Betnovate

Therapeutic indications

Betnovate is a cream, lotion or ointment that is classified under corticosteroids. It is applied on the body to treat various skin conditions such as swelling and itching that may be caused by eczema, dermatitis among other conditions. Among other conditions that Betnovate are indicated include:

• Atopic eczema
• Allergic contact dermatitis
• Irritant contact dermatitis
• Seborrheic dermatitis
• Psoriasis
• Thickened skin rash that may be caused by any of the various
• Skin disorders caused by skin rash, scratching. Such illnesses include neurodermatitis caused by lichen simplex
• Hard nodules on skin that cause severe itching. Examples of this include prudigonodularis
• Skin disorders that cause violet rashes on the skin, appearing on wrists, shins, lower parts of the back and sometimes genitals
• Discoid lupus erythematosus (DLE), a type of inflammatory disease
• Erythroderma that is characterized by intense and extensive reddening of the skin
• Insect bites and stings that cause various reactions and stings
• Lichen simplex
• Seborrheic dermatitis (an itchy rash that develops on the skin, scalp, ears, and one that may make on sensitive to sunlight.
• Discoid lupus erythematosus
• Prickly heat
• Used as a supplement to oral or injectable steroids for conditions of erythroderma (redness and inflammation of the skin that can also be scaly)
• Storage of Betnovate cream should be done in a cool, dry place, preferably away from direct sunlight and under 25⁰ The ointment should be stored below 30⁰C.
• It is recommended to keep the drug in its pack until next time when it will be ready for use.
• Like other medicines, it should be stored away from the reach of children. This should be a distance of at least 1.5m from the ground.
• Expired drugs should not be used.

Do I need a prescription?

This drug can only be issued under doctor’s prescription.

Chemical composition

The main composition is Betamethasone valerate. It is classified under Schedule S4 of drugs. Inactive or excipient ingredients include the following:

• White soft paraffin
• Liquid paraffin
• Chlorocresol (preservative)
• Cetostearyl alcohol
• Cetomacrogol 1000
• Monobasic sodium phosphate
• Water-purified.

Mechanism of action (MoA)

The main component in Betnovate is betamethasone that is classified as a steroid that is used to reduce skin inflammation. These inflammations are caused by allergies or irritations on the skin and in this process, they make blood vessels to dilate, hence the process of swelling, reddening, irritation, becoming itchy and painful. The effect of betamethasone is to prevent irritation by stopping the production of inflammatory substances in the body. This action prevents the skin from reddening, becoming swollen and associated pain.

Contraindications

• Allergic reactions such as red, itchy skin that may appear as lumps or hives.
• Acne rosacea
• Mouth inflammation
• Bacterial skin infections such as boils, impetigo or cellulitis
• Fungal skin infections such as tinea and ringworms
• Skin tuberculosis
• Viral skin infections such as chickenpox, cold sores among others.

Side effects

• There are not many or serious side effects of the drug. However, there are likely to occur if they are used under dressings that are tightly done and often out of air circulation. Where they are used in tight dressings and out of reach of fresh air for circulation, the drug may be absorbed into the body and by so doing, these may show up in other side effects or conditions a listed below:
• Stomach ulcers
• High blood pressure
• Wounds taking too long to heal
• Increased susceptibility to infections
• Increased growth of facial and body hair or hypertrichosis
• Acne
• Body fluids may increase
• Weakness of muscles

Less serious or common side effects

Common side effects include the following:

• Itching
• Burning
• Dryness
• Redness

Serious side effects

These side effects may have negative effects on the health of individuals and should be reported immediately:

• Blood-thinning, accompanied by ease of bruising of the skin
• Mouth rashes
• Stretch marks or streaks on the skin
• Infections at hair roots
• Change of skin color
• Heat rash
• Acne
• Allergic reactions that may be noted by:
• Wheezing
• Swelling of eyelids, face, lips or mouth
• Rashes
• Tightness of chest
• Fainting

Other less common symptoms include:

• Blurred vision
• Increased appetite
• Dryness of skin
• Change of skin color
• Increased susceptibility to infections
• Retardation of growth in children
• Change of voice to hoarse
• depression
• Indigestion
• Anxiety and nervousness
• Itchy skin
• Increase in weight
• Moon face or rounding of the face
• Obesity
• Wrinkling of skin

Rare incidents

These are very rare instances that are associated with the consumption of the drug. These include the following:

• A decline in hormone level of cortisol in the blood
• Sugar levels may increase in the blood or urine. This means some lab tests may have some issues
• Increased blood pressure
• Cataracts or cloudy lens in the eyes
• Pressure may increase in eyes (glaucoma)
• Bones may weaken due to gradual mineral loss. Patients taking this drug may need to test for osteoporosis, especially for people that are susceptible to it.

Drug and disease interactions

These include the effects of foods, liquids, diseases that may arise as a result of using this drug.

Tuberculosis: People that are recuperating from TB should be cautious when using this drug. It may lead to a relapse of the disease. It is important to observe for signs of this disease in case it relapses

Electrolyte imbalance: The drug may cause imbalances of various minerals in the body. These include calcium, potassium, sodium. Patients with this possibility of developing electrolyte imbalances should be cautious.

Gastrointestinal perforations: Suppression of the immune system may result if the drug is taken in large quantities. Such cases may result in increased vulnerability of infections as the body fails to ward off some infections. It is recommended to reduce dosage. Hence the for people with various infections to avoid this drug.

Infections: This may result due to immunosuppression especially when consuming heavy doses. For this reason, it (corticosteroids) is not recommended for patients with infections.

Scleroderma: This is a major interaction where patients suffering from this disease have their connective tissue becoming hard and stiff

Myocardial infarction: Patients with heart conditions need to be more cautious when using corticosteroids

Ocular herpes infection: Herpes simplex virus infecting eyes may interact with the drug. Extra caution should be observed when using Betnovate

Threadworm infection: People with this condition need to be more cautious with the drug.

Interaction with drugs

• Ritonavir and itraconazole
• Amlodipine
• Mifepristone
• Warfarin: A dose may be adjusted if using warfarin drugs due to other severe side effects that may occur such as blood clotting, chest pains and loss of vision. Seek medical help in such incidences
• Ethinyl Estradiol
• Insulin
• Ciprofloxacin: interaction with this is especially high for elderly patients. It may cause tendons in ankles, shoulder, and biceps to swell.
• BCG vaccine

Interaction with alcohol

This effect is unknown, but you may need to seek medical advice if you need to take alcohol.

Interaction with food

There is no documented effect of the interaction of the drug with food

What to do if you miss a dose

Ensure to maintain the frequency of applications advised by a doctor. Reducing the usage of the drug may make the condition not to improve. Besides, using it more than it was recommended could cause increased side effects.

If you forget to apply the drug, apply as soon as you remember. Do not use more of the drug to make up for the missed doses. This could be excessive.

Dosage

• This is an ointment that is applied to the body but whether it is a cream or ointment, it depends on the condition of the patient. Betnovate cream is used in skins that are moist and weeping. The more greasy ointment is used in skins that are dry and scaly. The other option is Betnovate lotion that is appropriate for hairy skins. This type is also appropriate in cases where minimal amounts are needed over large areas.
• After purchasing the drug, puncture the seal using the inverted end of the cap by pushing the pointed onto it. The minimal amount should be applied thinly on affected areas, once or twice a day. Squeeze a small amount of Betnovateonto a finger, rub against the affected area thoroughly until it evens out. It is preferred to pat the skin as opposed to rubbing it. Applied the cream onto skin should be massaged until it disappears. Always replace the cap and place the tube into its wrapper until next use.
• There is no specific amount of cream, an ointment that should be applied. However, a rough guide to this is to use one fingertip unit if applying using both sides of hands, two fingertip units for foot, three fingertip units for one arm, seven fingertip units for chest and abdomen and seven fingertip units for back and buttocks.
• Use only enough drug on affected area once or twice a day.

Precautions

• Do not do occlusive dressings if you suffer from skin infections
• Do not use it on underage children below 1. If need be, consult a doctor first.
• Ensure to check expiry date first before using this drug. Also, be sure to check of the tube is punctured, broken.
• Inform the doctor if you have any allergic reactions to other drugs, foods, dyes or food preservatives
• Seek medical if you are pregnant or plan to get pregnant.
• Do not use in dressings that would last for a long time and are open. This may cause blood thinning.
• Long term use of the drug in dressings and especially in tight dressings may result in other conditions such as absorption of the drug into the body.
• Betnovate cream, ointment or lotion should be applied once or two times a day on infected areas.
• The drug should be reduced as soon as symptoms start to improve. The frequency can be reduced with time as symptoms improve.
• Betnovate should not be used on broken skin. It may be used on broken skin if it is receiving some other kind of treatment.
• The drug may not be used on the face unless a skin or any other qualified an approved specialist direct so.
• Ensure the cream, lotion or ointment does not get to the nostrils, eyes or mouth. If this happens, ensure to rinse it off completely with clean water.
• Your hands should always be clean before and after applying this cream, lotion or ointment.
• The area where this drug has been used should not be covered tightly. Airtight bandages should not be used with this drug due to the risk of absorption.
• The drug is inflammable. Ensure to keep away from objects that ignite fire such as gas or electricity. Smoking is also not advised when using this drug.
• Do not stop using the drug unless the doctor has advised so. For children, this period should be stopped or reduced after one week. However, do not exceed the period prescribed by a doctor. As a rule, stop using this drug after symptoms reduce and you feel better.
• If you have an infected a skin area and you intend to use or you are already using Betnovate, stop using the drug immediately and seek medical advice.
• Do not use the drug if you have any of any fungal, bacterial or viral skin infection. Viral skin infections include chickenpox, thrush, cold sores, shingles or herpes simplex.
• Stop using the drug if you develop irritation or sensitization.
• It is not recommended to use the drug if you have acne or acne rosacea
• it may not be used with nappy rash.
• Do not use this drug if you have widespread plaque psoriasis
• This drug is not appropriate with itchy skins that have inflammations
• The drug must not be used as a skin ointment or moisturizer
• There are animal studies that have shown the possibility of animals giving birth to malformed younglings when exposed to corticosteroids during pregnancy. These studies were done on animals and not necessarily imply similar symptoms could affect people. However, care should be taken to ensure least amounts of corticosteroids are absorbed into the skin.
• Steroids could pass to breastmilk. Caution should be taken to ensure levels absorbed the least possible. If you must apply in breasts, then it should not be just before giving birth.
• Do not do occlusive dressings, unless advised so by a doctor
• The drug should not be used before bathing, swimming or showering. This can reduce the effectiveness of the drug
• The medicine has been prescribed specifically for your condition. Do not share it with anybody else even if you think they have conditions that can be treated with this. A doctor needs to be consulted before making such decisions. Sharing it may harm other people.
• It is recommended to always read all the attached notes accompanying the drug. Important information may be relevant to users.
• Take note of swellings on the skin while taking this drug. It may indicate allergic reaction to the drug.

Substitutes of the drug

Betaform 0.1% cream, manufactured by Cipla Ltd

References

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