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| Trade names | Diprolene, Sernivo, Diprosone, others |
| Other names | Betamethasone-17,21-dipropionate |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a682799 |
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| Routes of administration | Topical |
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| ECHA InfoCard | 100.024.551 |
| Chemical and physical data | |
| Formula | C28H37FO7 |
| Molar mass | 504.595 g·mol−1 |
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Betamethasone dipropionate is aglucocorticoidsteroid withanti-inflammatory andimmunosuppressive properties. It is applied as atopical cream, ointment, lotion or gel (Diprolene) to treatitching and other skin conditions such aseczema. Minor side effects include dry skin and mild, temporary stinging when applied.[2] Betamethasone dipropionate is a "super high potency" corticosteroid used to treat inflammatory skin conditions such asdermatitis,eczema andpsoriasis. It is a synthetic analog of the adrenal corticosteroids. Although its exact mechanism of action is not known, it is effective when applied topically to cortico-responsive inflammatory dermatoses.[3] It is available as ageneric medication.[4]
Although the absorption of betamethasone dipropionate is small, when used for prolonged periods of time (periods exceeding two weeks), or across a large surface area (total use greater than 50 grams per week), it can have adverse effects. One such effect is the ability of the corticosteroid to suppress thehypothalamic–pituitary–adrenal axis.[3][5] This can lead to a depression in the release of adrenal hormones such ascortisol andadrenocorticotropic hormone, or ACTH. Symptoms of HPA axis suppression are often subtle and variable, but can often be detected using simple blood or urine tests such at ACTH stimulation test or urinary free cortisol.[5] Those at increased risk for HPA axis suppression are those who are more likely to absorb more of the steroid through the skin. These groups include:
HPA axis suppression is preventable by supplementation with glucocorticosteroids. If HPA axis suppression occurs, it is often reversed shortly after discontinuation of treatment.[6]
Absorption of topical corticosteroids depends on several factors such as the vehicle, or delivery system used by the drug, the integrity of the epidermal barrier, and whether or not an occlusive bandage is used in combination with the drug.[3]
The absorption of topical betamethasone dipropionate is theoretically minuscule; however, if absorbed it follows the same pharmacokinetic profile as is typical of systemic corticosteroids. It is metabolized primarily by the liver by hydrolysis to its metabolitesbetamethasone 17-monopropionate (primary) andbetamethasone and the 6β-hydroxy derivatives of those metabolites, and it is excreted primarily by the kidneys.[3][7]
Betamethasone dipropionate is a white to almost white crystalline powder.[medical citation needed]
Betamethasone dipropionate was patented byMerck in 1987, as an augmented cream/lotion, Diprolene in the U.S., and Disprosone in Europe.[8] These patents expired in 2003 and 2007 respectively leading to generic production of betamethasone dipropionate. During this time other topical corticosteroids such astriamcinolone acetonide andclobetasol propionate also became available as generic creams. Merck filed for "pediatric exclusivity" in 2001 launching a clinical trial to prove betamethasone dipropionate's safety and efficacy for use in pediatrics.[9]
Betamethasone has also been used in the formulation ofcombination products such asLuxiq,Lotrisone andTaclonex.
Brand names include Alphatrex, Beta-Val, Diprolene, Diprolene AF, Diprosalic (withsalicylic acid)[13] Diprosone, Dovobet (LEO Pharma A/S),[14] Eleuphrat and Luxiq.[citation needed]
