betamethasone topical (Diprolene, Luxiq, Dermabet, Alphatrex, Diprolene AF, Diprolene Glycol, Diprosone, Valnac, BetaVal, Sernivo)

Dosing and uses of Diprolene, Luxiq (betamethasone topical)

• Adult
• Pediatric

 

Adult dosage forms and strengths

cream/lotion/ointment

• 0.05%
• 0.1%

geL

• 0.05%

foam

• 0.12% (Luxiq)

spray

• 0.05% (Sernivo)

 

Plaque Psoriasis

Indicated for mild-to-moderate plaque psoriasis in adults

Sernivo spray: Apply to affected area(s) q12hr

 

Steroid-Responsive Dermatoses

Apply ointment/cream/lotion/gel (betamethasone dipropionate) qDay or q12hr

Apply ointment (betamethasone valerate) qDay or q8hr

Luxiq: Apply foam to scalp q12hr

 

Pediatric dosage forms and strengths

cream/lotion/ointment

• 0.05%
• 0.1%

geL

• 0.05%

foam

• 0.12%

 

Inflammatory Conditions

<12 years: Not recommended

≥12 years: Apply to affected area q12hr (low or medium potency)

Dosing considerations

• Use minimal amount for shortest period of time to avoid HPA axis suppression

 

Steroid-Responsive Dermatoses

Apply ointment/cream/lotion/gel (betamethasone dipropionate) qDay or q12hr

Apply ointment (betamethasone valerate) qDay or q8hr

 

Diprolene, Luxiq (betamethasone topical) adverse (side) effects

Frequency not defined

Skin atrophy

Striae

Allergic dermatitis

Burning

Dry skin

Erythema folliculitis

Hypertrichosis

Irritation

Miliaria

Vesiculation

Acneform lesions

Pigmentation changes

HPA suppression (with higher potency used >2 wk)

 

Warnings

Contraindications

Underlying infection present

Hypersensitivity

Ophthalmic use

 

Cautions

Chronic topical corticosteroid therapy may interfere with growth and development in children

Prolonged treatment with corticosteroids is associated with Kaposi sarcoma (consider discontinuation of therapy if diagnosed)

Discontinue if contact dermatitis occurs; not for use in patients with decreased skin circulation

Manifestations of Cushing syndrome, hyperglycemia, or glycosuria occur, especially if occlusive dressings are used

 

Pregnancy and lactation

Pregnancy category: C

Lactation: It is not known whether topical corticosteroid use could result in sufficient systemic absorption to produce detectable quantities in human milk; use with caution.

 

Pregnancy categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

 

Pharmacology of Diprolene, Luxiq (betamethasone topical)

Mechanism of action

Corticosteroids decrease inflammation by stabilizing leukocyte lysosomal membranes, preventing release of destructive acid hydrolases from leukocytes, inhibiting macrophage accumulation in inflamed areas, reducing leukocyte adhesion to capillary endothelium, reducing capillary wall permeability and edema formation, decreasing complement components, antagonizing histamine activity and release of kinin from substrates, and reducing fibroblast proliferation, collagen deposition, and subsequent scar tissue formation

 

Absorption

Yes

 

Administration

Topical Administration

Use medium to very high potency for less than 2 weeks to reduce local and systemic side effects

Use low potency for chronic therapy

Avoid medium to very high potency on face, folds, and groin, because use in these areas can increase steroid absorption

Use lower potency for children (ie, increased BSA/kg, therefore increased systemic absorption)