Potent corticosteroid

Betamethasone

Brand names: Betnesol, Celestone, Betnovate (topical)

Adult dose

Dose: Antenatal lung maturation: 12mg IM ×2 doses 24h apart; oral / topical / IV per indication

Route: Oral / IM / IV / Topical / Eye / Ear

Frequency: Per indication

Clinical pearls

RCOG GTG: antenatal corticosteroids 24+0–34+6 weeks (consider up to 35+6) for fetal lung maturation
BAD topical steroid potency ladder — betamethasone valerate 0.1% potent
Tapering important for prolonged courses

Contraindications

Systemic infection (untreated)
Live vaccines
Hypersensitivity

Side effects

Cushingoid features (long-term systemic)
Adrenal suppression
Hyperglycaemia
Hypertension
Osteoporosis
Mood change
Topical: skin atrophy, telangiectasia, striae, perioral dermatitis, periorificial dermatitis

Interactions

Strong CYP3A4 inhibitors
Live vaccines
NSAIDs (GI bleeding)
Diabetic medications

Monitoring

Glucose
BP
Bone health
Adrenal function (long-term)
Skin atrophy (topical)

Reference: BNF; RCOG GTG 7; BAD; https://bnf.nice.org.uk/drugs/betamethasone/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways