Betamethasone

Betamethasone: Uses, Dosage and Side Effects

Overview

• Alters the transcription of DNA, leading to alterations in cellular metabolism which causes a reduction in inflammatory responses.
• Has high glucocorticoid and virtually no mineralocorticoid activity.
• Betamethasone also antagonizes insulin and ADH.

Uses of Betamethasone

• Short-term relief of many inflammatory but non-infectious conditions.

Dose of Betamethasone in Dogs and Cats

Dogs:

• Otic: 4 drops of polypharmaceutical to affected ear q12h. If using a combination formulation with florfenicol and terbinafine then administer to the affected ear and repeat once after 7 days.

• Ocular: 1 drop of ophthalmic solution to affected eye q6–8h.

• Skin: apply cream to affected area q8–12h.

• Anti-inflammatory: 0.04 mg/kg i.v., i.m. q3wk prn for up to 4 injections, 0.025 mg/kg p.o. q24h.

Cats:

• Ocular: dose as for dogs.

• Skin: dose as for dogs.

• Anti-inflammatory: 0.04 mg/kg i.v. q3wk prn for up to 4 injections.

Side Effects of Betamethasone in Dogs and Cats

• Catabolic effects of glucocorticoids lead to weight loss and cutaneous and muscle atrophy.
• Chronic therapy may lead to iatrogenic hyperadrenocorticism.
• Vomiting, diarrhoea and GI ulceration may develop.
• Glucocorticoids may increase glucose levels and decrease serum T3 and T4 values.
• Impaired wound healing and delayed recovery from infections may be seen.

Contraindications of Betamethasone in Dogs and Cats

• Do not use in pregnant animals.
• Systemic corticosteroids are generally contraindicated in patients with renal disease and diabetes mellitus.
• Topical corticosteroids are contraindicated in ulcerative keratitis.

Some Notes:

• The long duration of activity makes it unsuitable for long-term daily or alternate-day use. On a dose basis, 0.12 mg betamethasone is equivalent to 1 mg prednisolone.
• Prolonged use of glucocorticoids suppresses the hypothalamic-pituitary axis, resulting in adrenal atrophy.
• There is an increased risk of GI ulceration if used concurrently with NSAIDs.
• Phenobarbital may accelerate the metabolism of corticosteroids and antifungals (e.g. itraconazole) may decrease it.