BETAMETHASONE VALERATE

For topical use only. If no improvement is seen after two to four weeks, the diagnosis should be reconsidered and specialist referral may be necessary. Adults, adolescents and the elderly A small quantity of Betamethasone Valerate Ointment should be applied to the affected area one to three times daily until improvement occurs.

025% Ointment. Allow adequate time for absorption after each application before applying an emollient. If no improvement is seen within two to four weeks, reassessment of the diagnosis, or referral, may be necessary. In the more resistant lesions, such as the thickened plaques of psoriasis on elbows and knees, the effect of Betamethasone Valerate Ointmentcan be enhanced, if necessary, by occluding the treatment area with polythene film.

Overnight occlusion only is usually adequate to bring about a satisfactory response in such lesions; thereafter improvement can usually be maintained by regular application without occlusion. Therapy with betamethasone valerate should be gradually discontinued once control is achieved and an emollient continued as maintenance therapy.

Rebound of pre- existing dermatoses can occur with abrupt discontinuation of betamethasone valerate. Recalcitrant dermatoses Patients who frequently relapse Once an acute episode has been treated effectively with a continuous course of topical corticosteroid, intermittent dosing (apply once a day twice a week without occlusion) may be considered.

This has been shown to be helpful in reducing the frequency of relapse. Application should be continued to all previously affected sites or to known sites of potential relapse. This regimen should be combined with routine daily use of emollients.

The condition and the benefits and risks of continued treatment must be re-evaluated on a regular basis. Paediatric population Betamethasone valerate is contraindicated in children under one year of age. Children are more likely to develop local and systemic side effects of topical corticosteroids and, in general, require shorter courses and less potent agents than adults; Courses should be limited to five days.

Occlusion should not be used. Care should be taken when using betamethasone valerate to ensure the amount applied is the minimum that provides therapeutic benefit. For topical administration. Elderly Clinical studies have not identified differences in responses between the elderly and younger patients.

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Long-term continuous topical therapy should be avoided where possible, particularly in infants and children, as adrenal suppression, with or without clinical features of Cushing's syndrome and reversible hypothalamic-pituitary-adrenal (HPA) axis, can occur even without occlusion.

9 Overdose). g. on intertriginous areas or under occlusive dressings (in infants the nappy may act as an occlusive dressing) • Increasing hydration of the stratum corneum • Use on thin skin areas such as the face • Use on broken skin or other conditions where the skin barrier may be impaired • In comparison with adults, children may absorb proportionally larger amounts of topical corticosteroids and thus be more susceptible to systemic adverse effects.

This is because children have an immature skin barrier and a greater surface area to body weight ratio compared with adults. The face, more than other areas of the body, may exhibit atrophic changes after prolonged treatment with potent topical corticosteroids.

This must be borne in mind when treating such conditions as psoriasis, discoid lupus erythematosus and severe eczema. Therefore, treatment courses should be limited to five days and occlusion should not be used. If applied to the eyelids, care is needed to ensure that the preparation does not enter the eye, as glaucoma and cataract might result from repeated exposure.

Long term continuous or inappropriate use of topical steroids can result in the development of rebound flares after stopping treatment (topical steroid withdrawal syndrome). A severe form of rebound flare can develop which takes the form of a dermatitis with intense redness, stinging and burning that can spread beyond the initial treatment area.

It is more likely to occur when delicate skin sites such as the face and flexures are treated. Should there be a reoccurrence of the condition within days to weeks after successful treatment a withdrawal reaction should be suspected.

Rosacea, acne vulgaris, pruritus without inflammation, perioral dermatitis and use in widespread plaque psoriasis. g. herpes simplex, chickenpox). Hypersensitivity to any component of the preparation. g. g. impetigo); primary or secondary infections due to yeast; peri-anal and genital pruritus; dermatoses in children under 1 year of age, including dermatitis and napkin eruptions.