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Indications:

# Severe allergic reactions, such as anaphylaxis, angioedema or severe asthma attack. # Severe drop in blood pressure causing dizziness, paleness and sweating (shock) due to surgical or accidental trauma or severe infection. # Inadequate production of natural steroid hormones by the adrenal glands (acute adrenal insufficiency) due to abnormal stress in people with Addison’s disease, Simmond’s disease, people who have had their adrenal glands surgically removed, and people with underactive adrenal glands due to prolonged corticosteroid therapy. # Local injection into inflamed soft tissue, such as tennis elbow, tenosynovitis, or bursitis.

Contraindications:

Hypersensitivity to any of the ingredients. Patients with osteoporosis; psychosis; severe psychoneuroses; peptic ulcer, doubtfully quiescent or active tuberculosis and in patients suffering from acute viral infections including herpes zoster or herpes simplex ulceration of the eye. Pregnancy and lactation. Patients should not be vaccinated with live vaccines while being treated with betamethasone.

Adverse reactions:

Electrolyte disturbances are characterized by hypertension and oedema, because of the retention of sodium and water, and the increase in potassium, excretion may cause hypokalaemic alkalosis. Increased susceptibility to all kinds of infection; sepsis; tuberculosis; fungal infections; viral infections and delayed wound healing have been reported. Acute adrenal insufficiency may occur during prolonged therapy or on cessation and may be precipitated by stressful situations. Growth retardation has been reported in children. High doses during pregnancy may cause foetal or neonatal adrenal suppression. Reversible Cushingoid symptoms mat be produced with large doses. Due to mobilisation of calcium and phosphorus, osteoporosis and spontaneous fractures, nitrogen depletion, and hyperglycaemia may occur. Other side-effects reported were; amenorrhoea, hyperhidrosis, skin thinning, ocular changes including development of cataract, mental and neurological disturbances, intracranial hypertension, acute pancreatitis, muscle weakness and aseptic necrosis of bone. Increased coagulability of the blood may lead to thrombo-embolic complications. Care should be taken in patients with congestive heart failure; hypertension; diabetes mellitus; epilepsy; glaucoma; infective diseases; ocular herpes simplex, chronic renal failure; uraemia and in elderly patients. Patients with quiescent tuberculosis should be observed closely and should receive chemoprophylaxis if corticosteroid therapy is prolonged.

Interactions:

* Simultaneous administration of barbiturates, carbamazepine, phenytoin, primidone, or rifampicin may reduce the effect of corticosteroids. * Excessive potassium loss may be due to concurrent administration of corticosteroids with potassium-depleting diuretics e.g. furosemide. * When corticosteroids are given with non-steroidal anti-inflammatory agents, an increase incidence of gastro-intestinal bleeding and ulceration may occur. * Requirements of antidiabetics and antihypertensives may be increased. * Serum concentrations of salicylates may be decreased. * Antimuscarinic effects may be decreased in myasthenia gravis. * It interferes with assay procedures for endogenous substances.

Warnings:

Betamethasone Injection should not be administered intrathecally or subconjuctivally. Toxic effects may result from withdrawal or from continued use or large doses.

Form:

SOLUTION FOR INJECTION

Dosage and Administration

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Consultants Corner

Dr. Talal Sabouni

Dr. Talal Sabouni UROLOGY AND KIDNEY TRANSPLANT

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Samir Moussa M.D. ENT Specialist

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Dr. Hani Najjar Pediatrics, Neurology
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