Betamethasone (Diprolene) Indications and Dosage

acute lymphocytic leukemia (ALL)
Addison’s disease
adrenal hyperplasia
adrenocortical insufficiency
adrenogenital syndrome
allergic conjunctivitis
allergic rhinitis
alopecia
anaphylaxis
angioedema
ankylosing spondylitis
anterior segment inflammation
asthma
atopic dermatitis
berylliosis
bronchospasm prophylaxis
bursitis
chorioretinitis
chronic lymphocytic leukemia (CLL)
chronic obstructive pulmonary disease (COPD)
Churg-Strauss syndrome _†
contact dermatitis
corneal ulcer
Crohn’s disease
cutaneous T-cell lymphoma (CTCL)
dermatitis
dermatitis herpetiformis
dermatomyositis
discoid lupus erythematosus
eczema
endophthalmitis _†
epicondylitis
erythroblastopenia
exfoliative dermatitis
gastroenteritis
gouty arthritis
graft-versus-host disease (GVHD)
granuloma annulare
Graves’ ophthalmopathy
hemolytic anemia
Hodgkin’s disease
hyaline membrane disease prophylaxis _†
hypercalcemia
hypoplastic anemia
idiopathic thrombocytopenic purpura (ITP)
iritis
juvenile rheumatoid arthritis (JRA)
keloids
keratitis
laryngotracheobronchitis (croup)
lichen planus
lichen simplex
Loeffler’s syndrome
mixed connective tissue disease _†
multiple myeloma _†
multiple sclerosis
myasthenia gravis
mycosis fungoides
nasal polyps
necrobiosis lipoidica diabeticorum
nephrotic syndrome
non-Hodgkin’s lymphoma (NHL)
optic neuritis
osteoarthritis
pemphigus
pityriasis rosea
pneumonitis
polyarteritis nodosa _†
polychondritis _†
polymyositis
postoperative ocular inflammation
proteinuria
pruritus
psoriasis
psoriatic arthritis
pulmonary edema _†
rheumatic carditis
rheumatoid arthritis
Rhus dermatitis
sarcoidosis
seborrheic dermatitis
serum sickness
Stevens-Johnson syndrome
systemic lupus erythematosus (SLE)
temporal arteritis _†
tenosynovitis
thrombocytopenia
thyroiditis
trichinosis
tuberculosis
ulcerative colitis
urticaria
uveitis
vernal keratoconjunctivitis
Wegener’s granulomatosis _†

_† non-FDA-approved indication

Betamethasone (Diprolene) Indications and Dosage

Equivalent Glucocorticoid dosages. These are general approximations and may not apply to all diseases or routes of administration.
Equivalent glucocorticoid dosages:
Cortisone--25 mg
Hydrocortisone--20 mg
Prednisolone--5 mg
Prednisone--5 mg
Methylprednisolone--4 mg
Triamcinolone--4 mg
Dexamethasone--0.75 mg
Betamethasone--0.6 mg

General Comparative Topical Corticosteroid Potency:
NOTE: The following is a general representation. Check specific product formulations prior to making potency decisions.
Very High Potency
Betamethasone dipropionate (augmented)
Clobetasol
Diflorasone diacetate ointment
Halobetasol
High Potency
Amcinonide
Betamethasone dipropionate
Desoximetasone gel or ointment, or cream >= 0.25%
Diflorasone diacetate cream
Fluocinolone cream >= 0.2%
Fluocinonide
Halcinonide
Triamcinolone >= 0.5%
Medium Potency
Beclomethasone
Betamethasone benzoate
Betamethasone valerate
Clobetasone
Desoximetasone cream < 0.25%
Diflucortolone
Fluocinolone ointment or topical solution or cream < 0.2%
Flurandrenolide >= 0.025%
Fluticasone
Hydrocortisone butyrate
Hydrocortisone valerate
Mometasone
Triamcinolone < 0.5%
Low Potency
Alclometasone
Clocortolone
Desonide
Dexamethasone
Flumethasone
Flurandrenolide < 0.025%
Hydrocortisone base
Hydrocortisone acetate

For hyaline membrane disease prophylaxis _† , for the purpose of fetal lung maturation to prophylax against anticipated neonatal respiratory distress syndrome (RDS) _† in premature infants:
Intramuscular dosage (betamethasone sodium phosphate and betamethasone acetate combination):
Adult females of third trimester gestation: Used to induce fetal lung maturation in preparation for premature delivery; the dosage administered to the expectant mother is 2 ml (containing 6 mg betamethasone sodium phosphate with 6 mg betamethasone acetate) IM once daily for 2 or 3 days prior to delivery.

For the treatment of acute graft-versus-host disease (GVHD):
Intramuscular dosage (betamethasone sodium phosphate and betamethasone acetate combination):
Adults and children: 0.5-9 mg IM daily. Dose range is one third to one half the normal corticosteroid oral dose given every 12 hours.

For the treatment of nonsuppurative thyroiditis:
Oral dosage (betamethasone):
Adults: 0.6-7.2 mg/day PO, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

Intramuscular dosage (betamethasone sodium phosphate and betamethasone acetate combination):
Adults and children: 0.5-9 mg IM per day. Dose range is one third to one half the normal oral dose given every 12 hours.

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required, adjust according to patient response.

For the treatment of acute exacerbations of multiple sclerosis:
Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required, adjust according to patient response.

For palliative management of leukemia and lymphoma in adults and acute leukemias of childhood including acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), Hodgkin’s disease, non-Hodgkin’s lymphoma (NHL), or multiple myeloma _† :
Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

Intramuscular dosage (betamethasone sodium phosphate and betamethasone acetate combination):
Adults and children: 0.5-9 mg IM per day. Dose range is one third to one half the normal oral dose given every 12 hours.

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required, adjust according to patient response.

For maintenance therapy in selected cases of acute rheumatic carditis, systemic dermatomyositis (polymyositis), systemic lupus erythematosus (SLE), temporal arteritis _† , Churg-Strauss syndrome _† , mixed connective tissue disease _† , polyarteritis nodosa _† , relapsing polychondritis _† , polymyalgia rheumatica _† , vasculitis _† , or Wegener’s granulomatosis _† :
Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required, adjust according to patient response.

For the treatment of corticosteroid-responsive ophthalmic disorders including allergic conjunctivitis (not controlled topically), allergic marginal corneal ulcer, anterior segment inflammation, chorioretinitis, conjunctivitis, endophthalmitis _† , Graves’ ophthalmopathy, herpes zoster ophthalmicus, iritis, keratitis, postoperative ocular inflammation, optic neuritis, diffuse posterior uveitis, or vernal keratoconjunctivitis:
Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required, adjust according to patient response.

For the management of symptomatic sarcoidosis or for the treatment of hypercalcemia associated with cancer or sarcoidosis:
Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required, adjust according to patient response.

For the treatment of respiratory inflammatory conditions including airway-obstructing hemangioma _† in infants, aspiration pneumonitis, berylliosis, bronchial asthma, chronic obstructive pulmonary disease (COPD), laryngotracheobronchitis (croup), Loeffler’s syndrome, or non-cardiogenic pulmonary edema _† , or for bronchospasm prophylaxis:
NOTE: Betamethasone should be administered parenterally initially in the treatment of severe manifestations of these diseases, particularly where airway obstruction is present.
Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required, adjust according to patient response.

For the treatment of allergic disorders including anaphylaxis or anaphylactoid reactions, angioedema, acute noninfectious laryngeal edema, drug hypersensitivity reactions, serum sickness, or severe perennial or seasonal allergic rhinitis:
NOTE: Betamethasone should be administered IM or IV initially in the treatment of anaphylaxis or anaphylactoid reactions, angioedema, and acute noninfectious laryngeal edema.
Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required, adjust according to patient response.

for the treatment of urticarial transfusion reactions:

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required, adjust according to patient response.

For the treatment of adrenocortical function abnormalities (NOTE: Hydrocortisone and cortisone are the preferred agents for these conditions):

for the treatment of acute adrenocortical insufficiency:

Intramuscular dosage (betamethasone sodium phosphate and betamethasone acetate combination):
Adults: 0.5-9 mg IM per day. Dose range is one third to one half the normal oral dose, given every 12 hours.
Children: 17.5 mcg (base)/kg IM or 500 mcg (base)/m2 IM in three divided doses every third day; or approximately half the dosage once a day.

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required, adjust according to patient response.

for the treatment of congenital adrenal hyperplasia, chronic primary (Addison’s disease) or secondary adrenocortical insufficiency, or adrenogenital syndrome:

Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

Intramuscular dosage (betamethasone sodium phosphate and betamethasone acetate combination):
Adult: 0.5-9 mg IM per day. Dose range is one third to one half the normal oral dose, given every 12 hours.
Children: 17.5 mcg (base)/kg IM or 500 mcg (base)/m2 IM in three divided doses every third day; or approximately half the dosage once a day.

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required. Maintenance dosage should be adjusted according to patient response.

For the treatment of hematologic disorders including idiopathic thrombocytopenic purpura (ITP), secondary thrombocytopenia in adults, acquired (autoimmune) hemolytic anemia, erythroblastopenia (RBC anemia), and congenital hypoplastic anemia:
Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

For the adjunctive treatment of tuberculosis:

for the adjunctive treatment of fulminating or disseminated pulmonary tuberculosis used concurrently with appropriate antituberculous therapy:

Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required, adjust according to patient response.

for the adjunctive treatment of tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous therapy:

Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required, adjust according to patient response.

For the treatment of trichinosis with neurologic or myocardial involvement:
Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required, adjust according to patient response.

For the treatment of inflammatory bowel disease including Crohn’s disease (regional gastroenteritis) and ulcerative colitis:
Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required, adjust according to patient response.

For the induction of diuresis or remission of proteinuria in the nephrotic syndrome:
Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required, adjust according to patient response.

For the treatment of nasal polyps:
Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required, adjust according to patient response.

For the treatment of severe cases of myasthenia gravis not controlled by antimyasthenic agents alone:
Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

For adjunctive therapy in the treatment of rheumatic disorders e.g., acute gouty arthritis, ankylosing spondylitis, juvenile rheumatoid arthritis (JRA), osteoarthritis, polychondritis _† , psoriatic arthritis, rheumatoid arthritis:
Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required, adjust according to patient response.

Intra-bursal or intra-articular (betamethasone sodium phosphate and betamethasone acetate combination):
Adults and children: 1.5-12 mg (0.25-2 ml)/dose at the appropriate site as follows:
very large joint 1-2 ml; large joint 1 ml; medium joint 0.5-1 ml; small joint 0.25-0.5 ml. For acute gouty arthritis use 0.5-1 ml/dose.

Intra-articular or soft-tissue dosage (betamethasone sodium phosphate):
Adults: Dosage depends on the degree of inflammation and the size and location of the affected area.

For the treatment of acute episodes or exacerbation of nonrheumatic inflammation including acute and subacute bursitis, epicondylitis, and acute non-specific tenosynovitis:
Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

Intramuscular or intravenous dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg IV or IM per day may be required, adjust according to patient response.

Intra-bursal or intra-articular (betamethasone sodium phosphate and betamethasone acetate combination):
Adults and children: 1.5-3 mg (0.25-0.5 ml)/dose at the appropriate site as follows:
bursitis, under heloma durum or heloma molle give 0.25-0.5 ml/dose. For bursitis, under calcaneal spur or for bursitis over hallux rigidus or digiti quinti varus give 0.5 ml/dose. For tenosynovitis, periostitis of cuboid give 0.5 ml/dose.

Intra-articular or soft-tissue dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg may be used. Repeat as needed. Dosage depends on the degree of inflammation and the size and location of the affected area.

For the treatment of moderate-to-severe inflammatory conditions, including pruritus, of corticosteroid-responsive dermatologic disorders such as alopecia areata, cutaneous T-cell lymphoma (CTCL) (aka mycosis fungoides), atopic dermatitis, bullous dermatitis herpetiformis, contact dermatitis, generalized exfoliative dermatitis, nummular dermatitis, seborrheic dermatitis, eczema, granuloma annulare, keloids, lichen planus, lichen simplex chronicus, lichen striatus, subacute cutaneous and discoid lupus erythematosus, pretibial myxedema, necrobiosis lipoidica diabeticorum, pemphigoid, pemphigus, pityriasis rosea, psoriasis, Rhus dermatitis (due to poison ivy, poison oak, or poison sumac), sarcoidosis, Stevens-Johnson syndrome, sunburn, or urticaria:
NOTE: Systemic therapy or intralesional injection of corticosteroids may be necessary for some conditions based on the type and severity of the disorder or inadequate response to topical therapy.
Oral dosage (betamethasone):
Adults: 0.6-7.2 mg PO per day, given as a single dose or in divided doses.
Children: 62.5-250 mcg/kg/day PO or 1.875-7.5 mg/m2/day PO, given in 3 or 4 divided doses.

Intradermal or intralesional dosage (betamethasone sodium phosphate and betamethasone acetate combination):
Adults and children: 1.2 mg (0.2 ml)/cm², intradermally, up to 6 mg (1 ml) at weekly intervals.

Intralesional dosage (betamethasone sodium phosphate):
Adults: Up to 9 mg may be used. Repeat as needed. Dosage depends on the degree of inflammation and the size and location of the affected area.

Topical dosage (cream, lotion, or ointment):
NOTE: Use of Diprolene® AF or Diprosone products (cream, lotion or ointment) in children <= 12 years is not recommended (betamethasone_diprolene_contraindications_and_precautions/">see Precautions).
Adults and adolescents: Apply a thin film of a 0.025-0.1% (base) to affected area 2-4 times a day.

Topical dosage (aerosol):
Adults and children: Spray an area about the size of the patient’s hand for not more than 3 seconds from a distance of about 15 cm 3-4 times daily.

for the relief of the inflammatory and pruritic manifestations of corticosteroid-responsive scalp dermatoses (e.g., scalp psoriasis or seborrheic dermatitis):

Topical dosage (0.12% betamethasone valerate foam):
Adults: Apply topically to the scalp twice daily, morning and night.

Maximum Dosage Limits:
Corticosteroid dosage must be individualized and is highly variable depending on the nature and severity of the disease, route of treatment, and on patient response.

Adults: 45 g/week (Diprolene® cream or ointment); 50 g/week (Diprolene® gel); 50 ml/week topically for no longer than 2 weeks (Diprolene® lotion).
Elderly: 45 g/week (Diprolene® cream or ointment); 50 g/week (Diprolene® gel); 50 ml/week topically for no longer than 2 weeks (Diprolene® lotion).
Adolescents: 45 g/week (Diprolene® cream or ointment); 50 g/week (Diprolene® gel); 50 ml/week topically for no longer than 2 weeks (Diprolene® lotion).
Children < 12 years: Diprolene® products and betamethasone foam are not recommended in these patients.

Patients with hepatic impairment:
Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed.

Patients with renal impairment:
Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.

_† non-FDA-approved indication

[ Last revised: 7/19/2004 1:30:00 PM ]

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