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What is Betamethasone (Frenaler Cort)?

Betamethasone (Frenaler Cort) sodium phosphate and Betamethasone (Frenaler Cort) acetate combination injection provides relief for inflamed areas of the body. It is used to treat a number of different conditions, such as inflammation (swelling), severe allergies, adrenal problems, arthritis, lung or breathing problems, blood or bone marrow problems, eye or vision problems, lupus, serious skin conditions, kidney problems, ulcerative colitis, and flare-ups of multiple sclerosis. Betamethasone (Frenaler Cort) sodium phosphate and Betamethasone (Frenaler Cort) acetate combination is a corticosteroid (cortisone-like medicine or steroid). It works on the immune system to help relieve swelling, redness, itching, and allergic reactions.

Betamethasone (Frenaler Cort) sodium phosphate and Betamethasone (Frenaler Cort) acetate is to be given only by or under the direct supervision of your doctor.

Betamethasone (Frenaler Cort) Suspension is indicated for the treatment of acute and chronic corticosteroid-responsive disorders. Corticosteroid hormone therapy is an adjunct to, and not a replacement for conventional therapy.

Musculoskeletal and Soft Tissue Conditions: Rheumatoid arthritis, osteoarthritis, bursitis, ankylosing spondylitis, epicondylitis, radiculitis, coccydynia, sciatica, lumbago, torticollis, ganglion cyst, exostasis and fasciitis.

Allergic Conditions: Chronic bronchial asthma (including 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: 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: Disseminated lupus erythematosus, scleroderma, dermatomyositis, periarteritis nodosa.

Neoplastic Diseases: Palliative management of leukemias and lymphomas in adults; acute leukemia of childhood.

Other Conditions: 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.

Frenaler Cort sodium phosphate and Betamethasone
Frenaler Cort sodium phosphate and Betamethasone

Primary or secondary adrenocortical insufficiency may be treated with Betamethasone (Frenaler Cort) Suspension but should be supplemented with mineralocorticosteroids, if applicable.

Betamethasone (Frenaler Cort) Suspension is recommended for intramuscular injection in conditions responsive to systemic corticosteroids; injection directly into the affected soft tissues where indicated; intra-articular and periarticular injection in arthritides; intralesional injection in various dermatologic conditions; and local injection in certain inflammatory and cystic disorders of the foot.

HOW SHOULD I USE BETAMETHASONE (FRENALER CORT)?

Use Betamethasone (Frenaler Cort) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take Betamethasone (Frenaler Cort) by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
  • Use the dropper that comes with Betamethasone (Frenaler Cort) to measure your dose. Ask your pharmacist for help if you are unsure of how to measure your dose.
  • If Betamethasone (Frenaler Cort) needs to be stopped (or if a different medicine is added to therapy) by your doctor, this will be done gradually. The risk of side effects may be increased if Betamethasone (Frenaler Cort) is suddenly stopped.
  • If you miss a dose of Betamethasone (Frenaler Cort), take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Betamethasone (Frenaler Cort).

This medication is used to treat a variety of skin conditions (e.g., eczema, dermatitis, allergies, rash). Betamethasone (Frenaler Cort) reduces the swelling, itching, and redness that can occur in these types of conditions. This medication is a medium-strength corticosteroid.

How to use Betamethasone (Frenaler Cort) topical

Use this medication on the skin only. However, do not use it on the face, groin, or underarms unless directed to do so by your doctor.

Wash and dry your hands before using. Clean and dry the affected area. Apply a thin film of medication to the affected area and gently rub in, usually 1-3 times daily or as directed by your doctor. Do not bandage, cover, or wrap the area unless directed to do so by your doctor. If used in the diaper area on an infant, do not use tight-fitting diapers or plastic pants.

After applying the medication, wash your hands unless you are using this medication to treat the hands. When applying this medication near the eyes, avoid getting it in the eyes because this may worsen or cause glaucoma. Also, avoid getting this medication in the nose or mouth. If you get the medication in these areas, rinse with plenty of water.

Use this medication only for the condition for which it was prescribed. Do not use it for longer than prescribed.

Inform your doctor if your condition persists or worsens after 2 weeks.

Each gram of Betamethasone (Frenaler Cort) (Betamethasone (Frenaler Cort)*) Cream* contains: 640 mcg Betamethasone (Frenaler Cort) dipropionate (equivalent to 500 mcg Betamethasone (Frenaler Cort)).

Each gram of Betamethasone (Frenaler Cort) (Betamethasone (Frenaler Cort)*) Ointment* contains: 640 mcg Betamethasone (Frenaler Cort) dipropionate (equivalent to 500 mcg Betamethasone (Frenaler Cort)).

Betamethasone (Frenaler Cort) (Betamethasone (Frenaler Cort)*) Cream and Ointment contain Betamethasone (Frenaler Cort) dipropionate, a synthetic corticosteroid with anti-inflammatory activity to be administered topically.

Betamethasone (Frenaler Cort) dipropionate is a white to creamy white odorless crystalline powder insoluble in water; freely soluble in acetone and in chloroform; sparingly soluble in alcohol. It has a molecular weight of 504.16 and the empirical formula C28H37FO7; a chemical name of 9-fluoro-11β,17,21-trihydroxy-16β-methylpregna-1,4-diene-3,20-dione,17,21-dipropionate.

BETAMETHASONE (FRENALER CORT) DOSAGE

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Kit, Injection:

Pod-Care 100C: Betamethasone (Frenaler Cort) sodium phosphate 3 mg and Betamethasone (Frenaler Cort) acetate 3 mg per 1 mL [contains benzalkonium chloride, disodium edta]

ReadySharp Betamethasone (Frenaler Cort): Betamethasone (Frenaler Cort) sodium phosphate 3 mg and Betamethasone (Frenaler Cort) acetate 3 mg per 1 mL [contains benzalkonium chloride, disodium edta]

Suspension, Injection:

Betamethasone (Frenaler Cort): Betamethasone (Frenaler Cort) sodium phosphate 3 mg and Betamethasone (Frenaler Cort) acetate 3 mg per 1 mL (5 mL) [contains benzalkonium chloride, edetate disodium]

Generic: Betamethasone (Frenaler Cort) sodium phosphate 3 mg and Betamethasone (Frenaler Cort) acetate 3 mg per 1 mL (5 mL)

Dosing: Adult

Note: Dosages expressed as combined amount of Betamethasone (Frenaler Cort) sodium phosphate and Betamethasone (Frenaler Cort) acetate; 1 mg is equivalent to Betamethasone (Frenaler Cort) sodium phosphate 0.5 mg and Betamethasone (Frenaler Cort) acetate 0.5 mg.

Usual dosage range: IM: Initial: 0.25 to 9 mg/day (based on severity of disease and patient response).

Indication-specific dosing:

Antenatal fetal maturation (off-label use): IM: 12 mg every 24 hours for a total of 2 doses (ACOG 171 2016). A single course of Betamethasone (Frenaler Cort) is recommended for women between 24 and 34 weeks of gestation, including those with ruptured membranes or multiple gestations, who are at risk of delivering within 7 days. A single course may be appropriate in some women beginning at 23 weeks gestation or late preterm (between 34 0/7 weeks and 36 6/7 weeks gestation). A single repeat course may be considered in some women with pregnancies less than 34 weeks gestation at risk for delivery within 7 days and who had a course of antenatal corticosteroids >14 days prior (ACOG 171 2016; ACOG 713 2017, ACOG 188 2018).

Bursitis (other than of foot): Intra-articular: 3 to 6 mg (0.5 to 1 mL) for one dose; additional injections may be required for acute exacerbations or chronic conditions; generally, injections should be separated by a minimum of 4 to 6 weeks and limited to ≤4 injections per year. If symptoms are not improved after 1 or 2 injections, additional injections are unlikely to provide benefit (Cardone 2002); following resolution of acute episodes, reduced doses may be warranted for chronic conditions.

Dermatologic conditions: Intradermal: 1.2 mg/cm displayed a good or excellent response (Chowdri, 1994). Another trial (n=25, age range: 7 weeks to 2 years) used lower doses of 3 to 12 mg (in combination with triamcinolone); 16 patients experienced a marked response (Kushner, 1985).

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Polygot is a migraine medicine

Polygot – tablets (coated) containing caffeine 0.1 g and ergotamine tartrate 0.001 g (1 mg). Polygot is used for migraine (vasoparalytic form), as well as a drug that lowers intracranial pressure in vascular, traumatic, infectious lesions of the central nervous system. The effect is due to the vasoconstrictor effect of ergotamine and improvement of cerebral function under the influence of caffeine.

Polygot is a migraine medicine

It is prescribed orally on 1-2 tablets per intake during a headache attack 2 times a day, then 1 tablet 2-3 times a day for several days (up to 1 month). After oral administration, about 62% of ergotamine is absorbed in the gastrointestinal tract. Maximum plasma concentrations are achieved 2 hours after oral administration. Binding to plasma proteins is 98%. Ergotamine is metabolized in the liver to form pharmacologically active metabolites. Ergotamine is excreted mainly with bile both unchanged and as metabolites. Excretion is biphasic, with half-lives of 2.7 hours and 21 hours for I and II phases, respectively. After oral administration caffeine is absorbed quickly and almost completely. Binding with plasma proteins is 35%. Caffeine is almost completely metabolized in the body. Metabolites are excreted mainly with urine. The elimination half-life is about 3.5 hours.

Polygot is a migraine medicine

One of the most common forms of headache is migraine, which affects about 13% of the population in the world, mainly women. Migraine is a very severe disease and represents a significant burden to society and, above all, to patients who suffer from frequent attacks of headache. Unlike many other types of headache, migraine is characterized by predominantly severe attacks with severe disadaptation, impaired ability to work and daily functioning. According to data of a large-scale study of the American Migraine Study II, on the days of attacks, about 53% of patients completely lose the ability to work. On average, each migraine patient loses 3.2 working days per year. The proportion of patients who have to continue working at the time of a headache attack has a more than 46% reduction in work activity. Therefore, the vast majority of patients (about 80%) have to take pain medication during almost every attack. It is for this reason that migraine headaches are the fourth most frequent reason for seeking emergency care, accounting for 1-3% of all cases. This is often due not only to severe, prolonged, or poorly manageable headaches, but also to the many unusual, difficult-to-tolerate symptoms that almost always accompany migraine pain.

There are two main strategies for treating migraine: migraine attack control and prophylactic treatment. The goals of preventive treatment are to reduce the frequency, intensity and duration of attacks, to reduce the need for headache medication, and to increase adaptation and daily functioning. Prophylactic treatment is not indicated for all patients, but only for those who suffer from frequent attacks or attacks that are accompanied by severe disadaptation, and in cases when patients themselves prefer preventive treatment. In contrast, attack control is necessary for virtually all patients, both those who have frequent attacks and those who have infrequent attacks. The goal of migraine attack control is to eliminate the headache and associated symptoms, and to prevent the possibility of pain recurrence.

Sarcoidosis – lung disease

Systemic lung disease, characterized by the formation of granules in the lung tissue, is accompanied by cough, chest pain, weakness, fever.
Sarcoidosis is a more frequent disease than is commonly thought. The incidence of sarcoidosis in the world ranges from 11 to 640 per 100,000 people. The disease develops at any age, even after 70 years, but the peak of sarcoidosis is 40 years. It was believed that women suffer from sarcoidosis more often than men. However, apparently, it is not so: women simply have more pronounced symptoms of the disease, which means they are more likely to see doctors.

The cause of sarcoidosis is unknown, so there is still no exhaustive definition of the disease. The main finding is sarcoid granulomas (epithelioid cell granulomas without caseosal necrosis).

Complaints

Sarcoidosis - lung disease

In more than 90% of cases, the lungs or intra-thoracic lymph nodes are affected, but there are no complaints, at least not at an early stage. Even with extensive lung damage (chest X-ray) there may be no breathlessness or coughing. Dyspnea and other complaints usually occur at an advanced stage of the disease.

The first manifestation of sarcoidosis may be eye damage. Iridocyclitis, chorioiditis, conjunctivitis and lacrimal gland affection with xerophthalmia (dry eyes) are noted in 25% of cases. Approximately 20% of patients have the first sarcoidosis: plaques from orange-pink to brown color. Approximately 10% of patients suffer from the nervous system. Sarcoidosis may be suspected of impaired pituitary function or hypercalcemia (increased calcium levels). In addition, manifestations of sarcoidosis are hepatosplenomegaly (increase in the liver and spleen), bone damage (more often phalanges of the fingers) and symmetrical lesions of the joints. Significant pathology of the heart is rare, but in some cases there are violations of heart rhythm, cardiomyopathy. In 10% of patients, especially those with extensive affection of lymph nodes, there is a fever.

Stages

The stages of sarcoidosis are determined from the data of chest X-ray.
Stage I: bilateral increase in bronchopulmonary lymph nodes.
Stage II: Bilateral enlargement of bronchopulmonary lymph nodes and diffuse lesions of the pulmonary parenchyma, reticular remodeling of the lung pattern, but sometimes multiple focal or biliary shadows.
Stage III: Affection of the pulmonary parenchyma without enlargement of bronchopulmonary lymph nodes.
The probability of spontaneous remission (self-recovery) at stages I, II and III is 80, 50 and 30% respectively.

Diagnostics

Sarcoidosis - lung disease

In 90% of patients the disease is limited to lesions of the intra-thoracic lymph nodes and lungs and often runs asymptomatically. In such cases, radiological changes may be an accidental finding, for example, during a prophylactic examination or examination for another disease. As already mentioned, the first manifestation of sarcoidosis may be lesion of other organs. In any case, before making a diagnosis, the doctor must obtain histological confirmation of sarcoidosis.

Treatment

Despite the fact that glucocorticoids have been used for over 45 years, there is still no consensus on the advisability of their treatment for lung sarcoidosis. Practice shows that glucocorticoid treatment is justified in all patients with stages II and III, if within 6-12 months there are no signs of spontaneous remission or there are signs of deterioration (according to radiography and examination of respiratory function). As a rule, taking 40 mg of prednisolone a day is sufficient.
Although some specialists recommend starting treatment only when there are complaints, studies have shown that shortness of breath appears in the irreversible phase of the disease. Therefore, it is better to prescribe glucocorticoids before complaints occur to prevent the development of irreversible changes.
Most specialists adhere to the following indications for prescription of glucocorticoids: 1) uveitis (begin with local treatment), 2) hypercalcemia, 3) myocardial damage (especially cardiomyopathy), 4) neurological disorders. If glucocorticoids are contraindicated for any reason, the following drugs are recommended: methotrexate, chloroquine, azathioprine and oxyphenbutazone.

Observation

Surveillance of sarcoidosis patients necessarily includes regular chest X-rays and examination of external respiration function (spirometry). The frequency of examination depends on the course of the disease, as well as the preferences of the attending physician. The course of sarcoidosis can be assessed by the activity of angiotensin-converting enzyme in the blood. The frequency of relapse after treatment of patients with stages II and III is about 25%. Therefore, at the end of treatment, patients should be monitored for several years. The probability of relapse is significantly reduced, if for more than a year the condition remains stable and there are no signs of sarcoidosis activity.

Lung diseases: important facts that need to be known

Medicine knows many diseases associated with our lungs and other respiratory system organs. Some of these diseases are chronic, some are fatal and some can be quickly treated. What should you know about lung diseases?

Lung diseases: important facts that need to be known

Medicine knows many diseases related to our lungs and other respiratory system, ranging from bronchitis, asthma of varying intensity, chronic lung disease, to deadly diseases – lung cancer and idiopathic pulmonary fibrosis. Some of these diseases are chronic, some are fatal, and some can be quickly treated.

As with the treatment of any other disease, the wrong diagnosis and improperly appointed treatment can lead to significant deterioration of health. Some of the respiratory illnesses are widespread, especially in the cold winter, while others are considered rare and poorly understood.

What is known about respiratory diseases?

Lung diseases: important facts that need to be known

The most common childhood disease is bronchial asthma. About 5%-10% of children suffer from severe chronic forms of asthma, which is characterized by severe inflammation of the respiratory tract and is accompanied by prolonged seizures of breathing difficulties.
Some of the lung diseases are chronic, and medicine still does not know the methods that would lead to their complete cure. However, recent medical research has led to the emergence of new drugs and treatments that can significantly improve patients’ quality of life. For example, a real breakthrough was the emergence of new drugs to treat pulmonary fibrosis. New drugs change the course of the disease, improve the quality of life of patients and help slow down the rate of deterioration. New drugs have also appeared against lung cancer.
Lung diseases may manifest themselves at a very early age. Chronic obstructive pulmonary disease is considered a disease of the elderly, and is usually diagnosed at the age of 50-60 years. But it is important to know that much of these diagnoses were made at a late stage, when the disease is already difficult to treat. The first symptoms of the disease may appear at the age of + 40 years.
The condition worsens in the cold season: most often the symptoms of respiratory illness are exacerbated in autumn and winter. In cold air promotes asthmatic reactions and breathing difficulties. This rule is common for almost all lung diseases.
Passive smoking can also cause respiratory diseases. For a long time, there was a widespread perception that only people who smoke are susceptible to respiratory diseases. Research shows that for a number of diseases (obstructive pulmonary disease, pulmonary fibrosis, and lung cancer), smoking remains a major development factor. But to date, it has been found that both the above diseases and other lung diseases can also be diagnosed in people who have never smoked in their lives, but are constantly in a smoking environment, being passive smokers.
There are products that provoke sputum and cough. In particular, we are talking about dairy products. Although there is still no consensus in the medical community on whether or not to avoid dairy products for patients with asthma or lung disease, the general recommendation remains to limit the daily diet of products that cause mucus and sputum. Such products include milk, citrus fruits, bananas, and peanuts.
Personal approach to the treatment of each patient is a very important component of therapy, especially today, when there are a variety of modern techniques and developments that can significantly improve the quality of life of patients with the most severe, chronic respiratory diseases. Medicines, including biological drugs, are selected strictly individually, so the use of drugs that are incompatible with the patient’s body can lead to serious complications.

Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease is a disease of the lungs, characterized by a chronic restriction of air flow in the respiratory tract. Symptoms worsen with time. Dyspnea during physical activity gradually turns into dyspnea at rest. This disease is often not diagnosed and can be dangerous to life. Previously, COPD was often called the terms “chronic bronchitis” and “emphysema”.

Risk factors

Chronic obstructive pulmonary disease

The main cause of COPD is tobacco smoke (including secondary smoke inhalation or secondhand smoke). Other risk factors include: indoor air pollution (e.g., through the use of solid fuels for cooking and heating); air pollution; dust and chemicals in the workplace (fumes, irritants and fumes); frequent infections of the lower respiratory tract in childhood.
In the past, men were more likely to be affected by COPD, but because in high-income countries the prevalence of smoking among women is as high as among men, and in low-income countries women are more likely to be affected by indoor air pollution (e.g., from solid fuels for cooking and heating), today men and women are almost equally affected.
More than 90 percent of deaths from COPD occur in low- and middle-income countries, where effective strategies to prevent and control the disease are not always implemented or available.

Symptoms

Chronic obstructive pulmonary disease develops slowly and is usually manifested in people older than 40-50 years. The most common symptoms of COPD are shortness of breath (“air shortage”), chronic cough and sputum separation. As the health condition worsens, the patient may have difficulty even doing the usual daily activities, such as climbing a small flight of stairs or carrying a suitcase. In addition, patients often have exacerbations, that is, serious episodes of severe shortness of breath, cough and sputum separation, which last from a few days to several weeks. These episodes can lead to a marked decrease in work capacity and the need for emergency medical care (including hospitalization), and sometimes death.

Diagnosis and Treatment

Chronic obstructive pulmonary disease

Usually, the suspicion of chronic obstructive pulmonary disease arises in people with the symptoms described above. The diagnosis can be confirmed by a breath test called spirometry, which measures how much air a person can exhale at a time with maximum force and how quickly.
Chronic obstructive pulmonary disease is incurable. However, available medications and physiotherapy can alleviate symptoms, increase the ability to bear the load and improve quality of life, as well as reduce the risk of death. The most effective and cost-effective treatment for COPD among smokers is smoking cessation.
The availability of opportunities to diagnose and treat COPD depends on the degree of resource availability. WHO has published guidelines with specific recommendations for COPD management in primary health care settings and resource-constrained settings.

WHO activity

WHO’s work on COPD is part of the organization’s overall efforts to prevent and control non-communicable diseases. The goals of WHO are: to raise awareness of the global epidemic of non-communicable diseases; create a healthier environment, especially for poor and disadvantaged populations;
reduce common risk factors for non-communicable diseases, such as tobacco use, poor nutrition and physical inactivity; preventing premature death and preventable disability due to major non-communicable diseases.
The WHO Framework Convention on Tobacco Control was developed in response to the globalization of the tobacco epidemic to protect billions of people from the harmful effects of tobacco. It is the first global health agreement concluded by WHO and ratified by more than 180 countries.

Chronic bronchitis

Chronic bronchitis is a chronic inflammation of bronchitis resulting from prolonged acute bronchitis (e.g. after measles or flu) or long-term exposure of the mucous membrane of bacteria to bronchitis (e.g. after the passage of measles or flu), Haemophilus influenzae, Streptococcus pneumoniae) or viruses (e.g. RS-virus, adenoviruses), physical and chemical factors (smoking, cooling the respiratory tract, dusting the air with industrial waste, etc.). etc.), so says Dr. Denis Slinkin.

It is now proven that chronic bronchitis develops in almost 100% of cases among smokers. Chronic inflammation may be accompanied by metaplasia of the epithelium, resulting in a decrease in the number of cells with eyelashes. With constant exposure to cigarette smoke may dysplasia epithelium, uthe development of malignant tumors.

In the clinic, exacerbations of the disease are combined with periods of remission. Most patients with chronic bronchitis develop pulmonary emphysema. Complications of chronic bronchitis are right ventricular failure and lung failure, so says Dr. Denis Slinkin.

Morphological changes

Dr. Denis Slinkin

Dr. Denis Slinkin will assert that in the early stages of the disease chronic bronchitis of infectious nature may initially have a local nature, there is inflammation of respiratory bronchitis with a diameter of less than 2 mm. Chronic inflammation may lead to destruction of the bronchial wall and surrounding elastin fibres, which leads to the development of centrolobular emphysema. Reduced air pressure and pliability of the bronchial walls, together with blockage of the lumen by slime, lead to significant difficulties in air passage through the airways. Chronic bronchitis and emphysema are usually observed simultaneously in different proportions.