Last update Nov. 4, 2021

Betamethasone

Low Risk

Moderately safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.

Corticosteroid with high anti-inflammatory potency (25 times more than hydrocortisone) with the main glucocorticoid effect and almost no mineralcorticoid effect. Oral, parenteral (iv, im, intra-articular, intra-lesional), topical (dermatological, otic and ophthalmological) and inhalation administration. Authorized use in children under one year. Since the last update we have not found any published data on its excretion in breast milk. Its pharmacokinetic data make it likely to pass into breast milk in an amount that could be significant, so in prolonged treatments it is advisable to use corticosteroids known for their scarce passage into milk.

SYSTEMIC USE: ORAL, IM, IV, INTRA-ARTICULAR, INTRALESIONAL

When administered before delivery it may induce delay in phase II of Lactogenesis (coming-in) and a decrease of milk production within the first week post-partum (Henderson 2008). Other corticosteroids such as dexamethasone can cause a decrease in prolactin, which could decrease milk production especially during the first weeks (Hubina 2002, Risch 1987). Large intra-articular doses of other corticosteroids (methylprednisolone, triamcinolone) may transitory decrease milk production (Babwah 2013, McGuire 2012). Corticosteroids are commonly used in Pediatrics and have no side effects when used alone or in short treatments. In nursing mothers, the occasional use and in non-prolonged treatments of betamethasone is compatible with breastfeeding by monitoring milk production.

TOPICAL USE: DERMATOLOGICAL, OTOLOGICAL, OPHTHALMOLOGICAL, INHALED

The small dose and poor plasma absorption of most topical preparations (nasal, ophthalmological, otological, dermatological (Leo 2011) or inhaled) make it very unlikely that a significant amount will pass into breast milk. Whenever a treatment for nipple eczema or dermatitis is required the lowest potency steroid compound should be used (Barrett 2013). It should be applied right after the feed to make sure it has disappeared before the next nursing occurs. Otherwise, wipe cream out with a clean gauze. Do not continuously use for longer than ten days at a time (Amir 1993). Preparations containing betamethasone, mupirocin and miconazole are not superior to lanolin creams in treating nipple pain, cracking and inflammation than lanolin creams (Dennis 2012). Reportedly, a case of mineral-steroid toxicity has occurred due to continuous use of cream on the nipple (De Stefano 1983). It is advisable to avoid the application to the nipple of creams, gels and other topical products containing paraffin (mineral oil) so that the infant does not absorb them (Concin 2008, Noti 2003). WHO Model List of Essential Drugs 2002: Topical use compatible with breastfeeding.

Alternatives

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Other names

Betamethasone is also known as


Betamethasone in other languages or writings:

Tradenames

Main tradenames from several countries containing Betamethasone in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 393 daltons
Protein Binding 64 %
Tmax 0,2 - 0,5 hours
T1/2 5,6 - 10,2 hours

References

  1. AEMPS-Galenicum Derma. Cuatrocrem. Ficha técnica. 2017 Full text (in our servers)
  2. AEMPS. Calcipotriol-Betametasona (Daivobet). Ficha técnica. 2014 Full text (in our servers)
  3. Babwah TJ, Nunes P, Maharaj RG. An unexpected temporary suppression of lactation after a local corticosteroid injection for tenosynovitis. Eur J Gen Pract. 2013 Dec;19(4):248-50. Abstract
  4. Barrett ME, Heller MM, Fullerton Stone H, Murase JE. Dermatoses of the breast in lactation. Dermatol Ther. 2013 Abstract
  5. McGuire E. Sudden loss of milk supply following high-dose triamcinolone (Kenacort) injection. Breastfeed Rev. 2012 Mar;20(1):32-4. Review. Abstract
  6. Dennis CL, Schottle N, Hodnett E, McQueen K. An all-purpose nipple ointment versus lanolin in treating painful damaged nipples in breastfeeding women: a randomized controlled trial. Breastfeed Med. 2012 Dec;7(6):473-9. Abstract
  7. Leo. Calcipotriol & Betamethasone (Dovobet). Product Monograph. 2011 Full text (in our servers)
  8. Henderson JJ, Hartmann PE, Newnham JP, Simmer K. Effect of preterm birth and antenatal corticosteroid treatment on lactogenesis II in women. Pediatrics. 2008 Abstract Full text (link to original source) Full text (in our servers)
  9. Concin N, Hofstetter G, Plattner B, Tomovski C, Fiselier K, Gerritzen K, Fessler S, Windbichler G, Zeimet A, Ulmer H, Siegl H, Rieger K, Concin H, Grob K. Mineral oil paraffins in human body fat and milk. Food Chem Toxicol. 2008 Abstract
  10. Noti A, Grob K, Biedermann M, Deiss U, Brüschweiler BJ. Exposure of babies to C15-C45 mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 2003 Abstract
  11. Hubina E, Nagy GM, Tóth BE, Iván G, Görömbey Z, Szabolcs I, Kovács L, Góth MI. Dexamethasone and adrenocorticotropin suppress prolactin secretion in humans. Endocrine. 2002 Abstract
  12. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  13. Amir L. Eczema of the nipple and breast: a case report. J Hum Lact. 1993 Abstract
  14. Risch SC, Janowsky DS, Judd LL, Gillin JC, Mott MA, Rausch JL, Huey L. Measurement of ACTH and prolactin in the dexamethasone suppression test. Acta Psychiatr Scand. 1987 Nov;76(5):535-40. Abstract
  15. De Stefano P, Bongo IG, Borgna-Pignatti C, Severi F. Factitious hypertension with mineralocorticoid excess in an infant. Helv Paediatr Acta. 1983 Abstract

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