Betamethasone sodium phosphate
- Drugs List
- Therapeutic Indications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
Ear/Eye/Nose drops containing betamethasone sodium phosphate 0.1% w/v.
Short-term treatment of steroid responsive inflammatory conditions of the eye after clinical exclusion of bacterial, viral and fungal infections.
Non-infected inflammatory conditions of the ear or nose.
The frequency of dosing depends on the clinical response. If there is no clinical response within 7 days of treatment, the drops should be discontinued.
Treatment should be the lowest effective dose for the shortest possible time. After more prolonged treatment (over 6 to 8 weeks), the drops should be withdrawn slowly to avoid relapse.
Instil 1 or 2 drops into the affected eye(s) every one or two hours until control is achieved, frequency of dosing may then be reduced.
Instil 2 or 3 drops into the affected ear(s) every two or three hours until control is achieved, frequency of dosing may then be reduced.
Instil 2 or 3 drops into each nostril two or three times daily.
No dosage adjustment necessary ( see Dosage-Adult ).
No dosage adjustment necessary ( see Dosage-Adult ).
Prolonged use may lead to the risk of adrenal suppression in infants.
Bacterial, viral, fungal, tuberculous or purulent conditions of the eye
Herpetic keratitis (e.g. dendritic ulcer)
Undiagnosed red eye
Perforated tympanic membrane
Solution contains benzalkonium chloride and is therefore contraindicated for soft contact lens wearers
Precautions and Warnings
Prolonged use in infants may cause adrenal suppression.
The medication may cause transient blurring of vision on instillation into the eye. Patients should be warned not to drive or operate hazardous machinery unless vision is clear.
Nasal administration of corticosteroids is not advised if the patient has pulmonary tuberculosis or following nasal surgery (until healing has occurred).
It is recommended that the height of children receiving prolonged treatment with nasal corticosteroids is regularly monitored. If growth is slowed, referral to a paediatrician should be considered.
Corticosteroid treatment should not be repeated without regular review to exclude raised intraocular pressure, cataract formation or infections.
Corticosteroids may reduce resistance to and aid in the establishment of bacterial, viral and fungal infections and mask the clinical signs of infections, preventing recognition of ineffectiveness of the antibiotic. In these cases, antibiotic therapy is mandatory.
Fungal infection should be suspected in any persistent corneal ulceration where a steroid has been used, or is in use and corticosteroid therapy discontinued if fungal infection confirmed.
Patients should not to wear contact lenses during treatment as they increase the chance of infection.
Pregnancy - safety not established ( see Pregnancy ).
Breastfeeding - safety not established ( see Lactation ).
Pregnancy and Lactation
The safety of the use of betamethasone eye drops in pregnancy has not been established.
Topical administration of corticosteroids to pregnant animals can cause abnormalities in foetal development, including cleft palate, interuterine growth retardation, low birth weight and reduced head circumference at birth. There may be a small risk of such effects in the human foetus.
The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14-17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
The safety of the use of betamethasone eye drops in nursing mothers has not been established.
At the time of writing, no reports of the use of betamethasone drops by a nursing mother have been located.
Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1
Effects on Ability to Drive and Operate Machinery
The ability to drive or operate machinery may be affected by transient blurring of vision. Patients should be warned not to drive or operate machinery unless vision is clear.
The ability to drive or operate machinery may be affected by transient blurring of vision. Advise patient not to drive or operate machinery unless vision is clear.
Increased intraocular pressure
Optic nerve damage
Reduced visual acuity
Visual field damage
Posterior subcapsular cataracts
Thinning of the ocular globe
Perforation of the ocular globe
Epithelial punctate keratitis
Irritation of nasal mucosa
Perforation of nasal septum
Ulceration of the nasal septum
Systemic effects of corticosteroids, particularly with high doses prescribed for a long period may include:
Growth retardation (children)
Adrenal suppression (infants)
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 ).
Shelf Life and Storage
Store below 25 degrees C.
Do not freeze.
Keep container in outer carton.
Last Full Review Date: December 2011
Reference SourcesBritish National Formulary, 62nd Edition (2011) Pharmaceutical Press, London.
BNF for Children (2011-2012) Pharmaceutical Press, London.
Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 2nd edition (2007) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.
Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 9th edition (2011) ed. Briggs, G., Freeman, R. and Yaffe, S. Lippincott Williams & Wilkins, Philadelphia.
Martindale: The Complete Drug Reference, 37th edition (2011) ed. Sweetman, S. Pharmaceutical Press, London.
Summary of Product Characteristics: Betnesol eye, ear and nose drops. UCB Pharma Ltd. Revised April 2011.
US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
Available at: https://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
Betamethasone Last revised: July 5, 2011
Last accessed: December 28, 2011
Already a member? Log in
Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.