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Diprolene: 7 things you should know

Medically reviewed by Carmen Fookes, BPharm. Last updated on Dec 6, 2020.

1. How it works

  • Diprolene is a brand (trade) name for augmented betamethasone dipropionate which is a super-high potency topical corticosteroid formulation that may be used to treat inflammation and itching caused by several different skin conditions, such as eczema or psoriasis, that respond to topical steroids.
  • Experts aren't sure exactly how betamethasone dipropionate, the active ingredient in Diprolene, works, but they believe it may be inducing phospholipase A2 inhibitory proteins, collectively called lipocortins. These proteins are thought to control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2. Corticosteroids in general are also thought to play a role in cellular signaling and immune function.
  • Diprolene formulations are augmented which means they contain propylene glycol which helps the formulation penetrate the skin faster and be absorbed more quickly.
  • Diprolene belongs to the class of medicines known as topical corticosteroids.

2. Upsides

  • Diprolene may be used to treat several different skin conditions, such as eczema or psoriasis, in adults and adolescents aged 13 years of age and older. It must be prescribed by a doctor because it is considered a super high potency corticosteroid.
  • Available as an ointment, cream, and a gel
  • Treats inflammation and itching.
  • Diprolene is an augmented ointment which means it penetrates the skin more quickly and works faster than non-augmented forms.
  • Diprolene cream is available as a generic under the name augmented betamethasone propionate cream.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Redness, folliculitis, itching, or vesiculation (spider vein formation) are the most common side effects reported. May also cause dry or cracking skin, stretch marks, thinning skin, acne, hypopigmentation, or hypersensitivity reactions, such as dermatitis or a rash.
  • Diprolene may increase the risk of developing an infection. See your doctor if you develop redness, warmth, swelling, oozing, or severe irritation of any treated skin. In people with a pre-existing infection, consider the concomitant administration of an appropriate antifungal or antibacterial agent. If no improvement is seen or the infection worsens, discontinue Diprolene until the infection has been adequately controlled.
  • Allergic contact dermatitis, manifesting as irritation can develop and Diprolene should be discontinued and appropriate therapy is given. Symptoms usually include a failure of the skin to heal rather than an exacerbation of psoriasis.
  • Doctors should monitor people administering Diprolene for possible signs of absorption through their skin. Symptoms may include weight gain in the face and shoulders, slow wound healing, skin discoloration, thinning skin, increased body hair, tiredness, mood changes, menstrual changes, and sexual changes. Do not use for longer than two weeks and do not give to children under the age of 13 as this increases the risk of adrenal suppression.
  • Diprolene should not be used in children and adolescents younger than 13 years of age because children can absorb larger amounts of this medicine through the skin and there is a high risk of hypothalamic-pituitary-adrenal (HPA) axis suppression.
  • Only use for the minimum time possible and no more than 2 consecutive weeks. The total dosage should not exceed 50 g (59 mL or 2 fl. oz.) per week. If complete disease control is not achieved after 2 weeks of treatment a less potent topical steroid may be substituted. If no improvement is seen reassess the diagnosis.
  • Diprolene may not be suitable for people with any type of skin infection, a history of skin reactions to steroid medications, liver disease, or an adrenal gland disorder.
  • Diprolene may increase levels of blood glucose (sugar) in the blood or urine. People with diabetes may need to monitor their blood sugar levels more carefully. Symptoms include increased thirst, increased urination, dry mouth, or fruity breath odor.
  • There is not enough data to know whether using Diprolene on the skin will harm an unborn baby. Women who are pregnant should only use Diprolene if the risks outweigh the benefits and only use it on the smallest area of skin and only for the shortest time possible.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Diprolene is a topical, super high-potency corticosteroid that may be used to treat skin conditions characterized by inflammation or itching that typically respond to topical corticosteroids. It should not be used by children under the age of 13 and it should not be applied for longer than two weeks. Diprolene is only available on prescription from a doctor.

5. Tips

  • Only apply a thin film of Diprolene to the affected areas once or twice a day as directed by your doctor. Do not use Diprolene on your face, groin, or armpits unless directed to by your doctor, and do not take it by mouth. If the product accidentally gets into your eyes or mouth, rinse them thoroughly with water.
  • Once applying Dirpolene, rub it in gently and completely. Do not apply Diprolene to broken or infected skin and avoid applying it to open wounds. Wash your hands thoroughly after applying Diprolene, unless the application is meant for your hands.
  • Do not cover the treated area with a bandage, plastic film, or a dressing unless your doctor tells you to because this may increase how much of the product is absorbed through your skin.
  • Do not apply more than 50 g (59 mL or 2 fl. oz.) of ointment, cream, or gel. Do not use for longer than 2 consecutive weeks. If your condition clears up before 2 weeks, then stop using Diprolene. Excessive use of Diprolene can lead to thinning skin, easy bruising, changes in body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.
  • Call your doctor if you develop an infection, redness, if your symptoms do not improve, or if they get worse.
  • Do not apply any other topical steroid medications to the same areas that you are treating with Diprolene unless your doctor tells you to.
  • Do not use Diprolene on your face. Diprolene is classed as a super potent topical corticosteroid and lower potency corticosteroids, such as hydrocortisone are more appropriate to use on the face if one is deemed necessary. You should always use the lowest potency corticosteroid that is effective for your skin condition for the shortest possible time.
  • Diprolene should not be used to treat acne; bacterial, fungal, or viral skin infections (such as herpes simplex, shingles, or chickenpox); bites or stings; eyelid conditions; mild dermatitis; perioral dermatitis; phimosis (a tight foreskin of the penis); rosacea; scabies; skin conditions caused by vaccinations, tuberculosis, or syphilis. Diprolene may be used to treat poison ivy if your doctor has prescribed it specifically for this use.
  • If you have surgery scheduled, tell your doctor you are using Diprolene.
  • Store at room temperature 77°F (25°C) as much as possible; however, occasional lower or higher temperatures are permitted between 59° and 86°F (15° - 30°C).
  • Diprolene may increase your risk of glaucoma or cataracts. Do not apply Diprolene near the eyes or anywhere on the face unless instructed to by your doctor. Report any visual symptoms to your doctor who may refer you to an ophthalmologist for evaluation.
  • Tell your doctor if you are pregnant, plan to become pregnant, or breastfeeding. If you are breastfeeding and your doctor has advised you to use Diprolene do not apply to any areas of the chest likely to come into contact with the baby's mouth.
  • Diprolene is not suitable for children. Do not share your Diprolene and do not use Diprolene in children under 13 years of age. It is much more potent than the hydrocortisone cream you can buy over-the-counter at the store.

6. Response and Effectiveness

  • It takes about one to three days for Diprolene to start working when it is being used to treat eczema. Some improvement in symptoms such as inflammation (redness) and itching, should be noticed within this time.
  • Three randomized trials found Diprolene effective at reducing the signs of psoriasis and atopic dermatitis when it was applied twice daily for 14 days.
  • Treatment with Diprolene should not exceed two weeks and no more than 50 grams of cream or ointment should be used per week. If no improvement is seen after two weeks, then your doctor should reassess your skin condition, because there may be another reason for your rash other than what has been initially diagnosed.
  • Diprolene Ointment applied at a rate of 14 gram/day was shown to suppress the plasma levels of adrenal cortical hormones following repeated application to areas of psoriasis. These effects were reversible when treatment was discontinued. Diprolene Ointment applied at a rate of 7 gram/day for 2 to 3 weeks was shown to cause minimal inhibition of the HPA axis in people with psoriasis or eczema.

7. Interactions

Diprolene is unlikely to interact with any other drugs that are taken orally because it is applied topically to the skin. However, excessive use of Diprolene may increase the risk of absorption of Diprolene, and possible interactions.

The product information for Diprolene lists only minor interactions. These include:

  • diabetic medications, such as insulin, glyburide, glimepiride, or glipizide (Diprolene may increase blood sugar levels or decrease the effectiveness of these medications)
  • oral or topical corticosteroids, such as prednisone (may increase the risk of HPA suppression).

Note that this list is not all-inclusive and includes only common medications that may interact with Diprolene. You should refer to the prescribing information for Diprolene for a complete list of interactions. Tell each of your health care providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

References

Diprolene (betamethasone dipropionate) [Package insert]. Updated 11/2020. Merck Sharp & Dohme Corp. https://www.drugs.com/pro/diprolene.html

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Diprolene only for the indication prescribed.

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