Pharmacological properties
Betamethasone is a synthetic glucocorticosteroid, has anti-inflammatory, antiallergic and antipruritic effects. When applied topically, it constricts blood vessels, relieves itching, reduces the release of inflammatory mediators (from eosinophils and mast cells), interleukins-1 and -2, gamma-interferon (from lymphocytes and macrophages), inhibits the activity of hyaluronidase and reduces the permeability of vascular walls. interacts with specific receptors in the cytoplasm of cells, stimulates the synthesis of mRNA, which induces the formation of proteins, including lipocortin. Lipocortins inhibit phospholipase A2, blocks the release of arachidonic acid and the biosynthesis of endoperoxides, prostaglandins, leukotrienes (which contribute to the development of inflammation, allergies and other pathological processes). The cream base provides a softening and moisturizing effect.
Betamethasone as a fluorinated corticosteroid is very limitedly absorbed into the systemic bloodstream through the skin. With local application, the intensity of absorption depends on the state of the epidermal barrier (inflammation and skin diseases increase absorption). When applying the cream to large areas of skin, as well as when using occlusive dressings, an increase in systemic absorption of the drug is possible. It binds to blood plasma proteins. It easily penetrates the histohematological barriers, including the placental barrier. Biotransformed mainly in the liver, the metabolites formed are inactive. Excreted by the kidneys; partially excreted in breast milk.
Indication
The drug is used to treat: eczema of various forms and localizations; psoriasis; neurodermatitis; dermatitis (contact, seborrheic, solar, exfoliative, radiation, intertriginous); anogenital itching; senile itching. It is also used as an adjunct to systemic glucocorticoid therapy in generalized erythroderma.
Application
The cream is applied topically. The dose of the drug is set individually, as it depends on the area of the affected area. The cream must be applied to the affected area with a thin layer 2 times a day, gently rubbing into the skin. After achieving clinical improvement, the frequency of use of the drug can be reduced to 1 time per day. The duration of treatment is determined by the elimination of the inflammatory process, cessation of itching, cleansing of the skin; the duration of the course of treatment depends on the type and severity of the disease, is determined by the doctor and is usually 1-2 weeks, but not more than 3 weeks; a break of at least 20 days is required between repeated courses. The course of treatment in children and patients with facial lesions should be no more than 5 days.
It should be used with caution in children; application of the drug to large areas of the body, as well as the use of occlusive dressings, is not recommended.
Contraindication
The drug should not be used for:
primary viral, fungal and bacterial skin lesions, skin tuberculosis, skin manifestations of syphilis, skin reactions after vaccination, acne, individual hypersensitivity to the components of the drug.
Side effects
The drug is usually well tolerated; with proper use, side effects are rare, but burning, itching, irritation, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis are possible. When using occlusive dressings, skin maceration, striae, and perspiration may occur.
Special instructions
Do not allow the drug to get into the eyes. Do not apply the cream to the skin around the eyes. In order to increase the effectiveness of therapy, it is possible to use occlusive dressings, however, it is necessary to bear in mind the possibility of developing systemic effects. Systemic absorption of betamethasone increases when the cream is used for a long time, on a large surface of the body, and when treating children.
Due to the fact that the safety of local GCS use in pregnant women has not been established, the prescription of drugs of this group during pregnancy is justified only if the expected benefit to the mother outweighs the potential risk to the fetus.
During pregnancy, drugs of this group should not be used in large doses or for long periods of time.
Since it is not known whether systemic absorption of topical corticosteroids can lead to detectable concentrations in breast milk, a decision should be made to either discontinue breastfeeding or discontinue the drug, taking into account the need for its use for the mother.
Interactions
When used topically, the drug has not been found to interact with other medications.
Overdose
Excessive and prolonged use of the drug on a large surface of the skin may lead to the manifestation of systemic effects characteristic of GCS, in particular, to suppression of the hypothalamic-pituitary-adrenal system with the development of secondary adrenal insufficiency and the appearance of symptoms of hypercorticism, including Itsenko-Cushing's syndrome (especially in children). Treatment is symptomatic.
Storage conditions
In a dry, dark place at a temperature of 15-25 ° C. Shelf life - 2 years.
