betamethasone topical (Diprolene, Luxiq, Dermabet, Alphatrex, Diprolene AF, Diprolene Glycol, Diprosone, Valnac, BetaVal, Sernivo)
Classes: Corticosteroids, Topical
Dosing and uses of Diprolene, Luxiq (betamethasone topical)
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)