Treat infection if present; discontinue if infection persists or worsens. Do not use near eyes, or on diaper dermatitis or pre-existing skin atrophy. Do not use fluorinated steroids longer than 1 week on the face. Avoid abrupt cessation in chronic use. Systemic absorption increased by broken or inflamed skin, prolonged use, application to large surface area, or use of occlusive dressings. Occlude only if necessary; do not occlude higher potency products. Monitor adrenal function in children if a high potency product or occlusion is used, and in adults if more than 50g weekly of a high potency product is used. Discontinue or reduce dose or potency if HPA axis suppression, Cushing's syndrome, hyperglycemia, glucosuria, or irritation occurs. Use lowest effective dose and potency (esp. in children). Use caution if applying to face or body folds. Do not use continuously or for prophylaxis. Foams are flammable. Reevaluate periodically. Pregnancy (). Nursing mothers.
In an open-label HPA axis safety trial in subjects 3 months to 12 years of age with atopic dermatitis, Betamethasone dipropionate cream (augmented), % was applied twice daily for 2 to 3 weeks over a mean body surface area of 58% (range 35% to 95%). In 19 of 60 (32%) evaluable subjects, adrenal suppression was indicated by either a ≤5 mcg/dL pre-stimulation cortisol, or a cosyntropin post-stimulation cortisol ≤18 mcg/dL and/or an increase of <7 mcg/dL from the baseline cortisol. Out of the 19 subjects with HPA axis suppression, 4 subjects were tested 2 weeks after discontinuation of Betamethasone dipropionate cream (augmented), % and 3 of the 4 (75%) had complete recovery of HPA axis function. The proportion of subjects with adrenal suppression in this trial was progressively greater, the younger the age group.