Each tube contains :

• Betamethasone (as Betamethasone valerate)   0.1% w/w

¤ BETNOCIN® indicated for infections of the skin it used for the treatment of the following :

• Inflammatory dermatoses such as eczema, including atopic and discoid eczemas, seborrhoeic dermatitis, neurodermatitis, including lichen simplex and lichen planus, prurigo nodularis, psoriasis (excluding widespread plaque psoriasis),contact dermatitis, Discoid lupus erythematosus, An adjunct to system steroid therapy in generalised erythroderma, and insect bite.
• BETNOCIN® ointment are preferred for dry lesions and particularly useful for skin areas where topical absorption is poor such as the palm, sole, elbow and knees, while BETNOCIN® cream are useful for moist or weeping skin like face, neck and axilla. 

• Hypersensitivity to Betamethasone.
• Skin viral infections, rosacea, acne vulgaris, perioral dermatitis, perianal and genital pruritus, ulcerative conditions, untreated fungal infection, primary cutaneous viral infections (eg: herpes simplex, chickenpox), dermatoses in children under 1 year of age, including dermatitis & napkin eruptions.

¤ In case of prolonged use or application on extensive area, the following interactions must be considered:

• Concurrent use of corticosteroids with potassium-depleting diuretics may enhance hypokalemia; patient should have serum potassium level determinations at frequent intervals.
• Concurrent use of corticosteroids with cardiac glycosides (digoxin) may enhance the possibility of arrhythmia of digitalis toxicity.  
• The ulcerogenic potential of NSAIDs may be increased when used concurrently with corticosteroids.
• Concurrent use of corticosteroids with hypoglycemics may increase blood glucose levels; dosage adjustment of the antidiabetic agent is needed.
• Corticosteroids may reduce serum salicylate levels by increasing metabolism and/or clearance. Concurrent use needs caution especially in hypoprothrombinemia.
• Although reports are conflicting, caution is recommended when corticosteroids are used together with anticoagulants especially in patients prone to gastrointestinal ulceration and hemorrhage. 

• Prolonged use and/or application on extensive area should be avoided during pregnancy and lactation.

Common side effects:

•  local skin burning and pruritus.

very rare:

• hypersensitivity, features of hypercortisolism, dilation of the superficial blood vessels, thinning, striae,  pigmentation changes, hypertrichosis, allergic contact dermatitis, pustular psoriasis, exacerbation of symptoms, epidermal and dermal atrophy resulting in the thinning of the skin.

Over dosage:

• Acute over dosage is very unlikely to occur, however, in the case of chronic over dosage or misuse the features of hypercortisolism may appear and in this situation topical steroids should be discontinued gradually under medical supervision because of the risk of adrenal insufficiency.

• Apply a thin film to the affected area 2- 3 times daily until improvement occurs. It may then be possible to maintain improvement by applying once a day, or even less often. If no improvement is seen within 2- 4 weeks, reassessment of the diagnosis, or referral, may be necessary.
• BETNOCIN® ointment and cream are especially appropriate for dry, lichenified or scaly lesions, but this is not invariably so.In the more resistant lesions, such as the thickened plaques of psoriasis on elbows and knees, the effect of BETNOCIN® can be enhanced, if necessary, by occluding the treatment area with polythene film. Overnight occlusion only is usually adequate to bring about a satisfactory response in such lesions thereafter, improvement can usually be maintained by regular application without occlusion.

Children:

• courses should be limited to five days. Occlusion should not be used for topical administration.

• Avoid long-term continuous therapy especially in infants and children, on face, large areas or broken skin. If used on the face, courses should be limited, if possible, to five days, and occlusion should not be used, and avoid contact with the eyes.
• Topical steroids may be hazardous in psoriasis for a number of reasons, including rebound relapses, development of tolerances, risk of generalised pustular psoriasis and development of local or systemic toxicity due to impaired barrier function of the skin. If used in psoriasis careful patient supervision is important.
• Appropriate antimicrobial therapy should be used whenever treating inflammatory lesions which have become infected. Any spread of infection requires withdrawal of topical corticosteroid therapy and systemic administration of antimicrobial agents.
• Bacterial infection is encouraged by the warm, moist conditions induced by occlusive dressings, and so the skin should be cleansed before a fresh dressing is applied. 

• BETNOCIN® cream: tube of 15gm.
• BETNOCIN® ointment: tube of 15gm.

• BETNOCIN® cream: Store below 25ºC.
• BETNOCIN® ointment: Store below 25ºC.