Betamethasone

Structural formula
General
Non-proprietary name	Betamethasone
other names	9-fluoro-11 β , 17,21-trihydroxy-16 β -methylpregna-1,4-diene-3,20-dione
Molecular formula	C 22 H 29 FO 5
External identifiers / databases
EC number	206-825-4
ECHA InfoCard	100.006.206
PubChem	9782
DrugBank	DB00443
Wikidata	Q416132
Drug information
ATC code	A07 EA04 ; C05 AA05 ; D07 AC01 ; D07 XC01 ; H02 AB01 ; R01 AD06 ; R03 BA04 ; S01 BA06 ; S01 CB04 ; S02 BA07 ; S03 BA03 ;
Drug class	Glucocorticoids
properties
Molar mass	392.46 g · mol -1
Physical state	firmly
Melting point	232 ° C
solubility	almost insoluble in water (66.5 mg / l at 25 ° C)
safety instructions
	Please note the exemption from the labeling requirement for drugs, medical devices, cosmetics, food and animal feed
GHS labeling of hazardous substances danger
H and P phrases	H: 360-373
	P: 201-308 + 313
Toxicological data	> 4500 mg kg −1 ( LD 50 , mouse , oral )
	As far as possible and customary, SI units are used. Unless otherwise noted, the data given apply to standard conditions .

Betamethasone is a synthetic glucocorticoid that is used as a medicinal substance. The substance from the group of steroid hormones has anti-inflammatory, antiallergic and immunosuppressive effects . Betamethasone and its derivatives are part of a number of drugs for both systemic and local (topical) use . It differs from dexamethasone only in the position of the methyl group in position 16.

application

Betamethasone is used in the therapy of:

inflammatory skin diseases ( eczema , psoriasis, etc.)
allergic reactions (acute treatment after bee or wasp stings for insect venom allergy , anaphylactic shock , hives, etc.)
rheumatic diseases ( e.g. rheumatoid arthritis , acute rheumatic fever with carditis ),
Autoimmune diseases (e.g. systemic lupus erythematosus )
Diseases of the lungs and respiratory tract (severe acute asthma attack , chronic obstructive pulmonary disease , toxic pulmonary edema , initiation of lung maturation in the unborn if there is a risk of premature birth, etc.)
gastrointestinal inflammatory diseases ( Crohn's disease , ulcerative colitis )
A cream with 0.05% betamethasone is effective in treating phimosis and often makes circumcision unnecessary.

Betamethasone is also used for the supportive treatment of malignant tumors and for the prevention and treatment of vomiting during cytostatic treatment .

Its use to lower intracranial pressure, for example due to intracranial bleeding , is controversial and is no longer generally recommended.

Various derivatives or salts are used as required. For local application on the skin ( topical application ) are the betamethasone-17- valerate and betamethasone 17,21-di propionate in question. Both are highly effective, betamethasone-17-valerate is one of the topical glucocorticoids of category 1 (therapeutic index approx. 1).

In the guideline for the medical treatment of scalp psoriasis, betamethasone or the vitamin D ₃ analogue calcipotriol is recommended alone or as a fixed combination. In a study in which patients with scalp psoriasis had used a lipo-gel with betamethasone and calcipotriol for one year, 49% of the patients were virtually or completely free of symptoms after two weeks.

The water-soluble betamethasone dihydrogen phosphate disodium is available for injection. A prolonged effectiveness (depot effect) is achieved by adding poorly soluble betamethasone-17,21-dipropionate or betamethasone-21-acetate. The resulting injection suspension is not suitable for intravenous administration, but is primarily intended for injection into large joints ( intra-articular injection).

safety instructions

Since betamethasone penetrates the placenta, it can lead to complications such as hypoglycaemia in newborns (even in utero , i.e. still in the womb).

Trade names

Monopreparations

Bemon (D), Beta Creme (D), Betagalen (D), Beta Lotio (D), Betnesol (D, A, CH), Celestamine (D), Celestan (D), Celestoderm (CH), Celestone (CH) , Cordes Beta (D), Deflatop (D), Diproderm (A), Diproforte (A), Diprolen (CH), Diprophos (CH), Diprosalic (D), Diprosis (D), Diprosone (D, CH), Linolacort Beta (D), Soderm (D), Solu-Celestan (A)

Combination preparations

Betadermic (D), Betnovate (A, CH), Celestan (A), Daivobet (A, D, CH), Daivobet Gel (D), Diprogenta (D, A, CH), Diprophos (A), Diprosalic (A, CH), Enstilar (D, A, CH), Fucicort (D, CH), Lotricomb (D), Ophtasone (CH), Psorcutan Beta (D, A), Quadriderm (CH), Soderm plus (D), Sulmycin ( D), Triderm (CH), Xamiol (D), Xarniol (CH)

Web links

Betamethasone . safefetus.com. Retrieved December 15, 2010.

Individual evidence

↑ ^a ^b ^c Entry on betamethasone in the ChemIDplus database of the United States National Library of Medicine (NLM) .
↑ ^a ^b data sheet betamethasone from Sigma-Aldrich , accessed on March 13, 2011 ( PDF ).
↑ Ernst Mutschler, Gerd Geisslinger, Heyo K. Kroemer, Peter Ruth, Monika Schäfer-Korting: drug effects. Textbook of pharmacology and toxicology. 9th edition. Wissenschaftliche Verlagsgesellschaft mbH, Stuttgart 2008, ISBN 3-8047-1952-X .
^ RS Van Howe: Cost-effective treatment of phimosis . In: Pediatrics. Volume 102, Number 4, October 1998, p. E43, PMID 9755280 .
↑ Ciro Esposito, Antonella Centonze, Francesca Alicchio, Antonio Savanelli, Alessandro Settimi: Topical steroid application versus circumcision in pediatric patients with phimosis: a prospective randomized placebo controlled clinical trial. In: World Journal of Urology . 2008, 26, pp. 187-190, doi: 10.1007 / s00345-007-0231-2 .
↑ Nicola Zampieri, Michele Corroppolo, Veronica Zuin, Sanzio Bianchi, Francesco Saverio Camoglio: Phimosis and topical steroids: new clinical findings . In: Pediatric Surgery International . tape 23 , no. 4 , April 2007, pp. 331-335 , doi : 10.1007 / s00383-007-1878-x .
^ S1 guidelines for brain pressure ( memento from October 9, 2010 in the Internet Archive ) of the German Society for Neurology. In: AWMF online
^ S1 guidelines for intracerebral hemorrhage ( memento of August 21, 2010 in the Internet Archive ) of the German Society for Neurology. In: AWMF online
^ S1 guidelines on psoriasis of the hairy head of the German Dermatological Society. In: AWMF online
↑ TA Luger, F. Cambazard, FG Larsen, M. Bourcier, G. Gupta, F. Clonier, P. Kidson, NH Shear: A Study of the Safety and Efficacy of Calcipotriol and Betamethasone Dipropionate Scalp Formulation in the Long-Term Management of scalp psoriasis . In: Dermatology . tape 217 , no. 4 , 2008, p. 321-328 , doi : 10.1159 / 000155642 , PMID 18787325 .

[ChemIDplus-1] Entry on betamethasone in the ChemIDplus database of the United States National Library of Medicine (NLM) .

[Sigma-2] ta sheet betamethasone from Sigma-Aldrich , accessed on March 13, 2011 ( PDF ).

[mutschler-3] Ernst Mutschler, Gerd Geisslinger, Heyo K. Kroemer, Peter Ruth, Monika Schäfer-Korting: drug effects. Textbook of pharmacology and toxicology. 9th edition. Wissenschaftliche Verlagsgesellschaft mbH, Stuttgart 2008, ISBN 3-8047-1952-X .

[vanHowe1998-4] RS Van Howe: Cost-effective treatment of phimosis . In: Pediatrics. Volume 102, Number 4, October 1998, p. E43, PMID 9755280 .

[World_Journal_of_Urology-5] Ciro Esposito, Antonella Centonze, Francesca Alicchio, Antonio Savanelli, Alessandro Settimi: Topical steroid application versus circumcision in pediatric patients with phimosis: a prospective randomized placebo controlled clinical trial. In: World Journal of Urology . 2008, 26, pp. 187-190, doi: 10.1007 / s00345-007-0231-2 .

[Pediatric_Surgery_International-6] Nicola Zampieri, Michele Corroppolo, Veronica Zuin, Sanzio Bianchi, Francesco Saverio Camoglio: Phimosis and topical steroids: new clinical findings . In: Pediatric Surgery International . tape 23 , no. 4 , April 2007, pp. 331-335 , doi : 10.1007 / s00383-007-1878-x .

[7] S1 guidelines for brain pressure ( memento from October 9, 2010 in the Internet Archive ) of the German Society for Neurology. In: AWMF online

[8] S1 guidelines for intracerebral hemorrhage ( memento of August 21, 2010 in the Internet Archive ) of the German Society for Neurology. In: AWMF online

[9] S1 guidelines on psoriasis of the hairy head of the German Dermatological Society. In: AWMF online

[10] TA Luger, F. Cambazard, FG Larsen, M. Bourcier, G. Gupta, F. Clonier, P. Kidson, NH Shear: A Study of the Safety and Efficacy of Calcipotriol and Betamethasone Dipropionate Scalp Formulation in the Long-Term Management of scalp psoriasis . In: Dermatology . tape 217 , no. 4 , 2008, p. 321-328 , doi : 10.1159 / 000155642 , PMID 18787325 .