Betamethasone
Betamethasone is a potent, long-acting corticosteroid used for inflammation and immune-mediated disease.
Group
Glucocorticoid
Mechanism of Action
Activates glucocorticoid receptors to suppress inflammatory cell activity and mediator expression.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anti-inflammatory treatment | 0.1–0.2 mg/kg | PO | Every 12–24 h | |
| Immunosuppression | 0.2–0.5 mg/kg | PO | Every 12–24 h |
Cats
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Anti-inflammatory treatment | 0.1–0.2 mg/kg | PO | Every 12–24 h | |
| Immunosuppression | 0.2–0.5 mg/kg | PO | Every 12–24 h |
Large animals
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Inflammatory disease | 0.05–0.1 mg/kg | IM, PO | Every 24 h | The monograph gives a general large-animal regimen without assigning individual species. |
Indications
- Inflammatory disease
- Immune-mediated disease
- Equine osteoarthritis treated by intra-articular injection
Contraindications
- Do not inject an infected joint.
- Use cautiously with diabetes, renal failure, pregnancy, infection, ulcer risk or impaired wound healing.
- Systemic fungal infection unless a separate essential replacement indication exists.
- Avoid long-acting injectable glucocorticoids for chronic systemic therapy.
- Avoid IM corticosteroid injection with idiopathic thrombocytopenia.
- Late-pregnancy administration can induce parturition in large animals.
Interactions
- NSAIDs increase gastrointestinal injury risk.
- Potassium-depleting diuretics can increase hypokalemia risk; insulin requirements may rise during glucocorticoid exposure.
- Amphotericin B and potassium-depleting diuretics increase hypokalemia risk; hypokalemia increases digoxin toxicity.
- Ketoconazole can increase glucocorticoid exposure; rifampin and barbiturates may reduce it.
- Live attenuated vaccines should generally be avoided during immunosuppressive glucocorticoid treatment.
- Concurrent anticholinesterase treatment in myasthenia gravis can produce marked weakness; adjust under the disease-specific plan.
Adverse effects
- Polyphagia, polyuria and polydipsia
- Adrenal suppression
- Gastrointestinal ulceration
- Hepatopathy and hyperlipidemia
- Hyperglycemia and diabetes
- Immunosuppression and secondary infection
- Delayed healing and reduced protein synthesis
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Betamethasone 0.6 mg tablet Oral availability may be limited. | Tablet | 0.6 mg / tablet | PO |
| Betamethasone 3 mg/mL injection | Injection | 3 mg / mL | IM |
| Betamethasone oral solution 0.6 mg/5 mL | Oral Liquid | 0.6 mg / 5 mL | PO |
Monitoring and Administration
Monitor CBC and adrenal function during systemic treatment.
The equine intra-articular suspension combines rapid and prolonged release components. Administer 1.5 mL per joint (9 mg total betamethasone equivalents); intra-articular administration is not represented by the calculator route set.
Protect from light at room temperature. Open equine single-use vials once and discard the remainder.
An additional equine intra-articular alternative is 6–15 mg per joint; repeat only as necessary to maintain the clinical response. It is distinct from the fixed 9 mg-per-joint product regimen.
A historical canine pruritus regimen used Betasone aqueous suspension 0.25–0.5 mL per 20 lb IM, with no more than four injections. Product-specific composition and prolonged release must be retained; do not substitute a soluble injection.
Taper prolonged systemic therapy to allow adrenal recovery. Stress during or after tapering may require temporary glucocorticoid supplementation. Monitor glucose, weight, albumin, electrolytes and growth in young animals.