Topical/Cutaneous Corticosteroid-responsive dermatoses, Hyperkeratotic and scaling skin conditions
Adult: Betamethasone dipropionate 0.064% (equivalent to betamethasone 0.05%) and salicylic acid 3% ointment
Betamethasone dipropionate 0.064% (equivalent to betamethasone 0.05%) and salicylic acid 2% topical solution
Apply a thin film onto the affected area(s) 1-2 times daily for 2 weeks.
Betamethasone dipropionate 0.064% (equivalent to betamethasone 0.05%) and salicylic acid 2% lotion
Apply a few drops onto the affected area(s) 1-2 times daily. Effective maintenance therapy may be achieved with less frequent applications in certain patients. Dosing and treatment recommendations may vary among individual products or between countries (refer to detailed local product guidelines).
Child: Betamethasone dipropionate 0.064% (equivalent to betamethasone 0.05%) and salicylic acid 3% ointment
Betamethasone dipropionate 0.064% (equivalent to betamethasone 0.05%) and salicylic acid 2% topical solution
Apply a thin film onto the affected area(s) 1-2 times daily for 5 days. Effective maintenance therapy may be achieved with less frequent applications in certain patients. Dosing and treatment recommendations may vary among individual products or between countries (refer to detailed local product guidelines).
What are the brands available for Betamethasone + Salicylic acid in Hong Kong?
Hypersensitivity. Skin tuberculosis, viral lesions of the skin (e.g. vaccinia, varicella, herpes simplex), fungal or bacterial skin infections, napkin eruptions, acne, rosacea, perioral dermatitis, perianal and genital pruritus.
Special Precautions
Patient with psoriasis. Avoid long-term continuous treatment particularly in extensive body surface areas or skin folds. Limit use to 5 days when applied on the face. Children. Pregnancy and lactation.
Adverse Reactions
Significant: Adrenal suppression, hyperglycaemia, glucosuria; HPA axis suppression, Cushing's syndrome, linear growth retardation, delayed weight gain, intracranial hypertension (particularly in children); visual disturbances (e.g. blurred vision); topical steroid withdrawal reactions (withdrawal after long-term use), may be manifested as severe redness which can spread beyond the initial affected area, itching, burning or stinging sensation, and skin peeling; salicylism. Skin and subcutaneous tissue disorders: Local skin atrophy, striae, superficial vascular dilation (particularly on the face); burning, itching, irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, skin maceration.
Patient Counseling Information
Avoid contact with the eyes or mucous membranes. Do not use occlusive dressings unless directed by the doctor.
Monitoring Parameters
Monitor HPA axis suppression and adrenal insufficiency (particularly in children).
Overdosage
Symptoms: Betamethasone: Suppression of pituitary-adrenal functions leading to secondary adrenal insufficiency; manifestation of hypercorticism including Cushing's disease. Salicylic acid: Salicylism. Management: Symptomatic treatment. Treat electrolyte imbalance, if needed. In case of chronic toxicity, slowly withdraw the use of the product. Employ measures to remove the salicylate from the body. Administer oral Na bicarbonate to alkalinise the urine and force diuresis.
Lab Interference
Betamethasone: May suppress the wheal and flare reactions to skin test antigens.
Action
Description: Mechanism of Action: Betamethasone is a synthetic fluorinated corticosteroid. It is active topically and may reduce the production, release, and action of endogenous chemical mediators (including kinins, histamine, liposomal enzymes, prostaglandins) by inducing phospholipase A2 inhibitory proteins (lipocortins) and sequentially inhibiting the release of arachidonic acid. Betamethasone has an intermediate to very high range of potency.
Salicylic acid is a keratolytic agent. It produces desquamation of hyperkeratotic epithelium by dissolving the intercellular cement, leading to swelling, softening, maceration, and desquamation of the cornified tissue.
Pharmacokinetics: Absorption: Betamethasone: Absorbed percutaneously.
Salicylic acid: Readily absorbed after topical application. Distribution: Crosses the placenta.
Salicylic acid: Plasma protein binding: 50-80%, mainly to albumin. Metabolism: Betamethasone: Metabolised in the liver. Excretion: Betamethasone: Via urine and bile.
Salicylic acid: Via urine (52% as salicyluric acid, 42% as salicylate glucuronides, 6% as salicylic acid).
Chemical Structure
Betamethasone Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 9782, Betamethasone. https://pubchem.ncbi.nlm.nih.gov/compound/Betamethasone. Accessed Sept. 24, 2024.
Salicylic acid Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 338, Salicylic Acid. https://pubchem.ncbi.nlm.nih.gov/compound/Salicylic-Acid. Accessed Oct. 25, 2024.
D07XC01 - betamethasone ; Belongs to the class of potent (group III) corticosteroids in other combinations. Used in the treatment of dermatological diseases.
References
Anon. Betamethasone, Betamethasone Benzoate, Betamethasone Dipropionate, Betamethasone Valerate. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 04/10/2024.Anon. Salicylic Acid. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 04/10/2024.Beprosalic Lotion (HOE Pharmaceuticals Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 04/10/2024.Beprosalic Ointment (HOE Pharmaceuticals Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 04/10/2024.Betamethasone (Topical). UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 04/10/2024.Betamethasone and Salicylic Acid. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 04/10/2024.Brayfield A, Cadart C (eds). Betamethasone. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 04/10/2024.Brayfield A, Cadart C (eds). Salicylic Acid. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 04/10/2024.Diprosalic 0.05% w/w / 3% w/w Ointment (Organon Pharma [UK] Limited). MHRA. https://products.mhra.gov.uk. Accessed 04/10/2024.Diprosalic Scalp Application 0.05% w/w / 2% w/w, Cutaneous Solution (Organon Pharma [UK] Limited). MHRA. https://products.mhra.gov.uk. Accessed 04/10/2024.Joint Formulary Committee. Betamethasone with Salicylic Acid. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 04/10/2024.Salicylic Acid. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 04/10/2024.Topical Steroids: Introduction of New Labelling and a Reminder of the Possibility of Severe Side Effects, Including Topical Steroid Withdrawal Reactions. Medicines & Healthcare products Regulatory Agency. https://www.gov.uk/drug-safety-update. Accessed 21/10/2024.
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