Betamethasone for eyes, ears and nose - Brand names: Betnesol, Vistamethasone

Betamethasone for eyes, ears and nose is used to treat allergies and inflammation. It relieves swelling, redness and irritation.

It can help symptoms that affect your eyes and nose caused by hay fever or allergic rhinitis.

It's also used to treat inflammation in your outer ear, such as that caused by eczema, water or ear plugs.

Betamethasone is a type of medicine called a steroid (also known as a corticosteroid). This is not the same as an anabolic steroid.

Betamethasone is available on prescription only. It comes as an eye ointment or as drops for eyes, ears and nose.

It also comes combined with neomycin (an antibiotic). Betamethasone with neomycin drops are used when there's both inflammation and bacterial infection in the eye, nose or ear.

Betamethasone also comes as:

• tablets and injections – for many conditions, including asthma and rheumatoid arthritis
• skin treatments – for eczema, contact dermatitis and psoriasis

• You need to use betamethasone for eyes, ears and nose regularly for it to work, as advised by your doctor.
• Common side effects for eyes include irritation and blurry vision. For your nose, it can be sneezing and changes in your sense of smell and taste.
• If you're using betamethasone in your ears, you're unlikely to have any side effects.
• Only use a steroid treatment if your doctor prescribes it for you. Do not use someone else's medicine.
• Brand names include Betnesol and Vistamethasone. Betamethasone with neomycin is known by the brand name Betnesol-N.
• If your doctor has prescribed high doses of betamethasone to control your symptoms you may need to carry a steroid emergency card. Ask your pharmacist or doctor.

Adults, children and babies aged 1 month or over can use betamethasone.

It's not suitable for some people. To make sure this medicine is safe for you, tell your doctor or pharmacist if you:

• have ever had an allergic reaction to betamethasone, or any other medicine in the past
• have tuberculosis (TB)

If you're using it for your eyes, also tell them if you:

• have an infection in your eye, or it's producing pus
• have shingles
• have glaucoma
• have a thinning of your cornea (the part of your eye that covers your iris and pupil) or sclera (the white of your eyeball)
• have redness in your eyes that's not caused by an allergy or inflammation
• wear soft contact lenses

If you're using it for your nose, tell them if you:

• have an infection of the lining of your nose (that's not being treated)
• have recently had surgery on your nose (that's not healed yet)

Do not use betamethasone in your ears if you have a perforated ear drum.

Always follow your doctor's instructions, or the leaflet that comes with your medicine.

How to use the eye ointment

Betamethasone eye ointment is generally used 2 or 3 times a day.

However, if you use the eye drops during the day, you'll only need to use the ointment at night. This is because the effect of the eye ointment lasts longer than the eye drops.

To reduce the risk of betamethasone affecting your sleep, some doctors prescribe eye drops to use during the day and ointment to use at night.

1. Wash and dry your hands.
2. If you wear contact lenses, remove them before you use the eye ointment.
3. Tilt your head back.
4. Gently pull down your lower eyelid.
5. Hold the tube with the nozzle close to your eye and gently squeeze about 1 to 2 centimetres of the ointment into the space between your lower lid and your eye.
6. Close your eye for a few minutes, so the ointment can spread.
7. Repeat for your other eye, if treating both eyes.
8. Wait 15 minutes before putting your contact lenses back in.

How to use the eye drops

The usual dose is 1 or 2 drops in your eye every 1 or 2 hours. Once the redness, itching and soreness starts to feel better, the drops can be used less often.

1. Wash and dry your hands.
2. If you wear contact lenses, remove them before you use the eye drops.
3. Tilt your head back.
4. Gently pull down your lower eyelid.
5. Place drops in the gap between your lower lid and eye (squeeze the bottle very gently if necessary).
6. Blink a few times to spread out the drops.
7. Repeat for your other eye, if treating both eyes.
8. Wait 15 minutes before putting your contact lenses back in.

Regular eye check-ups

If you use betamethasone for your eyes for several weeks, your doctor may ask you to have check-ups. These are to make sure your medicine is working properly and that the dose is right for you.

Your doctor will check your eyes for:

• an increase in pressure
• infection

How to use the ear drops

The usual dose is 2 or 3 drops into the ear every 2 or 3 hours. Once the redness, itching and soreness starts to feel better, use the drops less often.

1. Tilt your head to one side, with the ear you are treating turned upwards.
2. Bring the tube up to the ear, with the nozzle close to your ear hole.
3. Gently squeeze the drops into your ear.
4. If you can, lie down for at least 10 minutes afterwards. Keep your head tilted to one side, so the ear being treated is facing the ceiling.
5. After this, gently put some cotton wool in your ear.
6. Repeat for your other ear, if treating both ears.

How to use the nose drops

The usual dose is 2 or 3 drops put into each nostril 2 or 3 times each day.

1. Blow your nose gently.
2. Tilt your head backwards.
3. Put the nozzle of the bottle into 1 nostril and gently squeeze.
4. Keep your head tilted and sniff gently to let the drops soak in.
5. Repeat for your other nostril if needed.

What if I forget to use it?

If you forget to use your ointment or drops, skip the missed dose and take your next one as normal.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember your medicines.

What if I use too much?

Using too much betamethasone ointment or drops is unlikely to harm you.

Do not worry if you use more of the drops or ointment by mistake.

Like all medicines, betamethasone can cause side effects, although not everybody gets them.

There are generally no side effects that affect the ear.

If your doctor has prescribed high doses of betamethasone, or you’re also taking other steroid medicines or tablets for fungal infections or HIV, you may get underactive adrenal glands as a side effect. Ask your doctor if you need to carry a steroid emergency card.

Common side effects for eye drops and ointment

If you are using betamethasone in your eyes, you may get:

• irritation, burning, stinging and itching in your eye
• blurred or cloudy vision

This can happen immediately after using the drops or ointment and usually only lasts a few minutes.

Common side effects for nose drops

If you are using betamethasone in your nose, you may experience side effects such as:

• sneezing, blocked, irritated or dry nose
• nosebleeds
• headache or dizziness
• changes in your sense of smell and taste

Serious side effects for eye drops and ointment

Tell your doctor straight away if you have side effects such as:

• ulcers on your eye – you may have pain in your eye and blurred vision
• problems with your sight – blurred or cloudy vision that does not improve or gets worse

Serious side effects for nose drops

Tell your doctor straight away if you have:

• a hole or ulcers in the tissue that divides your nose (septum)
• breathing problems
• changes in your eyesight, such as blurred vision that does not go away after a few minutes or a cloudy lens in the eye – these can be signs of increased pressure in your eyes (glaucoma) or a cataract

Serious allergic reaction

It happens rarely, but it is possible to have a serious allergic reaction (anaphylaxis) to betamethasone.

These are not all the side effects of betamethasone. For a full list see the leaflet inside your medicines packet.

What to do about:

• irritation, burning, stinging and itching in your eye – if you get these symptoms after putting in the eye drops, they should go after a few minutes as your eye gets used to the medicine. If they last longer and do not improve, stop using the eye drops or ointment and tell your doctor.
• blurred or cloudy vision – you may get some blurred or cloudy vision straight after putting the drops or ointment in your eye. If your sight does not go back to normal after a few minutes, or you think your sight is slowly getting worse, stop using the eye drops or ointment and tell your doctor.
• sneezing, blocked, irritated or dry nose, or nosebleeds – these will usually settle down as you get used to the medicine. Stop using your nose drops for a few days, then start again. Speak to your doctor if these side effects do not go away.
• headaches and dizziness – try to rest and drink plenty of fluids. Do not drink too much alcohol. Talk to your doctor if the headache does not go away or is severe.
• changes in your sense of smell and taste a few minutes after your dose – rinse your mouth with water or have a drink of water.

Betamethasone and pregnancy

It's generally OK to use betamethasone drops or ointment while pregnant. Very little is absorbed into your blood and this small amount is unlikely to cause any problems.

For safety your doctor will only prescribe betamethasone in pregnancy if the benefits outweigh the risks. They will prescribe the lowest dose that works for you.

If you're using the eye drops, you can further reduce the amount of betamethasone reaching your blood by pressing your finger onto the inner corner of your eye for 1 minute after using the drops.

Betamethasone and breastfeeding

Betamethasone drops and ointment are generally safe to use while breastfeeding. This is because only a small amount of betamethasone passes into your blood.

If you're using the eye drops, you can further reduce the amount of betamethasone reaching your blood by pressing your finger onto the inner corner of your eye for 1 minute after using the drops.

For more information about how using steroid nose drops might affect you and your baby during pregnancy, read this leaflet on treating allergic rhinitis on the Best Use of Medicines in Pregnancy (BUMPs) website.

It’s very unlikely that other medicines will affect how betamethasone eye ointment or eye, ear or nose drops work.

However, tell a pharmacist or doctor if you're taking:

• ritonavir (for HIV infection)
• cobicistat
• itraconazole (for a fungal infection)
• other medicines that contain steroids such as eczema creams, asthma inhalers, tablets, injections, eye or nose drops, and other nasal sprays

These medicines can increase the level of betamethasone in your body and increase the chances of side effects.

Mixing betamethasone with herbal remedies and supplements

There's very little information about taking herbal remedies and supplements while using betamethasone. Ask a pharmacist for advice.