Betamethasone Dipropionate

How it works

It binds glucocorticoid receptors to suppress the local inflammatory cascade, reducing cytokine production, leucocyte activity and prostaglandin synthesis at the injected site.

Prescribing in practice

• Do not inject into a joint or soft tissue if local or systemic infection is suspected, as corticosteroid injection can worsen and mask sepsis; exclude septic arthritis first.
• Use aseptic technique and limit the frequency of injections into a single joint, as repeated injections can damage cartilage and surrounding tissue.
• Systemic absorption can transiently raise blood glucose and suppress the adrenal axis, and post-injection flare may occur.

Monitoring

Monitor the injected joint for response and signs of infection, and review glycaemic control in patients with diabetes after injection.

Counselling the patient

• Some soreness may occur for a day or two after the injection before benefit is felt; rest the joint as advised.
• Seek urgent review if the joint becomes hot, increasingly swollen, very painful or you develop a fever.

Evidence & guidelines

Intra-articular corticosteroid injection is an established option for inflammatory joint and soft-tissue conditions, supported by standard musculoskeletal practice guidance.