Betnelan , Celestone
Celestone Soluspan
Beben , Benisone, Uticort
Alphatrex, Diprolene, Diprosone, Maxivate
Betameth, Betnesol , Celestone Phosphate, Celestone S, Cel-U-Jec, Selestoject
Betacort, Betaderm , Betatrex, Beta-Val, Betnovate , Celestoderm , Ectosone Lotion , Luxiq, Metaderm , Novobetamet , Valisone, Valisone Scalp Lotion, Valnac, Psorion cream
Classifications: hormone and synthetic substitute; adrenal corticosteroid; glucocorticoid; antiinflammatory
Prototype: Hydrocortisone
Pregnancy Category: C


Betamethasone 0.6 mg tablets; 0.6 mg/5 mL syrup

Betamethasone Acetate and Betamethasone Sodium 3 mg acetate, 3 mg sodium phosphate/mL suspension

Betamethasone Benzoate, Betamethasone Dipropionate, and Betamethasone Sodium Phosphate (pH 8.5) 4 mg/mL injection

Betamethasone Valerate 0.1% ointment; 0.01%, 0.05%, 0.1% cream; 0.1% lotion; 1.2 mg/g foam


Synthetic, long-acting glucocorticoid with minor mineralocorticoid properties but strong immunosuppressive, antiinflammatory, and metabolic actions.

Therapeutic Effects

Relieves antiinflammatory manifestations and is an immunosuppressive agent.


Reduces serum calcium in hypercalcemia, suppresses undesirable inflammatory or immune responses, produces temporary remission in nonadrenal disease, and blocks ACTH production in diagnostic tests. Topical use provides relief of inflammatory manifestations of corticosteroid-responsive dermatoses.

Unlabeled Uses

Prevention of neonatal respiratory distress syndrome (hyaline membrane disease).


In patients with systemic fungal infections. Pregnancy (category C), lactation, vaccines.

Cautious Use

Ocular herpes simplex; concomitant use of aspirin; osteoporosis; diverticulitis, nonspecific ulcerative colitis, abscess or other pyrogenic infection, peptic ulcer disease; hypertension; renal insufficiency; myasthenia gravis.

Route & Dosage

Antiinflammatory Agent
Adult: PO 0.6–7.2 mg/d IM/IV 0.5–9 mg/d as sodium phosphate

Topical See Appendix A-4
Child: PO 0.0175–0.25 mg/kg/d or 0.5–0.75 mg/m2/d divided q6–8h
Child: IM 0.0175–0.125 mg/kg/d or 0.5–0.75 mg/m2/d divided q6–8h

Respiratory Distress Syndrome
Adult: IM 2 mL of sodium phosphate to mother once daily 2–3 d before delivery



PREPARE: Direct: Give by direct IV undiluted or further diluted in D5W or NS.  

ADMINISTER: Direct: Give at a rate of 1 dose/min.  

INCOMPATIBILITIES Solution/additive: Amobarbital, ampicillin, bleomycin, colistimethate, dimenhydrinate, doxapram, doxorubicin, ephedrine, heparin, hydralazine, metaraminol, methicillin, nafcillin, pentobarbital, phenobarbital, prochlorperazine, promethazine, secobarbital, tetracycline. Y-site: Ergotamine, phenytoin.

Adverse Effects (1%)

Body as a Whole: Hypersensitivity or anaphylactoid reactions; aggravation or masking of infections; malaise, weight gain, obesity. Most adverse effects are dose and treatment duration dependent. CNS: Vertigo, headache, nystagmus, ataxia (rare), increased intracranial pressure with papilledema (usually after discontinuation of medication), mental disturbances, aggravation of preexisting psychiatric conditions, insomnia. CV: Hypertension; syncopal episodes, thrombophlebitis, thromboembolism or fat embolism, palpitation, tachycardia, necrotizing angiitis; CHF. Endocrine: Suppressed linear growth in children, decreased glucose tolerance; hyperglycemia, manifestations of latent diabetes mellitus; hypocorticism; amenorrhea and other menstrual difficulties. Special Senses: Posterior subcapsular cataracts (especially in children), glaucoma, exophthalmos, increased intraocular pressure with optic nerve damage, perforation of the globe, fungal infection of the cornea, decreased or blurred vision. Metabolic: Hypocalcemia; sodium and fluid retention; hypokalemia and hypokalemic alkalosis; negative nitrogen balance. GI: Nausea, increased appetite, ulcerative esophagitis, pancreatitis, abdominal distention, peptic ulcer with perforation and hemorrhage, melena; decreased serum concentration of vitamins A and C. Hematologic: Thrombocytopenia. Musculoskeletal: Osteoporosis, compression fractures, muscle wasting and weakness, tendon rupture, aseptic necrosis of femoral and humeral heads (all resulting from long-term use). Skin: Skin thinning and atrophy, acne, impaired wound healing; petechiae, ecchymosis, easy bruising; suppression of skin test reaction; hypopigmentation or hyperpigmentation, hirsutism, acneiform eruptions, subcutaneous fat atrophy; allergic dermatitis, urticaria, angioneurotic edema, increased sweating. Urogenital: Increased or decreased motility and number of sperm; urinary frequency and urgency, enuresis. With parenteral therapy, IV site: Pain, irritation, necrosis, atrophy, sterile abscess; Charcot-like arthropathy following intraarticular use; burning and tingling in perineal area (after IV injection).

Diagnostic Test Interference

May increase serum cholesterol, blood glucose, serum sodium, uric acid (in acute leukemia) and calcium (in bone metastasis). It may decrease serum calcium, potassium, PBI, thyroxin (T4), triiodothyronine (T3) and reduce thyroid I 131 uptake. It increases urine glucose level and calcium excretion; decreases urine 17-OHCS and 17-KS levels. May produce false-negative results with nitroblue tetrazolium test for systemic bacterial infection and may suppress reactions to skin tests.


Drug: barbiturates, phenytoin, rifampin may reduce pharmacologic effect of betamethasone by increasing its metabolism.


Not studied.

Nursing Implications

Assessment & Drug Effects

Patient & Family Education

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug