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Betamethasone is a potent synthetic corticosteroid that compounding pharmacies prepare as topical creams, ointments, lotions and solutions by prescription.
Betamethasone is a synthetic glucocorticoid, a man-made version of the adrenal hormone cortisol. It calms inflammation, itching and immune activity, and on the skin it also narrows small blood vessels and slows cell turnover. It is used as different esters: betamethasone dipropionate and valerate on the skin, and a sodium phosphate and acetate mix by injection. Diprolene Ointment (Organon), a super-high-potency topical corticosteroid, is FDA-approved for the inflammatory and itchy symptoms of corticosteroid-responsive skin conditions in patients 13 and older. Celestone Soluspan injectable suspension (Organon) is approved for a long list of allergic, skin, endocrine, joint, blood, eye, kidney, lung and other conditions, including intralesional and joint injection. A prescriber may order betamethasone compounded in a vehicle, strength or combination not manufactured. Compounded preparations are not FDA-approved and require a prescription.
Betamethasone does not carry a boxed warning. On the skin, high-potency products can suppress the body's own steroid production (HPA axis suppression), especially with large areas, wraps or occlusion, long use, broken skin, liver failure or use in children; they may also raise the risk of cataracts and glaucoma. Avoid the face, groin and armpits and any area of thinned skin, and do not bandage the area unless told to. Thinning skin, stretch marks, acne and color changes can occur. Do not use it if you are allergic to betamethasone or other corticosteroids. The injection label warns of serious nerve injuries, some fatal, after epidural injection; it is contraindicated by intramuscular injection in idiopathic thrombocytopenic purpura, and it raises infection risk, including severe chickenpox or measles. Systemic corticosteroids appear in breast milk, and LactMed prefers shorter-acting alternatives for systemic use. For use on the skin, LactMed says to use the least potent drug on the smallest area, keep the infant from touching treated skin, and avoid applying it to the nipple. For skin changes or vision problems, talk to your prescriber or pharmacist.
Betamethasone acts through the glucocorticoid receptor. Topically, StatPearls describes anti-inflammatory effects (upper dermal vasoconstriction, lipocortin-mediated phospholipase A2 inhibition and NF-kB suppression), antimitotic and immunosuppressive effects. Potency depends on ester and vehicle: augmented betamethasone dipropionate ointment and gel are class I (superpotent), betamethasone dipropionate ointment is class II, and betamethasone valerate cream, lotion and foam are medium potency. Ointments and occlusion increase absorption. In Celestone Soluspan, the soluble sodium phosphate ester gives prompt activity and the slightly soluble acetate gives sustained activity. Labeled indications include corticosteroid-responsive dermatoses (Diprolene Ointment, age 13 and older) and the systemic, intra-articular, soft tissue and intralesional uses listed for Celestone Soluspan, such as keloids, alopecia areata and acute gouty arthritis. Dosing per prescriber. StatPearls advises limiting high-potency topical courses and tapering, and considering HPA axis testing with potent steroids over large areas; monitor for atrophy, striae, hyperglycemia and ocular effects. With systemic use, watch for infection, hepatitis B reactivation and adrenal insufficiency after withdrawal. Betamethasone is not a controlled substance.
Compounded at Bayview
Patient guides for the preparations we make most often. Each one is compounded to order and requires a prescription.
We do not have a patient page for this ingredient yet. That does not mean we cannot make it. Bayview compounds this ingredient to a prescriber's order, and our full compounding formulary lists every preparation we make. Viewing the formulary requires a prescriber account.
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Every preparation in our formulary that contains this ingredient. Strength, base and dose form are set by the prescription.
Other salt forms of this molecule, and ingredients commonly compounded alongside it.
This page describes an active pharmaceutical ingredient, not a finished drug product. Bayview Pharmacy compounds preparations containing it only on a prescriber's order for an individual patient.
Compounded preparations are not FDA-approved, and the FDA has not evaluated them for safety, effectiveness, or manufacturing quality. Nothing on this page is a claim that any preparation is effective for any condition.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.
Our pharmacists work with prescribers to build preparations around a patient's dose, form and tolerances. Ask us what is possible with this ingredient.
