Betamethasone is a corticosteroid medication that is used to treat inflammation and immune system disorders. It works by reducing swelling, redness, itching, and allergic reactions. Betamethasone comes in various forms such as creams, ointments, lotions, gels, and solutions, and it can be applied topically to the skin, inhaled into the lungs, injected into muscles or joints, or taken orally. It is commonly used to treat conditions like eczema, psoriasis, dermatitis, allergic reactions, asthma, and arthritis. However, prolonged or excessive use of betamethasone can lead to side effects such as skin thinning, stretch marks, acne, and increased susceptibility to infections.

Betamethasone is a corticosteroid medicine that has strong anti-inflammatory effects. It is used in autoimmune and inflammatory conditions.

Betamethasone Uses (Indications):

• Intramuscular:
  • Allergic states:
    • It is effective in controlling severe allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, perennial or seasonal allergic rhinitis, serum sickness, transfusion reactions.
  • Dermatologic diseases:
    • It is indicated for various dermatological conditions including bullous dermatitis herpetiformis, exfoliative erythroderma, mycosis fungoides, pemphigus, severe erythema multiforme (Stevens-Johnson syndrome)
  • Endocrine disorders:
    • It is used for the management of congenital adrenal hyperplasia, hypercalcemia in malignancy, nonsuppurative thyroiditis.
    • The drug of choice in primary or secondary adrenocortical insufficiency is hydrocortisone/cortisone. Synthetic analogs can be concurrently used with mineralocorticoids where applicable; in infancy, mineralocorticoid supplementation is of particular importance.
  • Gastrointestinal diseases:
    • It is indicated for the management of regional enteritis and ulcerative colitis.
  • Hematologic disorders:
    • Acquired (autoimmune) hemolytic anemia, Diamond-Blackfan anemia, pure red cell aplasia, selected cases of secondary thrombocytopenia also needs additional therapy.
  • Neoplastic diseases:
    • It is given as palliative treatment of leukemias and lymphomas.
  • Nervous system:
    • Acute exacerbations of multiple sclerosis; cerebral edema secondary to a primary or metastatic brain tumor or craniotomy can be managed by betamethasone.
  • Ophthalmic diseases:
    • Sympathetic ophthalmia, temporal arteritis, uveitis, and ocular inflammatory conditions unresponsive to topical corticosteroids need betamethasone for control.
  • Renal diseases:
    • In patients with idiopathic nephrotic syndrome, in order to induce diuresis or remission of proteinuria or that due to lupus erythematosus, betamethasone is effective.
  • Respiratory diseases:
    • It is given in combination with ATT for fulminating or disseminated pulmonary tuberculosis. It is also used for idiopathic eosinophilic pneumonia, symptomatic sarcoidosis, or berylliosis.
  • Rheumatic disorders:
    • Short term therapy is advised as adjunctive therapy to tide the patient over an acute episode or exacerbation in acute gouty arthritis; acute rheumatic carditis; ankylosing spondylitis; psoriatic arthritis; rheumatoid arthritis, including juvenile rheumatoid arthritis, treatment of dermatomyositis, polymyositis, and systemic lupus erythematosus.
  • Miscellaneous:
    • Trichinosis with neurologic or myocardial involvement, tuberculous meningitis with subarachnoid block or impending block when used with appropriate antituberculous chemotherapy.
  • Intra-articular or soft tissue administration:
    • In order to tide the patient over an acute episode or exacerbation in acute gouty arthritis, acute and subacute bursitis, acute nonspecific tenosynovitis, epicondylitis, rheumatoid arthritis, synovitis of osteoarthritis, it is given as adjunct short term therapy.
  • Intralesional:
    • It is effective for treating keloids, alopecia areata, discoid lupus erythematosus, localized hypertrophic, infiltrated, inflammatory lesions of granuloma annulare, lichen planus, lichen simplex chronicus, and psoriatic plaques, necrobiosis lipoidica diabeticorum.

Off Label Use of Betamethasone in Adults:

• Accelerate fetal lung maturation.

Betamethasone dose in adults:

Usual dosage range:

• The typical dosage range for betamethasone when given intramuscularly (injected into the muscle) initially ranges from 0.25 to 9 milligrams per day.

Note:

• Betamethasone is a medicine that helps with inflammation and immune system issues.
• It comes in different forms like creams or injections.
• You might use it for skin problems like eczema or for conditions like asthma or arthritis.
• But too much can cause problems like thinning skin or acne.
• Doctors decide how much you need based on how bad your condition is and how you react to the medicine.

Betamethasone Indication-specific dosing:

Betamethasone off label treatment dose of Antenatal fetal maturation:

• According to the American College of Obstetricians and Gynecologists (ACOG), the typical dosage for this purpose is 12 milligrams injected into the muscle every 24 hours for a total of 2 doses.
• This treatment is recommended for pregnant women between 24 and 34 weeks of gestation who are at risk of delivering within 7 days.
• It may also be appropriate for certain cases beginning at 23 weeks gestation or for late preterm births between 34 0/7 weeks and 36 6/7 weeks gestation.
• In some situations, a single repeat course may be considered for women with pregnancies less than 34 weeks gestation who are at risk for delivery within 7 days and who received a course of antenatal corticosteroids more than 14 days prior.

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Betamethasone dose in the treatment of Bursitis (other than of foot), tenosynovitis, and peritendinitis:

• The typical dosage for these conditions involves injecting 3 to 6 milligrams (0.5 to 1 milliliter) directly into the affected area (intrabursal) for one dose.
• In some cases, multiple injections may be necessary for acute flare-ups or chronic conditions.
• If repeat injections are needed, the dosage may be reduced.
• This treatment helps reduce inflammation and alleviate symptoms in the affected area.

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Betamethasone dose in dermatological diseases:

• For intralesional use, the typical dosage is 1.2 milligrams per square centimeter (0.2 milliliters per square centimeter) for one dose, with a maximum of 6 milligrams (1 milliliter) administered weekly.

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Betamethasone dose in the treatment of Foot disorders:

• The medication is injected directly into the joint.
• The dosage typically ranges from 1.5 milligrams to 6 milligrams per dose, administered at 3 to 7-day intervals.

The specific dosage depends on the foot condition being treated:

• For bursitis, the dosage typically ranges from 1.5 milligrams to 3 milligrams (0.25 to 0.5 milliliters).
• For tenosynovitis, the typical dosage is 3 milligrams (0.5 milliliters).
• In cases of acute gouty arthritis, the dosage ranges from 3 milligrams to 6 milligrams (0.5 to 1 milliliter).

These injections help alleviate inflammation and reduce symptoms associated with these foot disorders.

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Betamethasone dose in the treatment of Multiple sclerosis:

Note: High-dose intravenous or oral methylprednisolone is typically recommended for managing acute exacerbations, as per treatment guidelines provided by organizations like the American Academy of Neurology (AAN) and the National Institute for Health and Care Excellence (NICE).

• The recommended dosage regimen for betamethasone in MS involves 30 milligrams administered intramuscularly daily for 1 week, followed by 12 milligrams every other day for 4 weeks.
• This treatment regimen aims to reduce inflammation and control symptoms associated with MS exacerbations.

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Betamethasone dose in the treatment of Rheumatoid and osteoarthritis:

The medication is injected directly into the affected joint. The dosage typically ranges from 3 milligrams to 12 milligrams per dose, with the specific dosage based on the size of the joint being treated:

• For very large joints such as the hip, the dosage typically ranges from 6 milligrams to 12 milligrams (1 to 2 milliliters).
• For large joints like the knee, ankle, or shoulder, the typical dosage is 6 milligrams (1 milliliter).
• For medium-sized joints such as the elbow or wrist, the dosage ranges from 3 milligrams to 6 milligrams (0.5 to 1 milliliter).
• For small joints like the fingers or sternoclavicular joint, the dosage ranges from 1.5 milligrams to 3 milligrams (0.25 to 0.5 milliliters).

These injections help alleviate inflammation and reduce pain associated with arthritis.

Betamethasone Dose in Children

Note:

• The dosage of betamethasone is typically expressed as the combined amount of betamethasone sodium phosphate and betamethasone acetate.
• This means that 1 milligram is equivalent to 0.5 milligrams of betamethasone sodium phosphate and 0.5 milligrams of betamethasone acetate.
• It's important to use the lowest effective dose for the shortest period of time to minimize the risk of suppressing the hypothalamic-pituitary-adrenal (HPA) axis, which is involved in regulating the body's response to stress and inflammation.

Betamethasone General dosing in the treatment of inflammatory and allergic conditions:

Infants, Children, and Adolescents:

• • The general dosing of betamethasone typically starts at 0.02 to 0.3 milligrams per kilogram per day when given intramuscularly.
  • This dosage corresponds to approximately 0.6 to 9 milligrams per square meter per day, spread across 3 or 4 divided doses throughout the day.
  • Adjustments to the dosage may be made based on the severity of the condition and the individual response to treatment.

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Betamethasone Intralesional dose in a larger Infantile hemangioma:

• Condition: Severe Infantile Hemangioma
• Method of Administration: Intralesional Injection
• Dosage:
  • Depends on the size of the lesion
  • Commonly reported: 6 milligrams administered as a 6 milligrams per milliliter solution, in combination with triamcinolone injection
  • Reported dosage range: 1.5 to 18 milligrams per dose
  • Administration frequency: Every 8 to 14 weeks, reported range: 6 to 25 weeks
• Age Group: Infants and Children
• Limited Data:
  • Dosing based on small trials and case-series, mainly in infants and children ≤4 years old.
  • Largest experience involved 70 patients aged 2 months to 12 years, using a betamethasone/triamcinolone combination injection. Results showed 89.23% of lesions with initial volume <20 cubic centimeters regressed by more than 50%, but only 22.2% of lesions with initial volume >20 cubic centimeters displayed a good or excellent response.
  • Another trial with 25 patients aged 7 weeks to 2 years used lower doses of 3 to 12 milligrams in combination with triamcinolone, with 16 patients experiencing a marked response.

Betamethasone Pregnancy Risk Category: C

• Betamethasone, a medication used during pregnancy, can cross the placenta, but it's partly broken down by placental enzymes.
• Studies suggest that using corticosteroids like betamethasone in the first trimester might be linked to oral clefts or lower birth weight, but the evidence isn't clear and could be affected by how much the mother takes and why she's taking it.
• Newborns born to mothers who used corticosteroids during pregnancy might have adrenal problems, so monitoring is important.
• However, using corticosteroids before birth can lower the chances of certain problems in premature babies, like bleeding in the brain, gut problems, and breathing difficulties.
• Doctors often give a single dose of betamethasone to pregnant women at risk of giving birth too early, especially between 24 and 34 weeks of pregnancy.
• In some cases, it might be considered starting at 23 weeks or for women between 34 and 36 weeks who might deliver soon.
• Doctors generally advise against giving multiple doses, but in certain situations, a second dose might be considered.
• When corticosteroids are needed for conditions like rheumatoid disorders during pregnancy, doctors usually recommend using the smallest effective dose for the shortest time, especially avoiding high doses in the first trimester.
• They might also use injections directly into joints if necessary during pregnancy.

Use betamethasone while breastfeeding

• Betamethasone, like other corticosteroids, can be found in breast milk.
• Its use before birth might delay milk production and reduce the amount of milk produced, especially when delivery happens 3 to 9 days after the betamethasone dose in women between 28 and 34 weeks of pregnancy.
• However, it didn't seem to affect milk production when birth occurred within 3 days or more than 10 days after treatment.
• Manufacturers advise caution when using betamethasone while breastfeeding because systemic corticosteroids in the mother's milk could lead to problems for the baby, like slowed growth or issues with their own corticosteroid production.
• Generally, corticosteroids are considered safe for breastfeeding when used in usual doses, but it's important to watch out for any adverse reactions in the baby and seek medical advice if needed.

Betamethasone Dose adjustment in renal disease:

• The manufacturer hasn't suggested any specific dose adjustments for betamethasone in patients with kidney disease.

Betamethasone Dose adjustment in liver disease:

• The manufacturer has not recommended any specific dose adjustments for betamethasone in patients with liver disease.

Side effects of Betamethasone:

• Cardiovascular:
  • Bradycardia
  • Cardiac Arrhythmia
  • Cardiomegaly
  • Circulatory Shock
  • Edema
  • Embolism (Fat)
  • Hypertension
  • Hypertrophic Cardiomyopathy
  • Myocardial Rupture (Following Recent MI)
  • Syncope
  • Tachycardia
  • Thromboembolism
  • Thrombophlebitis
  • Vasculitis
• Central Nervous System:
  • Abnormal Sensory Symptoms
  • Arachnoiditis
  • Depression
  • Emotional Lability
  • Euphoria
  • Headache
  • Increased Intracranial Pressure
  • Insomnia
  • Malaise
  • Meningitis
  • Myasthenia
  • Neuritis
  • Neuropathy
  • Paraplegia
  • Paresthesia
  • Personality Changes
  • Pseudotumor Cerebri
  • Psychic Disorder
  • Seizure
  • Spinal Cord Compression
  • Vertigo
• Dermatologic:
  • Acne Vulgaris
  • Allergic Dermatitis
  • Atrophic Striae
  • Diaphoresis
  • Ecchymoses
  • Erythema
  • Exfoliation Of Skin
  • Fragile Skin
  • Hyperpigmentation
  • Hypertrichosis
  • Hypopigmentation
  • Skin Atrophy
  • Skin Rash
  • Subcutaneous Atrophy
  • Suppression Of Skin Test Reaction
  • Thinning Hair
  • Urticaria
  • Xeroderma
• Endocrine & Metabolic:
  • Amenorrhea
  • Calcinosis
  • Cushingoid State
  • Decreased Glucose Tolerance
  • Decreased Serum Potassium
  • Fluid Retention
  • Glycosuria
  • Growth Suppression (Pediatric)
  • Hirsutism
  • HPA-Axis Suppression
  • Hypokalemic Alkalosis
  • Impaired Glucose Tolerance/Prediabetes
  • Insulin Resistance (Increased Requirements For Insulin Or Oral Hyperglycemic Agents)
  • Moon Face
  • Negative Nitrogen Balance
  • Protein Catabolism
  • Sodium Retention
  • Weight Gain
• Gastrointestinal:
  • Abdominal Distention
  • Change In Bowel Habits
  • Hiccups
  • Increased Appetite
  • Intestinal Perforation
  • Nausea
  • Pancreatitis
  • Peptic Ulcer
  • Ulcerative Esophagitis
• Genitourinary:
  • Bladder Dysfunction
  • Spermatozoa Disorder (Decreased Motility And Number)
• Hematologic & Oncologic:
  • Petechia
• Hepatic:
  • Hepatomegaly
  • Increased Liver Enzymes
• Hypersensitivity:
  • Anaphylactoid Reaction
  • Anaphylaxis
  • Angioedema
• Infection:
  • Infection (Decreased Resistance)
  • Sterile Abscess
• Local:
  • Injection Site Reaction (Intra-Articular Use).
  • Postinjection Flare (Intra-Articular Use)
• Neuromuscular & Skeletal:
  • Amyotrophy
  • Aseptic Necrosis Of Femoral Head
  • Aseptic Necrosis Of Humeral Head
  • Bone Fracture
  • Charcot Arthropathy
  • Lipotrophy
  • Myopathy
  • Osteoporosis
  • Rupture Of Tendon
  • Steroid Myopathy
• Ophthalmic:
  • Blindness
  • Blurred Vision
  • Cataract
  • Exophthalmos
  • Glaucoma
  • Increased Intraocular Pressure
  • Papilledema
• Respiratory:
  • Pulmonary Edema
• Miscellaneous:
  • Wound Healing Impairment

Contraindications to Betamethasone:

• Betamethasone is contraindicated if you have a hypersensitivity to any component of the formulation or if you're receiving intramuscular administration for immune thrombocytopenia, which was previously called idiopathic thrombocytopenic purpura.
• In Canada, there are additional contraindications not mentioned in the US labeling, including herpes simplex of the eye, systemic fungal infections, vaccinia, cerebral malaria, and use in areas with local infection.
• While there's limited documentation of allergenic cross-reactivity for glucocorticoids, due to similarities in chemical structure and pharmacologic actions, the possibility of cross-sensitivity cannot be ruled out entirely.

Warnings and precautions

Suppression of the adrenals:

• Betamethasone can lead to adrenal suppression, particularly in younger children or individuals receiving high doses for extended periods.
• This suppression may result in hypercortisolism or disruption of the hypothalamic-pituitary-adrenal (HPA) axis, potentially leading to adrenal crisis.
• When discontinuing corticosteroid treatment, it's crucial to do so gradually and with care.
• Special attention is needed when transitioning patients from systemic corticosteroids to inhaled products, as this can lead to adrenal insufficiency or withdrawal symptoms, including worsening allergic reactions.
• Adult patients taking more than 20 milligrams per day of prednisone (or its equivalent) may be most vulnerable.
• Fatalities have occurred due to adrenal insufficiency in asthmatic patients during and after switching from systemic corticosteroids to aerosol steroids.
• Aerosol steroids do not provide the systemic steroid required for trauma, surgery, or infections.
• In stressful situations, patients with suppressed HPA axis should receive adequate supplementation with natural glucocorticoids like hydrocortisone or cortisone instead of betamethasone, as it lacks mineralocorticoid activity.

Anaphylactoid reactions

• Rare cases of anaphylactoid reactions have been reported in patients receiving corticosteroids.
• Anaphylactoid reactions are severe and sudden allergic reactions that can occur after exposure to certain substances, including medications like corticosteroids.

Immunosuppression:

• Prolonged use of corticosteroids can weaken the immune system, making the body more susceptible to infections.
• This may lead to an increased risk of secondary infections or mask the symptoms of acute infections, including fungal infections, which could prolong or worsen the infections or limit the body's response to vaccines.
• Certain pathogens like amoeba, Candida, Cryptococcus, Mycobacterium, Nocardia, Pneumocystis, Strongyloides, or Toxoplasma can become activated or cause severe infections, sometimes leading to fatal outcomes.
• It's important to rule out conditions like amebiasis or Strongyloides infections before starting corticosteroid treatment.
• Patients using corticosteroids should avoid exposure to chickenpox or measles, and these medications should not be used to treat ocular herpes simplex, cerebral malaria, fungal infections, or viral hepatitis.
• Patients with latent tuberculosis or positive TB tests need close monitoring, and corticosteroid use should be limited in cases of active tuberculosis, usually only when the infection is severe and alongside antituberculosis treatment.
• It's crucial to rule out amebiasis, especially in patients with recent travel to tropical regions or unexplained diarrhea, before starting corticosteroid therapy.

Kaposi Sarcoma:

• Prolonged use of corticosteroids has been linked to the development of Kaposi sarcoma, as reported in some case studies.
• If signs of Kaposi sarcoma are observed, discontinuing corticosteroid therapy should be considered.
• Kaposi sarcoma is a type of cancer that usually affects the skin and mucous membranes, and it's commonly associated with conditions that weaken the immune system, such as HIV/AIDS.

Myopathy

• High doses of corticosteroids have been associated with a condition called acute myopathy, particularly in patients with neuromuscular transmission disorders.
• This condition can affect muscles, including those responsible for eye movement and breathing.
• It's important to monitor levels of creatine kinase, an enzyme that can indicate muscle damage, in patients receiving high-dose corticosteroids.
• Recovery from acute myopathy may be slow, so close monitoring and medical supervision are crucial.
• If symptoms of muscle weakness or discomfort develop, especially in the eyes or respiratory system, medical attention should be sought promptly.

Psychiatric disorders:

• Corticosteroid use can lead to various psychiatric disturbances, such as depression, euphoria, insomnia, mood swings, and changes in personality.
• Additionally, preexisting psychiatric conditions may worsen when corticosteroids are used.

Cardiovascular disease

• Patients with heart failure (HF) or hypertension should use corticosteroids cautiously due to potential risks.
• Corticosteroid use has been linked to electrolyte imbalances, fluid retention, and high blood pressure, which can worsen these conditions.
• Dietary adjustments might be needed to manage these effects.
• Additionally, caution is advised for patients with a recent history of myocardial infarction (MI), as corticosteroid use has been associated with left ventricular free wall rupture in some cases.

Diabetes:

• Patients with diabetes mellitus should use corticosteroids cautiously because these medications can affect glucose production and regulation in the body, potentially leading to high blood sugar levels (hyperglycemia).

Gastrointestinal Disease:

• Patients with gastrointestinal (GI) diseases, such as diverticulitis, recent intestinal surgeries, peptic ulcers, or ulcerative colitis, should use corticosteroids cautiously because they may increase the risk of perforation in the GI tract.
• It's important to avoid consuming ethanol (alcohol) while taking corticosteroids, as it can worsen irritation of the gastric mucosa.

Head injury

• High-dose intravenous methylprednisolone should not be used for the management of head injuries, as studies have shown an increased risk of mortality in patients receiving this treatment.
• Therefore, caution should be exercised, and alternative therapies should be considered for the management of head injuries.

Hepatic impairment

• Patients with hepatic impairment, including cirrhosis, should use corticosteroids with caution due to the potential risk of fluid retention, which can be exacerbated with long-term use.

Myasthenia gravis:

• Patients with myasthenia gravis should use corticosteroids cautiously, as these medications can potentially exacerbate symptoms, especially during initial treatment.
• Myasthenia gravis is a neuromuscular disorder characterized by muscle weakness and fatigue, and corticosteroids may affect neuromuscular transmission, leading to worsening of symptoms in some cases.

Ocular disease:

• Patients with ocular diseases such as cataracts or glaucoma should use corticosteroids cautiously, as prolonged use can increase intraocular pressure and exacerbate these conditions.
• Additionally, corticosteroids are not recommended for the treatment of optic neuritis, as they may lead to a higher frequency of new episodes.

Osteoporosis

• Patients with osteoporosis should use corticosteroids cautiously, as high doses or long-term use of these medications have been linked to increased bone loss and a higher risk of osteoporotic fractures.
• Corticosteroids can weaken bones by interfering with the body's natural bone-building process, leading to a reduction in bone density and an increased susceptibility to fractures.

Renal impairment

• Patients with renal impairment should use corticosteroids with caution because these medications may lead to fluid retention.
• Corticosteroids can affect fluid balance in the body, and in patients with renal impairment, this may exacerbate fluid retention and potentially worsen their condition.

Seizure disorders:

• Patients with a history of seizure disorder should use corticosteroids with caution, as seizures have been reported in the context of adrenal crisis.
• Adrenal crisis can occur when there is a severe deficiency of cortisol, a hormone that corticosteroids mimic.
• Corticosteroids can mask the symptoms of adrenal insufficiency, potentially leading to adrenal crisis, which may include seizures among other symptoms.

Thyroid disease:

• Patients with thyroid disease should be aware that changes in their thyroid status may require adjustments to their corticosteroid dosage.
• The metabolic clearance of corticosteroids can increase in hyperthyroidism (overactive thyroid) and decrease in hypothyroidism (underactive thyroid), affecting how the body processes these medications.

How to administer Betamethasone?

Coadministration with Local Anesthetic:

• When betamethasone suspension is coadministered with a local anesthetic, it can be mixed in the syringe.
• Use a local anesthetic such as 1% or 2% lidocaine HCl without parabens or a similar parabens-free local anesthetic.
• Withdraw the dose of betamethasone suspension from the vial into the syringe first.
• Then, draw up the local anesthetic into the same syringe.
• Shake the syringe briefly to mix the components.
• Do not inject the local anesthetic directly into the betamethasone suspension vial.

Intramuscular Administration:

• Do not administer the injectable sodium phosphate/acetate suspension intravenously or epidurally.

Intrabursal Injection for Tendinitis and Tenosynovitis:

• Inject into the affected tendon sheaths and not directly into the tendons.

Intradermal Injection:

• Use a 25-gauge, 1 mL (e.g., tuberculin) syringe with a ¼-inch needle.
• Inject the suspension to form a uniform depot.
• Do not inject subcutaneously.

Mechanism of action of Betamethasone:

• Betamethasone regulates how quickly proteins are made and decreases the movement of certain types of white blood cells and fibroblasts, which are cells involved in wound healing.
• It also helps to reduce inflammation by reversing changes in blood vessel permeability and stabilizing lysosomes within cells, which can help prevent or manage inflammation at a cellular level.

Protein Binding:

• Betamethasone is bound to proteins in the blood, with approximately 64% bound to proteins.

Metabolism:

• It undergoes metabolism primarily in the liver.

Elimination Half-Life:

• The half-life of elimination, which represents the time it takes for half of the drug to be removed from the body, is approximately 6.5 hours.

Time to Peak Serum Levels:

• When administered intravenously, betamethasone reaches peak serum levels within 10 to 36 minutes.

Excretion:

• Betamethasone is primarily excreted through the urine, with less than 5% of the drug excreted unchanged.

International Brands of Betamethasone:

• Bei Shi Li
• Betacort
• Betagen
• Betanoid
• Betasone
• Betnelan
• Betnesol
• Bufencon
• Celestan Depot
• Celeston
• Celeston Chronodose
• Celestone
• Celestone Chronodose
• Celestone Soluspan
• Cidoten
• Corteroid
• Cortixyl
• Depot
• Dacam RL
• Diprofos Depot
• Diprophos
• Diprosone Depot
• Diprospan
• Flosetron
• Inflacor
• Lenasone
• Metamar
• Solu Celestan
• Vistamethasone
• Walacort
• X-Beta

Betamethasone Brand Names in Pakistan:

Betamethasone Injection 4 mg/ml
Betnesol	Glaxosmithkline
Dansone	Danas Pharmaceuticals (Pvt) Ltd
Hameth	Hygeia Pharmaceuticals
Rekabson	Reko Pharmacal (Pvt) Ltd.

 

Betamethasone Eye Drops 0.1 % w/v
Betarex	Rex Pharmaceuticals Pakistan
Betatek	Innvotek Pharmaceuticals
Betnesol	Glaxosmithkline
Orbetam	Zafa Pharmaceutical Laboratories (Pvt) Ltd.
Probeta	Atco Laboratories Lintramuscularited

 

Betamethasone Ear Drops 0.1 % w/v
Betasol	Multinational Buisness Link
Orbetam	Zafa Pharmaceutical Laboratories (Pvt) Ltd.

 

Betamethasone Eye Ointment 0.1 % w/w
Betarex	Rex Pharmaceuticals Pakistan
Betnesol	Glaxosmithkline

 

Betamethasone Nasal Drops 0.1 % w/v
Orbetam	Zafa Pharmaceutical Laboratories (Pvt) Ltd.

 

Betamethasone Ointment 0.1 % w/w
Betacin	Geofman Pharmaceuticals
Betaderm	Atco Laboratories Lintramuscularited
Betaskin N	Trigon Pharmaceuticals Pakistan (Pvt) Ltd.
Betaval	Valor Pharmaceuticals
Betaval	Valor Pharmaceuticals
Betnovate	Glaxosmithkline
Betnovate	Glaxosmithkline
Biozon	Biogen Pharma
Dermoval	Shrooq Pharmaceuticals
Sonate	Bio Labs (Pvt) Ltd.
Sonate	Bio Labs (Pvt) Ltd.
Webnate	Webros Pharmaceuticals
Webnate -N	Webros Pharmaceuticals
Zynnovate	Zanctok Pharmaceuticals

 

Betamethasone Ointment 0.05 % W/W
Austasone	Bloom Pharmaceuticals (Pvt) Ltd.
B-Gen	Biogen Pharma
Beprosone	Sulk Pharma
Betacort	P.D.H. Pharmaceuticals (Pvt) Ltd.
Betaderm	Atco Laboratories Lintramuscularited
Betadip	Zafa Pharmaceutical Laboratories (Pvt) Ltd.
Clorazide	Trigon Pharmaceuticals Pakistan (Pvt) Ltd.
Diprocort	Pearl Pharmaceuticals
Diprocort G	Pearl Pharmaceuticals
Dipsone	Mass Pharma (Printravenousate) Lintramuscularited
Dison	Varioline International (Pvt) Ltd.
Effidex	Pharma Health Pakistan (Pvt) Ltd
Procort	Shrooq Pharmaceuticals
Provate	Saffron Pharmaceutical Company

 

Betamethasone Ointment 0.64 % W/W
Besalic	Global Pharmaceuticals

 

Betamethasone Cream 0.1 % W/W
Anglosone	Euro Pharma International
Beone Plus	Reliance Pharma
Betacin	Geofman Pharmaceuticals
Betaval	Valor Pharmaceuticals
Bethaheal	Webros Pharmaceuticals
Betnovate	Glaxosmithkline
Bintramuscularole	Zephyr Pharmatec (Pvt) Ltd.
Biozon	Biogen Pharma
Technobet	Derma Techno Pakistan
Webnate	Webros Pharmaceuticals
Webnate -N ,	Webros Pharmaceuticals

 

Betamethasone Cream 0.05 % W/W
B-Gen	Biogen Pharma
Beclic	Aintramusculars Traders
Benate	Neutro Pharma (Pvt) Ltd.
Beone	Reliance Pharma
Betacort	P.D.H. Pharmaceuticals (Pvt) Ltd.
Betaderm	Atco Laboratories Lintramuscularited
Betadip	Zafa Pharmaceutical Laboratories (Pvt) Ltd.
Betanate	Valor Pharmaceuticals
Betasporin	Caylex Pharmaceuticals (Pvt) Ltd.
Betawis	Caraway Pharmaceuticals
Dermoval	Shrooq Pharmaceuticals
Dioderm	Ucb Pharma
Diprocort	Pearl Pharmaceuticals
Diprosan	Sante (Pvt) Lintramuscularited
Effidex	Pharma Health Pakistan (Pvt) Ltd
Holfungin	Baxter Karachi
Procort	Shrooq Pharmaceuticals
Provate	Saffron Pharmaceutical Company

 

Betamethasone Gel 0.05 % W/W
Pro-One Gel	Glaxosmithkline

 

Betamethasone Lotion 0.1 % W/V
B.M.T.	Medera Pharmaceuticals (Pvt) Ltd.
Betaderm	Atco Laboratories Lintramuscularited
Betamet	Seatle Pharma Pakistan (Pvt) Ltd.
Betawis	Caraway Pharmaceuticals
Betnovate	Glaxosmithkline
Betonil	Glaxosmithkline
Biozon	Biogen Pharma
De-Sone	Derma Techno Pakistan
Technobet	Derma Techno Pakistan

 

Betamethasone Lotion 0.05 % W/V
Diprocort	Pearl Pharmaceuticals
Procort	Shrooq Pharmaceuticals
Provate	Saffron Pharmaceutical Company

 

Betamethasone Tablets 0.5 mg
Betamethasone	Geofman Pharmaceuticals
Betamethasone	Reko Pharmacal (Pvt) Ltd.
Betnelan	Glaxosmithkline
Betnesol	Glaxosmithkline