Pharmacological action of Betnovate

Betamethasone dipropionate is a synthetic GCS. It has anti-inflammatory, antipruritic, anti-allergic, vasoconstrictor, antiexudative and antiproliferative effects. When applied to the surface of the skin, it narrows blood vessels, relieves itching, reduces the release of inflammatory mediators (from eosinophils and mast cells), interleukins 1 and 2, interferon gamma (from lymphocytes and macrophages), inhibits activity and reduces the permeability of the vascular wall. Interacts with specific receptors in the cytoplasm of the cell, stimulates the synthesis of matrix ribonucleic acid, which induces the formation of proteins, including lipocortin, that mediate cellular effects. Lipocortin inhibits phospholipase A2, blocks the release of arachidonic acid and the biosynthesis of endoperoxides, prostaglandins, leukoproteins (contributing to the development of inflammation, allergies and other pathological processes).

Pharmacokinetics

When applied externally in therapeutic doses, the transdermal absorption of the active substance into the blood is very low. The use of occlusive dressings, inflammation and skin diseases increase transdermal absorption, which can lead to an increased risk of systemic side effects.

Indications of the active substances of the Betnovate cream

Skin diseases amenable to GCS therapy: atopic dermatitis / neurodermatitis, allergic contact dermatitis, eczema (various forms), contact dermatitis (including occupational) and other non-allergic dermatitis (including solar and radiation dermatitis), reactions for insect bites, psoriasis, bullous dermatoses, discoid lupus erythematosus, lichen planus, exudative erythema multiforme, pruritus of various etiologies, erythroderma.

Dosing regimen

External use. The dosage regimen is individual, depending on the indications, the patient's age and the clinical situation.

Contraindications to use 

Hypersensitivity, bacterial (skin tuberculosis, skin manifestations of syphilis), fungal, viral (chickenpox, herpes simplex) skin diseases, post-vaccination skin reactions, open wounds, trophic leg ulcers, rosacea, acne vulgaris, skin cancer, nevus, atheroma, melanoma, hemangioma, xanthoma, sarcoma, children up to 1 year old (cream and ointment) and up to 2 years old (spray), breastfeeding period.

With care

Cataract, diabetes mellitus, glaucoma, tuberculosis (with prolonged use or application to large areas of the body), children from 2 to 12 years old (spray).

Application during pregnancy and lactation

Contraindicated during pregnancy and lactation (breastfeeding).

Use in children

The drug is contraindicated for use in children under 1 year old (ointment and cream) and under 2 years old (spray).

With caution when using the spray form in children from 2 to 12 years old.

Special instructions

Long-term use of the drug on the skin of the face is not recommended, since the development of rosacea, perioral dermatitis and acne is possible. The course of treatment should not exceed 5 days.

The medicinal product is not intended for use in ophthalmology. Avoid contact with eyes. If the drug gets on the mucous membranes of the eye, it is possible to develop cataracts, glaucoma, fungal infections of the eye and exacerbation of herpes infection.

With prolonged treatment, when applied to extensive skin surfaces, as well as in the armpits and groin folds, when using occlusive dressings, diapers, systemic absorption of GCS is possible.

When applied on large surfaces and / or under an occlusive dressing, it is possible to suppress the function of the hypothalamic-pituitary-adrenal system and develop symptoms of hypercortisolism, there may be a decrease in the excretion of growth hormone, an increase in intracranial pressure.

The spray form is preferable for use in acute dermatosis, including those accompanied by exudation (the formation of weeping surfaces).

Use in pediatrics

Use in children aged 1-2 years is possible only under medical supervision. Children are more at risk of suppression of the function of the hypothalamic-pituitary-adrenal system due to the use of GCS for external use than adults, due to their higher ratio of body surface area and body weight and, accordingly, increased absorption of this agent. In children, this is accompanied by low plasma cortisol levels and a lack of response to ACTH stimulation. It is possible the occurrence of Itsenko-Cushing's syndrome, impaired growth and development, a slowdown in weight gain, an increase in intracranial pressure, manifested by protrusion of the fontanelle, headaches, bilateral edema of the optic nerve head.

Side effect

Skin and subcutaneous tissue: itching, burning, irritation, dry skin, folliculitis, hypertrichosis, striae, acne-like rashes ("steroid" acne), hypopigmentation, perioral dermatitis, allergic contact dermatitis, skin maceration, secondary infection, atrophy skin, local hirsutism, telangiectasia, prickly heat, purpura.

On the part of laboratory parameters: hyperglycemia, glucosuria.

From the side of the organ of vision: blurred vision.

Others: reversible suppression of adrenal cortex function, manifestation of Itsenko-Cushing's syndrome.