Betamethasone Sodium Phosphate Nasal Drops

How it works

Betamethasone is a potent glucocorticoid that suppresses local mucosal inflammation and oedema, reducing polyp size and improving nasal airflow.

Prescribing in practice

• Because betamethasone is more systemically absorbed than modern intranasal steroids, prolonged or high-dose use risks systemic corticosteroid effects and adrenal suppression, so courses should be limited and supervised.
• Correct head positioning when instilling the drops is essential to reach the polyp-bearing area and improve effectiveness.
• Avoid in untreated nasal or sinus infection, and use cautiously where there is recent nasal surgery or trauma.

Monitoring

For longer or repeated courses watch for features of systemic steroid exposure and review nasal response and the need for ENT referral or surgery.

Counselling the patient

• Use the recommended head-down position so the drops reach the right area.
• Do not exceed the prescribed duration without review.
• Report visual disturbance, mood change or other steroid-related effects.

Evidence & guidelines

Intranasal corticosteroids are first-line medical therapy for nasal polyps, with betamethasone drops reserved for short, supervised courses in resistant disease.