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Diprospan (betamethasone, corticosteroid)

Diprospan is the brand name of a combination of betamethasone dipropionate and betamethasone sodium phosphate. Betamethasone is a corticosteroid drug.

Uses

What is Diprospan used for?

Diprospan is intended for use in the treatment of acute and chronic corticosteroid-responsive disorders, such as:

  • Musculoskeletal and soft tissue conditions including rheumatoid arthritis, osteoarthritis, bursitis, ankylosing spondylitis, epicondylitis, radiculitis, coccydynia, sciatica, lumbago, torticollis, ganglion cyst, exostosis and fasciitis
  • Allergic conditions including chronic bronchial asthma (adjunctive therapy for status asthmaticus), hay fever, angioneurotic edema, allergic bronchitis, seasonal or perennial allergic rhinitis, drug reactions, serum sickness and insect bites
  • Dermatologic conditions including atopic dermatitis (nummular eczema), neurodermatitis (circumscribed lichen simplex), contact dermatitis, severe solar dermatitis, urticaria, hypertrophic lichen planus, necrobiosis lipoidica diabeticorum, alopecia areata, discoid lupus erythematosus, psoriasis, keloids, pemphigus, dermatitis herpetiformis and cystic acne
  • Collagen diseases including disseminated lupus erythematosus, scleroderma, dermatomyositis and periarteritis nodosa
  • Neoplastic diseases including palliative management of leukemias and lymphomas in adults and acute leukemia of childhood
  • Other conditions including adrenogenital syndrome, ulcerative colitis, regional ileitis, sprue, podiatric conditions (bursitis under heloma durum, hallux rigidus, digiti quinti varus), affections requiring subconjunctival injection, corticosteroid-responsive blood dyscrasias, nephritis and nephrotic syndrome

How should I take Diprospan?

Diprospan is recommended for IM injection in conditions responsive to systemic corticosteroids.

How do I store Diprospan?

This product is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store it in the bathroom or the freezer.

There may be different brands of this drug that may have different storage needs. So, it is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush this product down the toilet or pour them into a drain unless instructed to do so. Additionally, it is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & Warnings

What should I know before using Diprospan?

Before using this drug, tell your doctor if you are/have:

  • Pregnant or breastfeeding.
  • Taking any other medicines. This includes any prescription, OTC, and herbal remedies.
  • An allergy to any of the ingredients of this product.
  • Any other illnesses, disorders, or medical conditions.

Also, these are special precautions that you should take note of:

  • Diprospan is not for IV or SC use. Strict aseptic technique is mandatory in its use.
  • Patients should transition to oral corticosteroid therapy when possible.
  • Never abruptly stop corticosteroid therapy, as this can cause withdrawal or adrenal insufficiency.
  • Gradually taper down the dose toward the end of treatment.
  • Corticosteroids can suppress the immune system, therefore it is best to be completely immunized and avoid unnecessary exposure. Opportunistic infections may arise while using corticosteroids.

Is it safe during pregnancy or breastfeeding?

Unfortunately, there isn’t enough information about the safety of using this drug during pregnancy and breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking any medication.

Infants born to mothers who have received substantial doses of corticosteroids during pregnancy should be observed carefully for signs of hypoadrenalism.

Side Effects

What side effects can occur from Diprospan?

Like all drugs, this product may have side effects. If they occur, side effects are generally mild and resolve once treatment is finished or the dose is lowered. Some reported side effects include:

  • Fluid and electrolyte disturbances such as sodium retention, potassium loss, hypokalemic alkalosis, fluid retention, congestive heart failure in susceptible patients, hypertension
  • Musculoskeletal such as muscle weakness, corticosteroid myopathy, loss of muscle mass, aggravation of myasthenic symptoms in myasthenia gravis, osteoporosis, vertebral compression fractures, aseptic necrosis of femoral and humeral heads, pathologic fracture of long bones, tendon rupture, joint instability (from repeated intra-articular injections)
  • Gastrointestinal such as peptic ulcer with possible subsequent perforation and hemorrhage, pancreatitis, abdominal distention, ulcerative esophagitis
  • Dermatologic such as impaired wound healing, skin atrophy, thin fragile skin, petechiae and ecchymoses, facial erythema, increased sweating, suppressed reactions to skin tests, reactions e.g., allergic dermatitis, urticaria, angioneurotic edema
  • Neurologic such as convulsions, increased intracranial pressure with papilledema (pseudotumor cerebri) usually after treatment, vertigo, headache
  • Endocrine such as menstrual irregularities; development of cushingoid state; suppression of fetal intrauterine or childhood growth; secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness; decreased carbohydrate tolerance, manifestations of latent diabetes mellitus, increased requirements of insulin or oral hypoglycemic agents in diabetics
  • Ophthalmic such as posterior subcapsular cataracts; increased intraocular pressure, glaucoma; exophthalmos
  • Metabolic such as negative nitrogen balance due to protein catabolism
  • Psychiatric such as euphoria, mood swings; severe depression to frank psychotic manifestations; personality changes; insomnia
  • Others such as anaphylactoid or hypersensitivity and hypotensive or shock-like reactions

However, not everyone experiences these side effects. In addition, some people may experience other side effects. So, if you have any concerns about a side effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Diprospan?

This medication may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects.

To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist.

Drugs with known interactions:

  • Phenobarbital
  • Phenytoin
  • Rifampin
  • Ephedrine
  • Estrogen
  • Potassium-depleting diuretics
  • Cardiac glycosides
  • Amphotericin B
  • Coumarin-type anticoagulants
  • NSAIDs
  • Antidiabetic drugs
  • Somatotropin

If you experience an adverse drug interaction, stop taking this drug and continue taking your other medication. Inform your doctor immediately to reevaluate your treatment plan. Approaches include dose adjustment, drug substitution, or ending therapy.

Does food or alcohol interact with Diprospan?

This drug may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Diprospan?

This drug may interact with underlying conditions. This interaction may worsen your health condition or alter the way the drug works. Therefore, it is important to always let your doctor and pharmacist know all the health conditions you currently have.

Do not use this drug in the following conditions:

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using Diprospan.

What is the dose of Diprospan for an adult?

The recommended dose may include:

  • For systemic therapy, treatment is initiated with 1-2 ml in most conditions and repeated as necessary. Administration is by deep IM injection in the gluteal region.
  • 2 ml might be required initially in severe illness e.g., lupus erythematosus or status asthmaticus which has been resolved by appropriate life-saving procedures.
  • A wide variety of dermatologic conditions respond effectively to an IM injection of 1 ml, repeated according to the response of the condition.
  • In respiratory tract disorders, onset of relief from symptoms has occurred within a few hours after IM injection.
  • Effective control of symptoms with 1-2 ml is obtained in bronchial asthma, hay fever, allergic bronchitis and allergic rhinitis.
  • In the treatment of acute or chronic bursitis, excellent results are obtained with 1-2 ml IM injection, repeated as necessary.
  • An intra-articular injection of Diprospan is well tolerated in the joint and periarticular tissues. Recommended doses are:
    • Large joints (knee, hip, shoulder), 1-2 ml
    • Medium joints (elbow, wrist, ankle), 0.5-1 ml
    • Small joints (foot, hand, chest), 0.25-0.5 ml

Diprospan may be used effectively in disorders of the foot that are responsive to corticosteroid therapy. Bursitis under heloma durum may be controlled with 2 successive injections of 0.25 mL each.

In some conditions e.g., hallux rigidus, digiti quinti varus and acute gouty arthritis, onset of relief may be rapid. A tuberculin syringe with a 25-gauge needle is suitable for most injections. Recommended doses of 0.25 to 1 mL at intervals of approximately 1 week.

Once a good response is achieved, maintain therapy at the lowest effective dose and frequency. Toward the end of therapy, taper the dose down gradually to prevent adrenal insuffiency.

What is the dose for a child?

There is no established pediatric dose. It contains alcohol, which may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Diprospan available?

Diprospan is available in the following dosage forms and strengths:

  • Solution for injection, 1 ml ampule and 2 ml ampule

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to the nearest emergency room.

What should I do if I miss a dose?

If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Diprospan https://www.mims.com/philippines/drug/info/diprospan Accessed June 11, 2021

Betamethasone injection https://my.clevelandclinic.org/health/drugs/19531-betamethasone-injection Accessed June 11, 2021

The impact of intra-articular injection of diprospan at the knee joint on blood glucose levels in diabetic patients https://eurjrheumatol.org//en/the-impact-of-intra-articular-injection-of-diprospan Accessed June 11, 2021

Betamethasone dipropionate https://pubchem.ncbi.nlm.nih.gov/compound/Betamethasone-dipropionate Accessed June 11, 2021

Betamethasone Sodium Phosphate Injectable Suspension Rx https://www.empr.com/drug/betamethasone-sodium-phosphate-injectable-suspension/ Accessed June 11, 2021

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Written by Stephanie Nicole Nera, RPh, PharmD Updated Jun 15
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