Professional view

betamethasone sodium phosphate: prescribing and clinical use

Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.

betamethasone sodium phosphate: clinical details

Confirm the indication, formulation and route; exclude infection before prescribing eye, ear or nasal drops.
Use the minimum effective systemic exposure and plan withdrawal when adrenal suppression is possible.
Assess infection and vaccination history, relevant infection exposure, psychiatric history, diabetes, hypertension, gastrointestinal disease, osteoporosis, glaucoma and recent myocardial infarction.
Explain steroid-card or Steroid Emergency Card requirements where applicable.
The injection supplements rather than replaces established treatment in anaphylaxis, severe asthma or shock.

Hypersensitivity to betamethasone or formulation excipients.
Untreated systemic infection for systemic formulations.
Known sulphite or metabisulphite hypersensitivity for the selected injection.
For ophthalmic use: bacterial, viral, fungal, tuberculous or purulent eye disease, glaucoma, possible herpetic keratitis or an undiagnosed red eye.
For otic use: perforated tympanic membrane.
Do not inject directly into a tendon; intrathecal administration is not recommended.

Clinical response, infection and adrenal suppression during systemic treatment and withdrawal.
Blood pressure, glucose, electrolytes and weight where systemic exposure is clinically significant.
Mood, sleep, cognition and behaviour.
Bone, muscle and tendon complications with repeated or prolonged systemic treatment.
Visual symptoms, intraocular pressure, cataract and occult infection with repeated or prolonged ophthalmic treatment.
Growth in children receiving prolonged systemic or nasal treatment.

A water-soluble glucocorticoid with anti-inflammatory and immunosuppressive effects and potential hypothalamic–pituitary–adrenal axis suppression.

Soluble tablets provide systemic treatment and may be dissolved in water or swallowed whole.
The aqueous injection may be administered systemically or by selected local routes by trained professionals; it contains sodium metabisulphite.
Eye, ear and nose drops provide local treatment for non-infected inflammation. Selected preserved drops contain benzalkonium chloride, affecting soft-contact-lens use.
Local drops can cause systemic corticosteroid effects when used intensively or for prolonged periods.