Betamethasone Side Effects
For the Consumer
Applies to betamethasone: oral solution, parenteral suspension for injection
Side effects include:
Intra-articular and soft-tissue injection: Soft-tissue atrophy, hypopigmentation or hyperpigmentation, facial erythema, thin, fragile skin.
For Healthcare Professionals
Applies to betamethasone: compounding powder, injectable solution, injectable suspension, oral syrup, oral tablet
Corticosteroid complications are primarily dose and duration of therapy dependent. Adverse effects have occurred less frequently at physiologic or lower pharmacologic dosages.
Adverse effects associated with duration of corticosteroid therapy include those occurring during short-term therapy (up to three weeks) or those occurring during long-term therapy (greater than three weeks).
Short-term effects have included sodium retention-related weight gain and fluid accumulation, hyperglycemia and glucose intolerance, hypokalemia, gastrointestinal upset and ulceration, reversible depression of the hypothalamic-pituitary-adrenal axis, and mood changes including mild euphoria and insomnia, nervousness, restlessness, mania, catatonia, depression, delusions, hallucinations, and violent behavior.
Long-term effects have included hypothalamic-pituitary-adrenal activity suppression, Cushingoid appearance, hirsutism or virilism, impotence, menstrual irregularities, peptic ulcer disease, cataracts and increased intraocular pressure/glaucoma, myopathy, osteoporosis, and vertebral compression fractures.[Ref]
Endocrine side effects have included decreased glucose tolerance and hyperglycemia resulting in diabetes-like symptoms. Hypothalamic-pituitary-adrenal activity has been suppressed up to 12 months following long-term corticosteroid administration. Cushingoid appearance commonly has occurred with chronic therapy. Hirsutism or virilism, impotence, and menstrual irregularities may occur.[Ref]
Corticosteroid therapy may induce glucose intolerance by reducing the utilization of glucose in tissues and increasing hepatic glucose output. Diabetes mellitus requiring diet modifications and hypoglycemic agents has developed in some patients.
Adrenal suppression can persist for up to twelve months after long-term corticosteroid therapy. Giving corticosteroids once a day or once every other day may reduce adrenal suppression. After corticosteroid therapy has been tapered, supplemental corticosteroid therapy during times of physical stress may be required.[Ref]
Gastrointestinal side effects have included gastrointestinal upset, nausea, vomiting, and peptic ulcer disease. Pancreatitis, ulcerative esophagitis, gastrointestinal perforation, and hemorrhage also have been reported.[Ref]
Gastrointestinal effects have most commonly included nausea, vomiting, dyspepsia, and anorexia. Peptic ulcer disease has been associated with long-term corticosteroid therapy, but is relatively uncommon. Routine prophylactic therapy was not warranted in all individuals. Aluminum/magnesium-containing antacids generally have been used to manage GI complaints without significant drug interactions.[Ref]
Metabolic side effects have included hypernatremia (rare), hypokalemia, fluid retention, negative nitrogen balance and increased blood urea nitrogen concentration. Glucocorticoids have been reported to decrease the secretion of thyrotropin (TSH).[Ref]
Musculoskeletal side effects have included myopathy, osteoporosis, vertebral compression fractures, tendon rupture (particularly the Achilles tendon), and aseptic necrosis of bone. Aseptic necrosis has been reported most often to affect the femoral head.[Ref]
Corticosteroid myopathy has presented as weakness and wasting of the proximal limb and girdle muscles and generally has resolved following cessation of therapy.
Corticosteroids inhibit intestinal absorption and increase urinary excretion of calcium leading to bone resorption and bone loss. Postmenopausal females are at risk of loss of bone density. Sixteen percent of elderly patients treated with corticosteroids for 5 years may experience vertebral compression fractures.[Ref]
Immunologic side effects have included impairment in cell-mediated immunity and increased susceptibility to bacterial, viral, fungal and parasitic infections. Immune response to skin tests has been suppressed. Rare cases of anaphylaxis have been reported in patients receiving parenteral corticosteroids.[Ref]
Ocular side effects have included increased intraocular pressure, glaucoma, and posterior subcapsular cataracts.[Ref]
One study reviewing the use of intranasal steroids in 286,078 patients found no increased risk of cataracts.[Ref]
Pseudorheumatism or glucocorticoid-withdrawal syndrome not related to adrenal insufficiency has occurred on withdrawal of corticosteroids. Patients experienced anorexia, nausea, vomiting, lethargy, headache, fever, arthralgias, myalgias, and postural hypotension. Symptoms resolved when corticosteroid therapy was reinstated.[Ref]
1. Thomas TP "The complications of systemic corticosteroid therapy in the elderly." Gerontology 30 (1984): 60-5
2. Seale JP, Compton MR "Side-effects of corticosteroid agents." Med J Aust 144 (1986): 139-42
3. "Product Information. Celestone (betamethasone)." Schering Corporation, Kenilworth, NJ.
4. Klepikov PV, Kutyrina IM, Tareyeva IE "Steroid-induced hypertension in patients with nephrotic syndrome." Nephron 48 (1988): 286-90
5. Swartz SL, Dluhy RG "Corticosteroids: clinical pharmacology and therapeutic use." Drugs 16 (1978): 238-55
6. Cunliffe WJ, Burton JL, Holti G, Wright V "Hazards of steroid therapy in hepatic failure." Br J Dermatol 93 (1975): 183-5
7. Downie WW, Dixon JS, Lowe JR, Rhind VM, Leatham PA, Pickup ME "Adrenocortical suppression by synthetic corticosteroid drugs: a comparative study of prednisolone and betamethasone." Br J Clin Pharmacol 6 (1978): 397-9
8. Lamberts SE, Bruining HA, De Jong FH "Corticosteroid therapy in severe illness." N Engl J Med 337 (1997): 1285-92
9. Zaynoun ST, Salti IS "The effect of intracutaneous glucocorticoids on plasma cortisol levels." Br J Dermatol 88 (1973): 151-6
10. Tsuruoka S, Sugimoto K, Fujimura A "Drug-induced Cushing syndrome in a patient with ulcerative colitis after betamethasone enema: Evaluation of plasma drug concentration." Ther Drug Monit 20 (1998): 387-9
11. Surks MI, Sievert R "Drugs and thyroid function." N Engl J Med 333 (1995): 1688-94
12. Ledford D, Apter A, Brenner AM, Rubin K, Prestwood K, Frieri M, Lukert B "Osteoporosis in the corticosteroid-treated patient with asthma." J Allergy Clin Immunol 102 (1998): 353-62
13. Need AG, Philcox JC, Hartley TF, Nordin BE "Calcium metabolism and osteoporosis in cortiscosteroid-treated postmenopausal women." Aust N Z J Med 16 (1986): 341-6
14. Mizuta H, Kubota K, Shiraishi M, Kai K, Nakamura E, Takagi K "Steroid-related bilateral osteonecrosis of the patella." Arthroscopy 9 (1993): 114-6
15. Kitazawa Y "Increased intraocular pressure induced by corticosteroids." Am J Ophthalmol 82 (1976): 492-5
16. Derby L, Maier WC "Risk of cataract among users of intranasal corticosteroids." J Allerg Clin Immunol 105 (2000): 912-6
17. McDonnell PJ, Kerr Muir MG "Glaucoma associated with systemic corticosteroid therapy." Lancet 08/17/85 (1985): 386-7
18. Debnath SC, Abomelha MS, Jawdat M, et al "Ocular side effects of systemic steroid therapy in renal transplant patients." Ann Ophthalmol 19 (1987): 435-7
19. Leigh IM, Sanderson KV "Cutaneous changes produced by prolonged systemic steroid therapy." Br J Dermatol 101 Suppl (1979): 71-3
20. Klein JF "Adverse psychiatric effects of systemic glucocorticoid therapy." Am Fam Physician 46 (1992): 1469-74
21. Hoff DA, Mammel MC "Suspected betamethasone-induced leukemoid reaction in a premature infant." Pharmacotherapy 17 (1997): 1031-4
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA.
More about betamethasone
- During Pregnancy or Breastfeeding
- Dosage Information
- Drug Interactions
- Support Group
- Pricing & Coupons
- 5 Reviews
- Drug class: glucocorticoids
- FDA Alerts (3)
- Betamethasone (Systemic)
- Betamethasone Oral Solution
- Betamethasone sodium phosphate and betamethasone acetate Injection (Advanced Reading)