Alphatrex Side Effects
Generic Name: betamethasone topical
Note: This page contains information about the side effects of betamethasone topical. Some of the dosage forms included on this document may not apply to the brand name Alphatrex.
Not all side effects for Alphatrex may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.
For the Consumer
Applies to betamethasone topical: topical application cream, topical application foam, topical application gel/jelly, topical application lotion, topical application ointment
Other dosage forms:
In addition to its needed effects, some unwanted effects may be caused by betamethasone topical (the active ingredient contained in Alphatrex). In the event that any of these side effects do occur, they may require medical attention.
You should check with your doctor immediately if any of these side effects occur when taking betamethasone topical:More common
- Burning, itching, or stinging at the application site
- Hair loss
- thinning of the hair
- Blistering, burning, crusting, dryness, or flaking of the skin
- itching, scaling, severe redness, soreness, or swelling of the skin
- redness and scaling around the mouth
- thinning of the skin with easy bruising, especially when used on where the skin folds together (e.g. between the fingers)
Some of the side effects that can occur with betamethasone topical may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:Less common
- Acne or pimples
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- Burning and itching of the skin with pinhead-sized red blisters
- burning, itching, and pain in hairy areas, or pus at the root of the hair
- increased hair growth on the forehead, back, arms, and legs
- lightening of normal skin color
- lightening of treated areas of dark skin
- reddish purple lines on the arms, face, legs, trunk, or groin
- softening of the skin
For Healthcare Professionals
Applies to betamethasone topical: topical cream, topical foam, topical gel, topical lotion, topical ointment, topical spray
Skin atrophy may become evident within one to two months of use and is due to the inhibitory effect of corticosteroids on collagen formation. Skin on the face, axilla, and groin appear to be most susceptible to the adverse long-term effects of topical betamethasone. Use of high potency topical corticosteroids on these areas should be minimized or avoided.
Topical corticosteroid use may impair local immune response rendering the skin more susceptible to infections. Folliculitis has occasionally been reported.
Perioral dermatitis or rosacea-like dermatitis has occurred in patients treated with potent topical corticosteroids. These conditions may flare temporarily upon discontinuation of topical steroids, prompting patients to continue their use. If topical corticosteroids are discontinued, this flare and the initial dermatitis generally resolve over a few weeks.
Worsening of psoriasis has occurred in a few patients.[Ref]
Local side effects have included burning, itching, dryness, and irritation, especially when applied to denuded skin. Long-term use of topical corticosteroids may result in skin atrophy and thinning, and the development of striae, telangiectasia, subcutaneous hemorrhage, and easy bruising and bleeding. Allergic contact dermatitis has occasionally been reported.[Ref]
Adrenal suppression has been reported in patients with psoriasis using augmented betamethasone dipropionate at doses of approximately 50 grams per week. Plasma cortisol concentrations generally return to normal within one to two weeks following discontinuation of the drug, and in some cases return to normal during continued therapy. In a few cases adrenal failure has persisted up to four months.
If betamethasone dipropionate is to be used for an extended period of time, adrenal function should be evaluated periodically. Supplemental systemic steroids may be necessary during times of stress. Other less potent forms of betamethasone may cause adrenal suppression if used on large areas or with occlusive dressings.[Ref]
Endocrine side effects have included suppression of the hypothalamic-pituitary-adrenal (HPA) axis, resulting in cushingoid features and symptoms of adrenal suppression following withdrawal of the drug. These effects are more likely when higher potency topical corticosteroids are used over extensive areas or when occlusive dressing are used. In addition, augmented betamethasone, and the ointment and emollient cream formulation of betamethasone generally provide better penetration, and thus, higher risk of adrenal suppression.[Ref]
Steroid-induced cataracts and glaucoma have been reported, most often in patients receiving betamethasone eyedrops (not available in the US). In one patient, permanent eye damage resulted from long term application of betamethasone cream to the eyelids.[Ref]
Ocular side effects have included rare reports of glaucoma in patients using betamethasone on the face for long periods of time. Intraocular pressure does not always return to normal following discontinuation of the drug.[Ref]
Musculoskeletal side effects have included rare reports of osteoporosis. Avascular necrosis of the hips and vertebral fractures have been documented.[Ref]
Dermatologic side effects have included erythema, folliculitis, pruritus, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, secondary infection, miliaria, hypertrichosis, and vesiculation.[Ref]
1. Macdonald A "Topical corticosteroid preparations. Hazards and side-effects." Br J Clin Pract 25 (1971): 421-5
2. Grice K "Tinea of the hand and forearm. Betamethasone valerate atrophy." Proc R Soc Med 59 (1966): 254-5
3. Smith EB, Breneman DL, Griffith RF, Hebert AA, Hickman JG, Maloney JM, Millikan LE, Sulica VI, Dromgoole SH, Sefton J, et al "Double-blind comparison of naftifine cream and clotrimazole/betamethasone dipropionate cream in the treatment of tinea pedis." J Am Acad Dermatol 26 (1992): 125-7
4. "Product Information. Diprolene (betamethasone topical)." Schering Laboratories, Kenilworth, NJ.
5. Hellgren L "Induction of generalized pustular psoriasis by topical use of betamethasone-dipropionate ointment in psoriasis." Ann Clin Res 8 (1976): 317-9
6. Ellis CN, Katz HI, Rex IH Jr, Shavin JS, Van Scott EJ, VanderPloeg D "A controlled clinical trial of a new formulation of betamethasone dipropionate cream in once-daily treatment of psoriasis." Clin Ther 11 (1989): 768-74
7. Sneddon I "Perioral dermatitis." Br J Dermatol 87 (1972): 430-4
8. Barkey WF "Striae and persistent tinea corporis related to prolonged use of betamethasone dipropionate 0.05% cream/clotrimazole 1% cream (Lotrisone cream)." J Am Acad Dermatol 17 (1987): 518-9
9. Ruiz-Maldonado R, Zapata G, Lourdes T, Robles C "Cushing's syndrome after topical application of corticosteroids." Am J Dis Child 136 (1982): 274-5
10. Flynn MD, Beasley P, Tooke JE "Adrenal suppression with intranasal betamethasone drops." J Laryngol Otol 106 (1992): 827-8
11. Stoppoloni G, Prisco F, Santinelli R, Sicuranza G, Giordano C "Potential hazards of topical steroid therapy." Am J Dis Child 137 (1983): 1130-1
12. Stevens DJ "Cushing's syndrome due to the abuse of betamethasone nasal drops." J Laryngol Otol 102 (1988): 219-21
13. Reymann F, Kehlet H "Hypothalamic-pituitary-adrenocortical function. Association with topical application of betamethasone dipropionate." Arch Dermatol 115 (1979): 362-3
14. Walsh P, Aeling JL, Huff L, Weston WL "Hypothalamus-pituitary-adrenal axis suppression by superpotent topical steroids." J Am Acad Dermatol 29 (1993): 501-3
15. Cunliffe WJ, Burton JL, Holti G, Wright V "Hazards of steroid therapy in hepatic failure." Br J Dermatol 93 (1975): 183-5
16. Salde L, Lassus A "Systemic side-effects of three topical steroids in diseased skin." Curr Med Res Opin 8 (1983): 475-80
17. Butcher JM, Austin M, McGalliard J, Bourke RD "Bilateral cataracts and glaucoma induced by long term use of steroid eye drops." BMJ 309 (1994): 43
18. Eisenlohr JE "Glaucoma following the prolonged use of topical steroid medication to the eyelids." J Am Acad Dermatol 8 (1983): 878-81
19. Kitazawa Y "Increased intraocular pressure induced by corticosteroids." Am J Ophthalmol 82 (1976): 492-5
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