Medicinal Products

BETNESOL 4 mg / 1 mL

Generic drug of the therapeutic class: Anti-inflammatories
active ingredients: Betamethasone
laboratory: Sigma Tau (Italy)

Injectable solution
Box of 3 ampoules of 1 mL
All forms


The indications are:
- those of the general corticotherapy per os when the parenteral route is necessary in case of impossibility of the oral route (vomiting, gastric suction, disorders of consciousness);
- conditions requiring a rapid therapeutic effect:
. allergic:
severe angioedema in addition to antihistamines,
anaphylactic shock in addition to adrenaline.
. Infectious: severe typhoid fever, especially with mental confusion, shock, coma,
Stridulous laryngitis (subglottic laryngitis) in children.
. neurological:
cerebral edema (tumors, Toxoplasma abscess ...).
. ENT:
laryngeal dyspnea.
These are those of local corticosteroid therapy, when the condition justifies a high local concentration.
Any local injection prescription must be aware of the danger of infection, particularly the risk of promoting bacterial growth.
This drug is indicated in the conditions:
- dermatological:
keloid scars.
- OPH:
Periocular injections in certain inflammatory lesions of the anterior segment with participation of the intermediate uvea.
- ENT:
Intrasinusal irrigations in subacute or chronic sinusitis justifying drainage.
- rheumatologic:
. Intra-articular injections: inflammatory arthritis, osteoarthritis in thrust.
. Periarticular injections: tendonitis, bursitis.
. Soft tissue injections: talalgia, carpal tunnel syndrome, Dupuytren's disease.

Dosage BETNESOL 4 mg / 1 mL Solution for injection Box of 3 ampoules of 1 mL

- This specialty is not suitable for inhaled administration by nebulizer.
- Anti-inflammatory equivalence (equipotence) for 5 mg prednisone: 0.75 mg betamethasone.
The dosage varies according to the diagnosis, the severity of the condition, the prognosis, the patient's response and the tolerance to the treatment.
- In emergency: injection by direct venous route or infusion of 1 to 5 ampoules, renewable within 24 hours in adults. This dose may possibly be increased.
Children : 0.1 to 0.3 mg / kg / 24 hours.
- After the emergency period, reduce the dosage for 24 to 48 hours by intravenous or intramuscular injection.
Take over with tablets as soon as the use of the oral route is possible.
Intra and peri-articular routes: 0.25 ml to 1 ml depending on the size of the joint or area to be treated. The rhythm of the injections will be from 1 or 2 injections per week to 1 injection every 3 weeks.

Against indications

This drug is generally contraindicated in the following situations (there is, however, no absolute contraindication for life-threatening corticosteroid therapy):
- Hyper-sensitivity to one of the compounds,
- any infectious condition excluding specified indications (see indications section),
- certain viruses in evolution (in particular hepatitis, herpes, varicella, herpes zoster),
psychotic states not yet controlled by a treatment,
- live vaccines,
- coagulation disorders, anticoagulant treatment in case of intramuscular injection.
- This medicine is contraindicated in the following situations:
. Hyper-sensitivity to one of the compounds,
. local or general infection, or suspicion of infection,
. Severe coagulation disorders, ongoing anticoagulant therapy.
- Do not inject in intratendinous.
This drug is generally not recommended in combination with non-antiarrhythmic drugs, giving torsades de pointes (see section on interactions: sultopride).
- Breast-feeding: In the case of treatment at high doses and chronically, breastfeeding is not recommended.
- In the absence of data concerning the risk of calcification, it is preferable to avoid the administration of an intradiscal corticosteroid.
- Breast-feeding: in the case of treatment at large doses, breast-feeding is not recommended.

Betnesol side effects

Due to the presence of sodium metabisulfite (E223), risk of allergic reactions, including anaphylactic reactions and bronchospasm.
Rare cases of anaphylactic reactions have been reported in patients treated with parenteral corticosteroids (see warnings). Cardiac arrhythmias have also been described related to intravenous administration.
Other effects:
- Hydro-electrolytic disorders: hypokalemia, metabolic alkalosis, water-soluble retention, arterial hypertension, congestive heart failure.
- Endocrine and metabolic disorders: iatrogenic Cushing's syndrome, inertia of ACTH secretion, sometimes permanent adrenocortical atrophy, decrease in glucose tolerance, revelation of latent diabetes, stunting of growth in children, menstrual irregularities.
- Musculoskeletal disorders: Muscular atrophy preceded by muscle weakness (increased protein catabolism), osteoporosis, pathological fractures, particularly vertebral compression, aseptic osteonecrosis of the femoral heads.
Some cases of tendon ruptures have been described in an exceptional way, in particular in co-prescription with fluoroquinolones.
- Digestive disorders: hiccups, peptic ulcers, ulceration of the small bowel, perforations and gastrointestinal haemorrhages, acute pancreatitis have been reported, especially in children.
- Skin disorders: acne, purpura, bruising, hypertrichosis, delayed healing.
- Neuropsychic disorders:
. Frequently: euphoria, insomnia, excitement,
. rarely: manic pace; confusional or confuso-oniric states, convulsions,
. depressive state upon discontinuation of treatment.
- Eye disorders: some forms of glaucoma and cataracts.
The systemic adverse effects of glucocorticoids have a low risk of occurrence after local administration, given the low blood levels but the risk of hypercorticism (retention of water and sodium, imbalance of diabetes and hypertension ...) increases with dose and frequency of injections.
- risk of local infection (depending on the injection site): arthritis, ...
- localized atrophy of muscle, subcutaneous and cutaneous tissues. Risk of tendon rupture when injected into the tendons,
- acute arthritis with microcrystals (with microcrystalline suspension) of early onset,
- local calcifications,
- local and general allergic reactions,
- flush: headaches and flushing may occur. They usually go away in a day or two.

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