betamethasone dipropionate, augmented
Diprolene, Diprolene AF

betamethasone dipropionate
Alphatrex, Diprosone, Maxivate, Teladar

betamethasone valerate
Betaderm ◆, Betatrex, Beta-Val, Betnovate ◆, Celestoderm-V ◆, Ectosone ◆, Luxiq, Metaderm ◆, Novobetamet ◆, Psorion, Valisone

Available forms
Available by prescription only
betamethasone dipropionate, augmented
Cream, gel, lotion, ointment: 0.05%
betamethasone dipropionate
Aerosol: 0.1%
Cream, lotion, ointment: 0.05%
betamethasone valerate
Cream: 0.01%, 0.05%, 0.1%
Foam: 0.12%
Lotion, ointment: 0.1%

Indications and dosages
 Inflammation of corticosteroid-responsive dermatoses. Adults and children: Apply cream, lotion, ointment, or gel in a thin layer once daily to q.i.d.
 Relief of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses of scalp.
betamethasone valerate
Adults: Gently massage small amounts of foam into affected scalp areas b.i.d. (once in the morning and once at night) until control is achieved. If no improvement is seen within 2 weeks, reassess diagnosis.

Pharmacodynamics
Anti-inflammatory action: Stimulates the synthesis of enzymes needed to decrease the inflammatory response. Betamethasone, a fluorinated derivative, has the advantage of availability in various bases to vary the potency for individual conditions.

Pharmacokinetics
Absorption: Amount absorbed depends on the potency of the preparation, amount applied, and nature of the skin at the application site. It ranges from about 1% in areas with a thick stratum corneum to as high as 36% in areas with a thin stratum corneum. Absorption increases in areas of skin damage, inflammation, or occlusion. Some systemic absorption of topical steroids occurs.
Distribution: After topical application, drug is distributed throughout local skin. Drug absorbed into circulation is removed rapidly from the blood and distributed into muscle, liver, skin, intestines, and kidneys.
Metabolism: After topical administration, drug is metabolized primarily in skin. The small amount absorbed into systemic circulation is metabolized primarily in the liver to inactive compounds.
Excretion: Inactive metabolites are excreted by the kidneys, primarily as glucuronides and sulfates, but also as unconjugated products. Small amounts of metabolites also are excreted in feces.

Contraindications and precautions
Contraindicated in patients hypersensitive to corticosteroids.

Interactions
None significant.

Adverse reactions
GU: glycosuria (with betamethasone dipropionate).
Metabolic: hyperglycemia.
Skin: burning, pruritus, irritation, dryness, erythema, folliculitis, acneiform eruptions, perioral dermatitis, hypopigmentation, hypertrichosis, allergic contact dermatitis; secondary infection, maceration, atrophy, striae, miliaria (with occlusive dressings).
Other: hypothalamic-pituitary-adrenal axis suppression, Cushing’s syndrome.

Effects on lab test results
• May increase glucose level.

Overdose and treatment
No information available.

Special considerations
• Dose of augmented 0.05% gels or lotions shouldn’t exceed 50 g or 50 ml per week. Dose of Diprolene ointments or creams 0.05% shouldn’t exceed 45 g per week.
• To apply aerosol, direct spray onto affected area from a distance of 6 inches (15 cm) for only 3 seconds t.i.d. or q.i.d.
• Gently wash skin before applying. To prevent skin damage, rub medication in gently, leaving a thin coat. When treating hairy sites, part hair and apply directly to lesions.
• For application to the scalp, invert the can of foam. Dispense a small amount of drug onto a cool surface (not directly onto the hand because the drug will melt). Massage foam into scalp until foam disappears.
• Monitor patient for systemic adverse reactions during prolonged use or use on a large body surface area.
Pediatric patients
• Treatment with Diprolene ointment isn’t recommended in children younger than age 12.

Patient education
• Teach patient how to apply drug.
• Tell patient to stop drug and report signs of systemic absorption, skin irritation or ulceration, hypersensitivity, or infection.

Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE THREATENING.
◆ Canada only
◇ Unlabeled clinical use