Drugs List

Therapeutic Indications

Uses

Dermatitis
Eczema
Psoriasis excluding widespread plaque psoriasis

Contraindications

Children under 1 year
Varicella
Acne vulgaris
Perioral dermatitis
Rosacea
Skin infection
Skin ulcer

Precautions and Warnings

Breastfeeding
Pregnancy

Careful supervision of patients with psoriasis required
Use appropriate antimicrobial therapy in infected lesions
Some formulations contain cetostearyl alcohol
Some formulations contain propylene glycol
Breastfeeding: Wash product off breasts prior to breastfeeding infant
Cleanse skin thoroughly before applying occlusive dressings
Risk of glaucoma if preparation enters eye
Adrenal suppression may occur even without occlusion
Potential for withdrawal symptoms
Prolonged use may cause atrophic skin changes
Risk of generalised pustular psoriasis with use of topical corticosteroids
Some formulations contain chlorocresol, may cause allergic reactions
Discontinue therapy and use antimicrobials if secondary infection occurs
Avoid long-term use particularly in infants and children
Limit use in infants or on face to 5 days and without occlusion
Advise patient residue on clothing/bedding may cause fire hazard
Fire hazard: Keep away from naked flames and potential sources of ignition
Nappy may act as an occlusive dressing

In most cases the cream preparation is for use on moist or weeping skin where as the ointment is applicable for use on dry, lichenified, or scaly lesions. The correct preparation should be used depending on the patients condition.

The skin should be cleansed before the application of a fresh dressing. Bacterial infection is encouraged by warm, moist conditions induced by occlusive dressings.

When treating inflammatory lesions that are infected an appropriate antimicrobial should also be administered. If the infection spreads a discontinuation of beclometasone is required. Antimicrobial agents should then be administered systemically.

If there is no improvement in 2 to 4 weeks then diagnosis should be reassessed.

If there is a reoccurence in the days or weeks following successful treatment, especially if spread beyond the initial treatment area, this may be a withdrawal reaction. In this case specialist advice should be sought and the treatment only reapplied with caution.

Atrophic changes may become more apparent on the face than other parts of the body following long term treatment. This should be especially considered when the patient is being treated for psoriasis, discoid lupus erythematosus, and severe eczema.

When administered in patients suffering from psoriasis it is possible for the occurrence of rebound relapse, development of tolerance, risk of generalised pustular psoriasis, and systemic toxicity due to impaired barrier function of the skin. It is advised that careful patient supervision is maintained in this group.

Pregnancy and Lactation

Pregnancy

Use beclometasone with caution during pregnancy.

The manufacturer does not recommend using beclometasone during pregnancy.

Available reports indicate no increased risk of teratogenic or developmental effects (Briggs 2015). Schaefer (2015) states it has been used extensively in pregnant women and has a good safety record.

Lactation

Use beclometasone with caution during breastfeeding.

The manufacturer does not recommend breastfeeding while using beclometasone.

It is not known whether topical administration of corticosteroids would result in sufficient systemic absorption to produce detectable quantities in breast milk.

Studies of breastfed infants exposed to beclometasone have shown no adverse effects. (LactMed 2020)

When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure to the infant may sometimes be achieved by timing maternal doses to just after a feeding episode. If the cream is used on the nipple, it should be washed off before breastfeeding and re-applied later.

Side Effects

Exacerbation of symptoms
Hypercortisolism
Hypersensitivity reactions
Hypertrichosis
Impaired adrenal function
Local atrophic changes
Pustular psoriasis
Secondary infections
Skin pigmentation changes
Striae
Superficial vascular dilation
Thinning of skin

Presentation

Topical formulations of beclometasone dipropionate.

Drugs List

Therapeutic Indications

Uses

Dermatitis
Eczema
Psoriasis excluding widespread plaque psoriasis

Dosage

Adults

Contraindications

Children under 1 year
Varicella
Acne vulgaris
Perioral dermatitis
Rosacea
Skin infection
Skin ulcer

Precautions and Warnings

Breastfeeding
Pregnancy

Careful supervision of patients with psoriasis required
Use appropriate antimicrobial therapy in infected lesions
Some formulations contain cetostearyl alcohol
Some formulations contain propylene glycol
Breastfeeding: Wash product off breasts prior to breastfeeding infant
Cleanse skin thoroughly before applying occlusive dressings
Risk of glaucoma if preparation enters eye
Adrenal suppression may occur even without occlusion
Potential for withdrawal symptoms
Prolonged use may cause atrophic skin changes
Risk of generalised pustular psoriasis with use of topical corticosteroids
Some formulations contain chlorocresol, may cause allergic reactions
Discontinue therapy and use antimicrobials if secondary infection occurs
Avoid long-term use particularly in infants and children
Limit use in infants or on face to 5 days and without occlusion
Advise patient residue on clothing/bedding may cause fire hazard
Fire hazard: Keep away from naked flames and potential sources of ignition
Nappy may act as an occlusive dressing

In most cases the cream preparation is for use on moist or weeping skin where as the ointment is applicable for use on dry, lichenified, or scaly lesions. The correct preparation should be used depending on the patients condition.

The skin should be cleansed before the application of a fresh dressing. Bacterial infection is encouraged by warm, moist conditions induced by occlusive dressings.

When treating inflammatory lesions that are infected an appropriate antimicrobial should also be administered. If the infection spreads a discontinuation of beclometasone is required. Antimicrobial agents should then be administered systemically.

If there is no improvement in 2 to 4 weeks then diagnosis should be reassessed.

If there is a reoccurence in the days or weeks following successful treatment, especially if spread beyond the initial treatment area, this may be a withdrawal reaction. In this case specialist advice should be sought and the treatment only reapplied with caution.

Atrophic changes may become more apparent on the face than other parts of the body following long term treatment. This should be especially considered when the patient is being treated for psoriasis, discoid lupus erythematosus, and severe eczema.

When administered in patients suffering from psoriasis it is possible for the occurrence of rebound relapse, development of tolerance, risk of generalised pustular psoriasis, and systemic toxicity due to impaired barrier function of the skin. It is advised that careful patient supervision is maintained in this group.

Pregnancy and Lactation

Pregnancy

Use beclometasone with caution during pregnancy.

The manufacturer does not recommend using beclometasone during pregnancy.

Available reports indicate no increased risk of teratogenic or developmental effects (Briggs 2015). Schaefer (2015) states it has been used extensively in pregnant women and has a good safety record.

Lactation

Use beclometasone with caution during breastfeeding.

The manufacturer does not recommend breastfeeding while using beclometasone.

It is not known whether topical administration of corticosteroids would result in sufficient systemic absorption to produce detectable quantities in breast milk.

Studies of breastfed infants exposed to beclometasone have shown no adverse effects. (LactMed 2020)

When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure to the infant may sometimes be achieved by timing maternal doses to just after a feeding episode. If the cream is used on the nipple, it should be washed off before breastfeeding and re-applied later.

Side Effects

Exacerbation of symptoms
Hypercortisolism
Hypersensitivity reactions
Hypertrichosis
Impaired adrenal function
Local atrophic changes
Pustular psoriasis
Secondary infections
Skin pigmentation changes
Striae
Superficial vascular dilation
Thinning of skin

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: July 2022

Reference Sources

Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. and Yaffe, S. Lippincott Williams & Wilkins, Philadelphia.

Summary of Product Characteristics: Beclometasone dipropionate 0.25 mg/g cream. Essential Generics. Revised June 2022.
Summary of Product Characteristics: Beclometasone dipropionate 0.25 mg/g ointment. Essential Generics. Revised June 2022.

US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
Available at: https://www.ncbi.nlm.nih.gov/books/NBK501922/
Beclometasone. Last revised: 20 April 2020
Last accessed: 12 July 2022