Diprospan

Musculoskeletal & soft tissue conditions eg, RA, OA, bursitis, anklyosing spondylitis, epicondylitis, radiculitis, coccydynia, sciatica, lumbago, torticollis, ganglion cyst, exostosis, fasciitis. Allergic conditions eg, atopic (nummular eczema), contact & severe solar dermatitis, neurodermatitis (circumscribed lichen simplex), urticaria, hypertropic lichen planus, necrobiosis lipoidica diabeticorum, alopecia areata, discoid lupus erythematosus, psoriasis, keloids, pemphigus, dermatitis herpetiformis, cystic acne. Collagen diseases eg, disseminated lupus erythematosus, scleroderma, dermatomyositis, periarteritis nodosa. Adrenogenital syndrome; ulcerative colitis, regional ileitis; sprue; podiatric conditions (bursitis under heloma durum, hallux rigidus, digiti quinti varus); affections requiring subconjunctival inj; corticosteroid-responsive blood dyscrasias; nephritis & nephrotic syndrome.

Systemic therapy 1-2 mL deep IM inj & repeated as necessary. SLE or status asthmaticus Initially 2 mL. Dermatologic conditions 1 mL IM repeated according to the response of the condition. Symptomatic control of bronchial asthma, hay fever, allergic rhinitis & bronchitis 1-2 mL. Acute or chronic bursitis 1-2 mL IM & repeated as necessary. Acute subdeltoid, subacromial, olecranon & prepatellar bursitis 1-2 mL intrabursal inj. Acute tenosynovitis, tendinitis & peritendinitis 1 inj, may be repeated in chronic cases. Pain, soreness & stiffness relief in RA & OA 0.5-2 mL IA inj. Large joints (knee, hip, shoulder) 1-2 mL IA inj. Medium joints (elbow, wrist, ankle) 0.5-1 mL IA inj. Small joints (foot, hand, chest) 0.25-0.5 mL IA inj. Intralesional treatment 0.2 mL/cm². Max: 1 mL wkly. Bursitis under heloma durum or molle, synovial cyst & Morton's neuralgia (metatarsalgia) 0.25-0.5 mL. Bursitis under calcaneal spur, over hallux rigidus & over digiti quinti varus, tenosynovitis, cuboid periostitis 0.5 mL. Acute gouty arthritis 0.5-1 mL.

Hypersensitivity to betamethasone or other corticosteroids. Systemic fungal infection.

Not for IV use or epidural inj. Patients w/ idiopathic thrombocytopenic purpura. IM inj should be given deep into the large muscle to avoid local issue atrophy. Avoid local inj into a previously infected joint; direct in the substance of tendons. Appropriate antimicrobial therapy if diagnosis of sepsis is confirmed. Do not inject into unstable joints, infected areas or intervertebral spaces. Repeated inj into OA joints may increase joint destruction. Avoid overuse of the joint following IA corticosteroid therapy. History of allergy. Weigh potential benefits & risks before transferring from parenteral to oral administration. Monitoring may be necessary for up to 1 yr following cessation of long-term or high-dose therapy. May mask signs of infection & new infections may appear. Prolonged use may produce posterior subcapsular cataracts (especially in childn), glaucoma w/ possible damage to the optic nerves & may enhance secondary ocular infections due to fungi or viruses. Consider dietary salt restriction & K supplementation. Patients should not be vaccinated against smallpox during therapy. Avoid exposure to chickenpox or measles. Restrict therapy in fulminating or disseminated TB. Close observation in patients w/ latent TB or tuberculin reactivity. Enhanced corticosteroid effect in patients w/ hypothyroidism or cirrhosis. Possible corneal perforation in patients w/ ocular herpes simplex. Aggravate existing emotional instability or psychotic tendencies. Gradual dose reduction & avoid abrupt w/drawal. Nonspecific ulcerative colitis, diverticulitis, fresh intestinal anastomoses, active or latent peptic ulcer, renal insufficiency, HTN, osteoporosis & myasthenia gravis. False -ve results w/ nitroblue tetrazolium test. May alter the motility & number of spermatozoa. Pregnancy & lactation. Growth development in childn & infant.

Hiccups, peptic ulcer w/ possible subsequent perforation & hemorrhage, pancreatitis, abdominal distention, ulcerative esophagitis; impaired wound healing, skin atrophy, thin fragile skin; petechiae & ecchymoses; facial erythema; increased sweating; suppressed reactions to skin tests; reactions eg, allergic dermatitis, urticaria, angioneurotic edema; convulsions; increased ICP w/ papilledema (pseudotumor cerebri) usually after treatment; vertigo, headache; menstrual irregularities, development of cushingoid state, suppression of fetal intrauterine or childhood growth ,secondary adrenocortical & pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness; decreased carbohydrate tolerance, manifestations of latent DM, increased requirements of insulin or oral hypoglycemic agents in diabetics; posterior, blurred vision; -ve nitrogen balance due to protein catabolism; euphoria, mood swings; severe depression to frank psychotic manifestations; personality changes; insomnia; anaphylactoid or hypersensitivity & hypotensive or shock-like reactions.

May enhance metabolism & reduce therapeutic effects w/ phenobarb, phenytoin, rifampin, ephedrine. Excessive corticosteroid effect w/ estrogen or strong CYP3A4 inhibitors (eg, ketoconazole, itraconazole, clarithromycin, ritonavir, cobicistat-containing product). May enhance hypokalemia w/ K-depleting diuretics or amphotericin B. May enhance arrhythmias or digitalis toxicity w/ cardiac glycosides. May increase or decrease anticoagulant effects w/ coumarin-type anticoagulants. May increase occurrence or severity of GI ulceration w/ NSAIDs or alcohol. May decrease blood salicylate conc. Dosage adjustment of an antidiabetic drug may be necessary. May inhibit response to somatotropin.

Corticosteroid Hormones

H02AB01 - betamethasone ; Belongs to the class of glucocorticoids. Used in systemic corticosteroid preparations.

Rx