This product is used for the effective and fast treatment of some skin problems involving skin inflammation in which the risk of a concomitant infection is a concern, such as:
eczema (common skin disorder that causes the skin to become itchy and red).
Nummular dermatitis (chronic skin problem that causes skin itchiness, swelling and cracking in circular or oval patches)
prurigo nodularis (formation of hard and itchy lumps on the skin).
lichen simplex chronicus (patches of itchy, thickened skin from scratching).
psoriasis (thickened patches of red and inflamed skin, usually covered with silvery scales), excluding widespread plaque psoriasis.
lichen planus (red to purple, itchy and flat-topped bumps on the forearms, lower legs or wrists).
allergic skin reaction (e.g. contact dermatitis) due to a substance or an allergen that comes in contact with your skin.
otitis externa (inflamed, flaky and red skin of the outer ear and ear canal).
skin reactions due to insect bites.
seborrheic dermatitis (a scaly, red and itchy rash on the scalp, chest, back, and face).
prickly heat (skin rash caused by sweat trapped in the skin).
genital and anal intertrigo (rash that usually affects skin folds in the vagina or penis due to skin rubbing together and moisture).

Do not use Betamethasone valerate/ Neomycin sulfate:

If you have an allergy to betamethasone valerate, neomycin sulfate, or any of the ingredients present in this product.
If the package is ripped or has signs of tampering.
If the expiry date mentioned on the medication box has passed.
If you experience an allergic reaction or skin irritation upon use of this cream/ointment.
If you are pregnant, plan on getting pregnant or breastfeeding.
If you may be suffering from other skin problems (e.g. fungal infections such as athletes foot or oral thrush; bacterial skin infections; anal or genital itching; viral skin infections like cold sores, shingles, chickenpox; acne; itchy skin that is not inflamed.
some bacterial skin infections; otitis externa (swimmer’s ear) if the ear is perforated; skin inflammation around the mouth.
unusual redness of the face with papules or tiny blood vessels or pus-filled bumps known as rosacea).
The use of this medicine for other skin disorders may worsen your problem. Ask your doctor or pharmacist if you are not sure.
In children under the age of 2 years.
On large body areas or in large quantities due to the known ototoxic (ear damage) and nephrotoxic (kidney damage) risk of neomycin sulfate.

Warnings & Precautions:

Stop the medication right away and talk to your doctor or pharmacist if you develop any allergic or skin reactions to any of the ingredients present in this cream/ointment such as
skin itchiness, skin redness, shortness of breath, skin rash, swelling of the face or neck, decreased blood pressure and dizziness.
This medicine is designed for external topical use only. Do not swallow this product.
Avoid contact of the cream/ointment with your lips, eyes, mouth, sensitive areas of the neck and angles of the nose in order to avoid irritation.
In case of accidental contact, make sure to rinse the area very well with warm water and then pat dry.
Talk to your doctor immediately if you, or your child develop any vision problems (e.g. blurred vision).
Make sure not to use any occlusive dressings if you have a skin infection.
Talk to your doctor before starting this medicine if you have an allergy to any other medicines, dyes, foods or preservatives,
if you are pregnant, plan on getting pregnant, breastfeeding or plan on breastfeeding,
if you have any other health problems (especially if you suffer from an infection).
Make sure to tell your healthcare providers that you are using this medicine.
Do not use this product for more than 7 days unless recommended by your doctor.
If your skin does not feel better or is getting worse after 7 days, talk to your doctor for re-evaluation.
Talk to your doctor if you do not use this product as directed to make sure that he/she does not change you to another therapy thinking that this medicine did not work for you.
Do not share this medicine with anyone else even if they have the same signs.
Do not use tight-fitting nappies or plastic pants if this product is to be used on the nappy area of young children.
If your doctor recommends that you use a dressing; clean the skin very well before you apply it in order to prevent infections.
Do not apply this medicine under tight fitting clothes to avoid skin thinning.
Do not use this medicine for a long period of time on large areas to prevent its excessive absorption and subsequent undesirable side effects like blood vessels under your skin, stretch marks, changes in skin color, increased body hair growth, rounding of the face, skin thinning, or weight gain.
Do not use this product for other purposes.
Do not dilute this product.
You are at higher risk of developing an allergic reaction or an infection if you apply this product on an area of the skin that has eczema around a leg ulcer.
Talk to your doctor if you have a leg ulcer.
Antibiotics were shown to increase the risk of pseudomembranous colitis (type of bowel inflammation) in some patients.
The risk of developing this problem with this product is low because it has a topical antibiotic (not systemic),
however, the risk is higher if used for long periods of time or in large quantities.
Stop using this product and make sure to talk to your doctor if you develop pseudomembranous colitis signs like diarrhea or abdominal cramps.
This medicine may cause reversible hypothalamic-pituitary-adrenal (HPA) axis suppression (your central stress response system) and hypercortisolism (Cushing’s syndrome; increased cortisol levels) due to increased systemic absorption of topical corticosteroids.
Your doctor will gradually decrease the frequency of this medicine or will switch you to another milder topical corticosteroid if any of these happens.
This product should not be abruptly stopped in order to avoid glucocorticoid insufficiency.
You are at higher risk of developing systemic side effects depending on multiple factors like; type and potency of the corticosteroid used, duration of the corticosteroid use, use on wounded skin, large body areas, covered skin areas or thin skin areas like the face.
This medicine may increase the risk of contact sensitization (increased allergic reactions to the product even when your skin comes in contact with minutes of the product) when used for long periods of time.
This medicine may worsen and extend the infection due its ability to hide the signs.
If this happens, your doctor should gradually stop this medicine and start you on antibiotics if needed.

Possible Side Effects:

Possible side effects include allergy reactions (like rash, itching, red, swollen, blistered, or peeling skin, lumpy rash, wheezing, swelling of the eyelids, lips, face and mouth, chest tightness, fainting and difficult breathing) and worsening of your skin condition or infected skin. Common side effects include itching, burning and local skin pain.
Very rare side effects include tiny blood vessels below the skin, stretch marks, hair loss, skin redness, skin dryness, skin wrinkling, thinning of the skin, pustular psoriasis (raised bumps filled with pus below the skin that may rarely happen during or after the treatment if you have psoriasis),
opportunistic infections (infections that happen when you have a weakened immune system),
local hypersensitivity (allergic skin reactions), reversible hypothalamic-pituitary-adrenal (HPA) axis suppression,
hypercortisolism signs (like moon face and weight gain), delayed weight gain and growth retardation in children,
osteoporosis (bone fragility), cataract or glaucoma (increased eye pressure),
hyperglycemia (high blood glucose levels) or glycosuria (increased glucose in the urine),
hypertension (high blood pressure), increased weight or obesity, decreased cortisol levels produced in the body,
application site irritation, increase in hair growth, thickening or weak points in the hair that causes it to break easily),
change in skin color, allergic contact dermatitis (allergic skin reactions when the skin comes in contact with an allergen or a substance) and rash.

Other medicines and Betamethasone valerate/ Neomycin sulfate:

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medications including topical products (e.g. creams, lotions, ointments).
If you are taking itraconazole (used to treat some fungal infections).
If you are taking ritonavir (used to treat human immunodeficiency virus).
If you are taking neuromuscular blocking agents (used to produce paralysis in some procedures).
If you are taking systemic aminoglycoside antibiotics (used to treat some bacterial infections).

How to use Betamethasone valerate/ Neomycin sulfate:

Adults

Apply a thin layer of cream/ointment and gently massage it into the affected area as directed by your doctor
(usually 1 to 2 times per day) for up to 7 days.
If the doctor recommends a longer duration of therapy,
you will be switched to another corticosteroid product that does not contain neomycin sulfate.

Children

Dosing in children above 2 years old is the same as adults.
Do not use this medicine in children under the age of 2 years.
Use of this medicine is not recommended in children (especially if less than 12 years old) unless recommended by your doctor.
If recommended by the doctor, he/she should follow up closely with the child to check for the development of any undesirable side effect like growth retardation or adrenocortical suppression (lower production of cortisol in the body).
Children are more likely to develop local and systemic side effects of topical corticosteroids and,
therefore, need shorter treatment duration and milder medicines than adults.

Elderly

The minimum dose and duration of this product should be used in elderly patients due to their slower ability to eliminate medicines.

How To Use:

Wash and dry your hands before and after using the cream/ointment (do not wash your hands after using it if it is being used for the skin of your hands).
If you are applying this medicine to someone else, make sure to wear disposable plastic gloves or wash your hands immediately after applying the cream/ointment.
Make sure to replace the cap on the tube after using the cream/ointment in order to avoid leakage of the medicine.
Make sure to follow the directions of your healthcare provider.
Make sure to keep the cream/ointment away from your eyes.
Glaucoma and cataract may happen due to eye exposure to the product.
If accidental contact happens, wash your eyes thoroughly with running water for at least 10 minutes.
Make sure not to apply the cream/ointment below a dressing (e.g. bandage or plaster) in order to prevent excessive absorption of the medicine and subsequent undesirable side effects (damage to the nervous system).
If you are using a moisturizer, give time for this cream/ointment to be absorbed into your skin before you apply your moisturizer.
If you are taking this medicine for thick patches due to psoriasis on your elbows or knees, your doctor may recommend applying the cream/ointment under an airtight dressing at night in order to help the medicine to start working.
You will then apply your cream/ointment normally after a short period of time.
Do not use this cream/ointment on your face unless directed by your doctor.
If your skin condition does not improve, make sure to contact your doctor right away.
Do not use this cream/ointment on skin wounds or on large areas of the skin or in skin folds (e.g. the back of the knee) unless directed by your doctor.
Using less than recommended of this medicine may cause your skin not to improve.
Your doctor will determine for how long you will be using this product and may also adjust the frequency of using it depending on your response and.
This medicine is associated with more side effects if used for longer periods of time.
Do not change how you use this medicine without consulting your doctor first.
Ointments are used when the skin is dry and scaly, whereas creams are used when your skin is moist and weeping.
Dosage may be reduced if you have kidney impairment.

How to store Betamethasone valerate/ Neomycin sulfate:

Keep out of the reach of children and pets (e.g. a locked cupboard at least one-and-a-half meter above the ground)
Store in a dry place below 30°C
Do not use beyond the expiry date mentioned on the cream/ointment
Do not dispose medication in the wastewater or household waste, ask your pharmacist how to dispose medicines you no longer use
Do not leave your medicine on windowsills or in the car
Keep medication in its original pack to protect it from moisture and light

Manufacturer: Betnovate
Product form: Cream
Ingredients: Betamethasone - Neomycin