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Beloderm® (Ointment, Cream, Spray) Instructions for Use

ATC Code

D07AC01 (Betamethasone)

Active Substance

Betamethasone (Rec.INN registered by WHO)

Clinical-Pharmacological Group

Topical corticosteroids for external use

Pharmacotherapeutic Group

Corticosteroids used in dermatology; corticosteroids; high-potency corticosteroids (group III)

Pharmacological Action

Betamethasone dipropionate is a synthetic glucocorticosteroid.

It has anti-inflammatory, antipruritic, antiallergic, vasoconstrictive, anti-exudative, and antiproliferative effects.

When applied to the skin surface, it constricts blood vessels, relieves itching, reduces the release of inflammatory mediators (from eosinophils and mast cells), interleukins 1 and 2, gamma-interferon (from lymphocytes and macrophages), inhibits activity and reduces the permeability of the vascular wall.

It interacts with specific receptors in the cell cytoplasm, stimulates the synthesis of messenger ribonucleic acid, inducing the formation of proteins, including lipocortin, which mediate cellular effects.

Lipocortin inhibits phospholipase A2, blocks the release of arachidonic acid and the biosynthesis of endoperoxides, prostaglandins, and leukoproteins (which contribute to the development of inflammation, allergies and other pathological processes).

Pharmacokinetics

With topical application in therapeutic doses, transdermal absorption of the active substance into the blood is very insignificant.

The use of occlusive dressings, inflammation, and skin diseases increase transdermal absorption, which may lead to an increased risk of systemic side effects.

Indications

Skin diseases amenable to glucocorticosteroid therapy: atopic dermatitis/neurodermatitis, allergic contact dermatitis, eczema (various forms), contact dermatitis (including occupational) and other non-allergic dermatitis (including solar and radiation dermatitis), reactions to insect bites, psoriasis, bullous dermatoses, discoid lupus erythematosus, lichen planus, exudative multiforme erythema, pruritus of various etiologies, erythroderma.

ICD codes

ICD-10 code Indication
L10 Pemphigus [pemphigus]
L13 Other bullous disorders
L20.8 Other atopic dermatitis (neurodermatitis, eczema)
L23 Allergic contact dermatitis
L24 Irritant contact dermatitis
L28.0 Lichen simplex chronicus (circumscribed neurodermatitis)
L29 Pruritus
L30.0 Nummular eczema
L40 Psoriasis
L43 Lichen planus
L51 Erythema multiforme
L53 Other erythematous conditions
L56.2 Photocontact dermatitis [berloque dermatitis]
L58 Radiation dermatitis
L93.0 Discoid lupus erythematosus
T14.0 Superficial injury of unspecified body region (including abrasion, bruise, contusion, hematoma, bite of nonvenomous insect)
ICD-11 code Indication
9A06.70 Atopic eczema of the eyelids
EA80.0 Infantile atopic eczema
EA80.1 Childhood atopic eczema
EA80.2 Adult atopic eczema
EA80.Z Atopic eczema, unspecified
EA82 Nummular dermatitis
EA83.00 Lichen simplex of vulva
EA83.01 Lichen simplex of male genital organs
EA83.02 Lichen simplex of perianal area
EA83.0Z Lichen simplex of unspecified location
EA85.20 Atopic hand eczema
EA90.Z Psoriasis, unspecified
EA91.Z Lichen planus, unspecified type
EB12.Z Erythema multiforme, unspecified
EB40.Z Pemphigus, unspecified
EC90.Z Itching, unspecified
EH92 Dermatoses provoked by friction or mechanical impact
EH92.1 Blister due to friction
EJ7Z Radiation-induced dermatoses, unspecified
EK00.Z Allergic contact dermatitis, unspecified
EK02.Z Irritant contact dermatitis, unspecified
EK20 Photoallergic reaction to fragrances or cosmetic products
EM0Z Unspecified skin disorder
ND56.0 Superficial injury of unspecified body region

Dosage Regimen

The method of application and dosage regimen for a specific drug depend on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly adhere to the compliance of the dosage form of a specific drug with the indications for use and dosage regimen.

Apply a thin layer of the preparation to the affected skin areas once or twice daily.

For adults and adolescents, the frequency of application depends on the severity of the condition; initiate therapy with twice-daily application and reduce to once daily as symptoms improve.

For pediatric patients (children 1 year and older for cream/ointment; 2 years and older for spray), apply once daily; limit the duration of therapy to the shortest period necessary to achieve clinical effect.

Do not use for more than 5 consecutive days without medical supervision.

Do not use under occlusive dressings unless specifically directed by a physician.

When using the spray, shake the container well before use; hold it upright and spray from a distance of approximately 10-15 cm, covering the affected area with a thin, uniform layer.

For the cream and ointment, gently rub in until absorbed.

Wash hands thoroughly after application, unless the hands are the treated area.

Avoid application on the face, axillae, and groin unless prescribed.

If no clinical improvement is observed within 3-5 days, re-evaluate the diagnosis.

Discontinue treatment gradually upon resolution of symptoms to prevent rebound effects.

Adverse Reactions

Skin and subcutaneous tissue disorders pruritus, burning, irritation, dry skin, folliculitis, hypertrichosis, striae, acneiform eruptions (“steroid” acne), hypopigmentation, perioral dermatitis, allergic contact dermatitis, skin maceration, secondary infection, skin atrophy, local hirsutism, telangiectasia, miliaria, purpura.

Laboratory and instrumental data hyperglycemia, glucosuria.

Eye disorders blurred vision.

Other reversible suppression of adrenal cortex function, manifestation of Cushing’s syndrome.

Contraindications

Hypersensitivity, bacterial (skin tuberculosis, skin manifestations of syphilis), fungal, viral (chickenpox, herpes simplex) skin diseases, skin post-vaccination reactions, open wounds, trophic leg ulcers, rosacea, acne vulgaris, skin cancer, nevus, atheroma, melanoma, hemangioma, xanthoma, sarcoma, children under 1 year of age (cream and ointment) and under 2 years (spray), breastfeeding period.

With caution

Cataract, diabetes mellitus, glaucoma, tuberculosis (with long-term use or application to large areas of the body), children aged 2 to 12 years (spray).

Use in Pregnancy and Lactation

Contraindicated during pregnancy and lactation (breastfeeding).

Pediatric Use

The drug is contraindicated for use in children under 1 year of age (ointment and cream) and under 2 years (spray).

With caution when using the spray form in children from 2 to 12 years old.

Special Precautions

Long-term use of the drug on the skin of the face is not recommended, as the development of rosacea, perioral dermatitis and acne is possible.

The course of treatment should not exceed 5 days.

The medicinal product is not intended for use in ophthalmology.

Avoid getting the drug into the eyes.

If the drug gets on the mucous membrane of the eye, the development of cataracts, glaucoma, fungal eye infections and exacerbation of herpes infection is possible.

With prolonged treatment, when applied to large skin surfaces, as well as in the armpits and groin folds, when using occlusive dressings, diapers, systemic absorption of glucocorticosteroids is possible.

When applied to large areas and/or under an occlusive dressing, suppression of the function of the hypothalamic-pituitary-adrenal system and the development of symptoms of hypercortisolism are possible, a decrease in the excretion of growth hormone and an increase in intracranial pressure may be observed.

The spray form is preferable for use in the acute form of dermatosis, including those accompanied by exudation (formation of weeping surfaces).

Use in pediatrics

Use in children aged 1-2 years is possible only under medical supervision.

Children are more susceptible to the risk of suppression of the hypothalamic-pituitary-adrenal system due to the use of topical glucocorticosteroids than adults, due to their larger ratio of body surface area to body weight and, accordingly, increased absorption of this agent.

In children, this is accompanied by low plasma cortisol levels and lack of response to ACTH stimulation.

The occurrence of Cushing’s syndrome, growth and development disorders, slowing of weight gain, increased intracranial pressure, manifested by bulging fontanelle, headaches, bilateral optic disc edema is possible.

Storage Conditions

Store at 2°C (36°F) to 25°C (77°F). Keep in original packaging, protected from light. Keep out of reach of children.

Dispensing Status

Over-the-Counter

Important Safety Information

This information is for educational purposes only and does not replace professional medical advice. Always consult your doctor before use. Dosage and side effects may vary. Use only as prescribed.

Medical Disclaimer

Brand (or Active Substance), Marketing Authorisation Holder, Dosage Form

Marketing Authorization Holder

Belupo, Pharmaceuticals & Cosmetics d.d. (Croatia)

Dosage Form

Bottle OTC Icon Beloderm® Cream for external use 0.05%: tubes 5 g, 15 g, 20 g, 30 g, or 40 g

Dosage Form, Packaging, and Composition

Cream for external use white, homogeneous, without mechanical inclusions.

1 g
Betamethasone (as dipropionate) 0.5 mg

Excipients : chlorocresol – 1 mg, sodium dihydrogen phosphate monohydrate – 3 mg, phosphoric acid – 0.02 mg, white soft paraffin – 150 mg, liquid paraffin – 60 mg, macrogol cetostearyl ether – 22.5 mg, cetostearyl alcohol – 72 mg, sodium hydroxide – q.s., purified water – q.s. to 1 g.

5 g – aluminum tubes (1) – cardboard packs.
15 g – aluminum tubes (1) – cardboard packs.
20 g – aluminum tubes (1) – cardboard packs.
30 g – aluminum tubes (1) – cardboard packs.
40 g – aluminum tubes (1) – cardboard packs.

Marketing Authorization Holder

Belupo, Pharmaceuticals & Cosmetics d.d. (Croatia)

Dosage Form

Bottle OTC Icon Beloderm® Ointment for external use 0.05%: tubes 15 g, 20 g, 30 g, or 40 g

Dosage Form, Packaging, and Composition

Ointment for external use white, homogeneous, translucent.

1 g
Betamethasone (as dipropionate) 0.5 mg

Excipients : liquid paraffin – 50 mg, white soft paraffin – 949.3 mg.

15 g – aluminum tubes (1) – cardboard packs.
20 g – aluminum tubes (1) – cardboard packs.
30 g – aluminum tubes (1) – cardboard packs.
40 g – aluminum tubes (1) – cardboard packs.

Marketing Authorization Holder

Belupo, Pharmaceuticals & Cosmetics d.d. (Croatia)

Dosage Form

Bottle OTC Icon Beloderm® Express Topical spray 0.05%: 20 ml or 50 ml bottle

Dosage Form, Packaging, and Composition

Spray for external use in the form of a colorless, from transparent to slightly opalescent viscous solution, with the smell of isopropanol.

1 g
Betamethasone dipropionate 640 mcg,
   Which corresponds to the content of betamethasone 500 mcg

Excipients : isopropanol – 400 mg, carbomer – 2.5 mg, water – 596.86 mg, sodium hydroxide – q.s.

20 ml – polyethylene bottles (1) with a spray – cardboard packs.
50 ml – polyethylene bottles (1) with a spray – cardboard packs.

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