteroids is similar to that of systemic corticosteroids.

Corticosteroids bind to plasma proteins to varying degrees, are mainly metabolized in the liver and excreted in the urine.

Some topical corticosteroids and their metabolites are excreted with bile.

Indications

Treatment of dermatoses sensitive to therapy with potent corticosteroids, such as psoriasis; initial treatment for severe atopic eczema.

Application

Beloderm ointment / cream is applied in a thin layer to the affected skin several times a day, depending on the severity.

Mode of application

Apply a sufficient amount of ointment / cream with a thin layer to completely cover the affected areas of the skin, and gently rub. If the condition improves, the frequency of application can be reduced. Avoid prolonged use of Beloderm or applying ointment / cream to large areas (more than 20% of the body surface). This also applies to the treatment of more than 10% of the body surface for more than 1 week.

After improving the clinical picture, the use of a weak corticosteroids is often recommended.

The so-called tandem therapy approach is often recommended, which consists in the use of Beloderm 1 time per day, then after 12 hours - the corresponding local preparation that does not contain the active component.

Interval therapy may also be appropriate, which consists in the use of Beloderm and a local preparation that does not contain an active component, alternately for a week. You should carefully monitor the development of signs and symptoms of the systemic effect of the drug. The method of application should be adapted to the type of skin and stage of the disease. Beloderm is the predominant dosage form for dry, scaly and rough skin, with a chronic and subacute form of the disease.

With dermatoses associated with a bacterial infection, antibiotic therapy should be used. Patients with dermatoses of fungal origin require special treatment.

Do not use under occlusive dressings, since the side effect of the drug may increase.

Beloderm cutaneous spray should be applied 2 times a day from a distance of about 5 cm, by 1-2 clicks, spraying onto the affected area of ​​the skin or scalp and rub thoroughly. The volume of the solution released with one press is 0.1 ml.

In the treatment of some patients, it is sufficient to apply it less frequently to maintain the effect of the drug.

The recommended duration of treatment should not exceed 2 weeks. The maximum weekly dose is 50 ml.

Contraindications

Hypersensitivity to betamethasone or other corticosteroids, or other components of the drug. viral infections, including post-vaccination reactions and chickenpox; viral skin infections (e.g. herpes simplex, herpes zoster, chickenpox); rosacea; rosacea-like (perioral) dermatitis; bacterial dermatoses, including tuberculosis and syphilis of the skin; fungal diseases, ophthalmic diseases (Beloderm is not intended for ophthalmic use); do not use under occlusive dressings (gypsum).special care should be taken when applying Beloderm to the skin of the face. Avoid contact with eyes or mucous membranes. do not use in the first trimester of pregnancy (see section "use during pregnancy and lactation"). long-term treatment and / or use on a large surface of the skin should be avoided, since absorption of the active substance is possible.

Side effects

Frequency of side effects: very common (≥1 / 10); often (≥1 / 100, 1/10); infrequently (≥1 / 1000, 1/100); rarely (≥1 / 10,000, 1/1000); very rarely (≥1 / 10,000); unknown (frequency cannot be determined based on available data).

Treatment-related side effects

Skin tingling, skin tightening, skin cracking, heat sensation, lamellar skin peeling, focal skin peeling, follicular rash, erythema, telangiectasia, ecchymosis, allergic contact dermatitis, skin hyperpigmentation, hair depigmentation.

When using the drug on large surfaces or under an occlusive dressing, especially for a long period, it is necessary to keep in mind the possibility of developing a systemic effect of the drug.

In individuals with individual intolerance to the components of the drug, hypersensitivity reactions are possible.

Any side effects that occur with the systemic use of glucocorticoids, including suppression of the adrenal cortex, can occur with local use of glucocorticoids.

special instructions

Beloderm is generally well tolerated, but treatment should be discontinued if irritation or hypersensitivity occurs. with the development of a hypersensitivity reaction or skin irritation, the use of the drug should be stopped immediately and the patient should be given adequate therapy. in the presence of infection or fungal skin lesions, appropriate antifungal or antibacterial agents should be prescribed. if at the same time the desired effect does not occur quickly, the use of corticosteroids must be stopped until the signs of infection are eliminated.

Beloderm is not intended for use in ophthalmology. Avoid getting the drug on the mucous membranes. Beloderm should not be applied to the eyes and periorbital area due to the possible development of cataracts, glaucoma, fungal infections of the eye and exacerbation of herpes.

Systemic absorption of local corticosteroids, as a rule, increases with the dose, duration of treatment and the area of ​​the treated surface of the body. Therefore, corticosteroids with high activity in large areas of the skin should be used under careful and periodic monitoring of the hypothalamic-pituitary-adrenal (GGN) system. If oppression develops, the drug should be discontinued, the frequency of application should be reduced or the patient transferred to a weak-acting corticosteroids. The function of the GGN system, as a rule, is restored when the drug is discontinued.

In some cases, withdrawal symptoms may develop that require the addition of systemic corticosteroids.

Local and systemic toxicity may occur, especially after prolonged use b