Indications

Bet-A is indicated for-

• Suppression of inflammatory and allergic disorders including rheumatoid arthritis, rheumatoid carditis, severe hypersensitivity reactions, bronchial asthma, inflammatory skin disorders;
• congenital adrenal hyperplasia;
• ear, eye, nose and oral ulceration.

* রেজিস্টার্ড চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন'

Pharmacology

Corticosteroids bind to the glucocorticoid receptor, inhibiting pro-inflammatory signals, and promoting anti-inflammatory signals. Betamethasone phosphate has a short duration of action as it is rapidly hydrolyzed to betamethasone. Corticosteroids have a wide therapeutic window as patients may require doses that are multiples of what the body naturally produces. Patients taking corticosteroids should be counselled regarding the risk of hypothalamic-pituitary-adrenal axis suppression and increased susceptibility to infections.

Dosage & Administration

The lowest dosage that will produce an acceptable result should be used.

Adult Dosage: Usual range 0.5-5 mg daily. The dose used will depend upon the disease, its severity, and the clinical response obtained. The following regimens are for guidance only. Divided dosage is usually employed.

Short-term treatment: 2 to 3 mg daily for the first few days, subsequently reducing the daily dosage by 0.25 or 0.50 mg every two to five days, depending upon the response.

Rheumatoid arthritis: 0.5 to 2 mg daily. For maintenance therapy the lowest effective dosage is used.

Child Dosage: A proportion of the adult dosage may be used (e.g. 75% at twelve years, 50% at seven years and 25% at one year) but clinical factors must be given due consideration. Or as directed by the physician.

Use in elderly: The common adverse effects of systemic corticosteroids may be associated with more serious consequences in old age. Close clinical supervision is required to avoid life-threatening reactions.

* রেজিস্টার্ড চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন'

Interaction

Steroids may reduce the effects of anticholinesterases and non-steroidal anti-inflammatory agents. Rifampicin, rifabutin, carbamazepine, phenobarbitone, phenytoin, primidone, aminoglutethimide and ephedrine enhance the metabolism of corticosteroids; thus the corticosteroid therapeutic effect may be reduced.

Contraindications

Systemic infections, unless specific anti-infective therapy is employed. Hypersensitivity to any component of the tablets.

Side Effects

Side effects include diabetes, osteoporosis (which is a danger in elderly), muscle wasting (proximal myopathy), amenorrhoea and weight gain. High doses of corticosteroids can cause cushing’s syndrome-with moon face, striae, and acne; it is usually reversible on withdrawal of treatment. In children, administration of corticosteroids may result in suppression of growth.

Pregnancy & Lactation

Pregnancy category C. It should be given only if the potential benefit outweighs the potential risk to the fetus. No data is available for lactating mother.

Precautions & Warnings

Particular care is required when considering the use of systemic corticosteroids in patients with recent myocardial infarction, hypothyroidism, osteoporosis, hypertension or congestive heart failure, diabetes mellitus, history of active tuberculosis, glaucoma (or a family history of glaucoma), previous corticosteroid-induced myopathy, liver failure, renal insufficiency, epilepsy and peptic ulcer.

Therapeutic Class

Corticosteroid

Storage Conditions

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.