Pregnancy: Risk cannot be ruled out.
Lactation: Caution advised or effect undetermined.
Contraindications: Systemic fungal infections unless specific anti-infective therapy is used. Head injury, stroke.
Precautions: Active infections not controlled by antibiotics. Latent or active amoebiasis. History of TB, septicaemia, symptoms may be masked. Avoid or maintain extreme cautions in chickenpox, measles, psychiatric disorders, renal impairment, hepatic failure, cirrhosis, active peptic ulcer, myasthenia gravis, previous steroid myopathy, osteoporosis, epilepsy, hypothyroidism, diabetes, adrenal suppression, hypertension, recent MI, congestive heart failure, thromboembolic disorders, glaucoma, corneal perforation. WITHDRAWAL: Withdrawal gradually. Withdrawal symptoms may include fever, myalgia, arthralgia, rhinitis, itchy skin nodules and weight loss.
Severe asthma, allergic conditions, rheumatoid arthritis, collagen diseases.
ORAL: Adults: 0.5-5 mg daily; reduce for maintenance to minimum effective dose. Children: Under 1 year, not recommended; 1-7 years, quarter to
Disorders of the foot: A tuberculin syringe with a 25-gauge, ¾-inch needle is suitable for most injection into the foot. Intra-articular injection: Intra-articular injection is well tolerated in joints and peri-articular tissues. There is virtually no pain on injection, and the “secondary flare” that sometimes occurs a few hours after intra-articular injection of corticosteroids has not been reported with betamethasone sodium phosphate. Intradermal injection: Intralesional treatment should use a tuberculin syringe with a 25-gauge, ½-inch needle.
Live vaccines or other vaccines, anticoagulants, hypoglycaemia agents, antihypertensives, diuretics, erythromycin, rifamycin, amphotericin, azole antifungals, ritonavir, cyclosporin, cardiac glycosides. Oestrogens including oral contraceptives, somatropin. Carbamazepine, phenytoin, primidone, barbiturates. Muscle relaxants, NSAIDs, salicylates, sympathomimetics, mifepristone, methotrexate, theophylline, aprepitant.
Endocrine irregularities including menstrual problems, Cushingoid state, adrenal suppression, growth suppression in children. Increased susceptibility to infection, increased severity of infection. Fluid/electrolyte disturbance, hypertension, negative protein, nitrogen and calcium balance. Myopathy, tendon rupture, osteoporosis, osteonecrosis and fractures. Impaired wound healing, sweating, hirsutism, striae, telangiectasia, acne. GI disturbance, peptic ulceration, acute pancreatitis, candidiasis. Psychiatric effects, neurological effects, insomnia. Diabetes, impaired glucose tolerance, weight gain, increased appetite. Ocular disturbances including cataracts, raised intraocular pressure, optic nerve damage, corneal changes, glaucoma. Thromboembolism, leukocytosis.