CORTICOSTEROIDS
Betamethasone 21-Dec-2017
lINDICATIONS AND DOSE
Oral ulceration
▶TO THE LESION USING SOLUBLE TABLETS
▶Child 12–17 years: 500 micrograms 4 times a day, to be
dissolved in 20 mL water and rinsed around the mouth;
not to be swallowedlUNLICENSED USEBetamethasone soluble tablets not
licensed for use as mouthwash or in oral ulceration.IMPORTANT SAFETY INFORMATION
MHRA/CHM ADVICE: CORTICOSTEROIDS: RARE RISK OF CENTRAL
SEROUS CHORIORETINOPATHY WITH LOCAL AS WELL AS SYSTEMIC
ADMINISTRATION (AUGUST 2017)
See Corticosteroids, general use p. 434.lCONTRA-INDICATIONSUntreated local infection
lINTERACTIONS→Appendix 1 : corticosteroids
lSIDE-EFFECTSIncreased risk of infection
lPATIENT AND CARER ADVICEPatient counselling is advised
for betamethasone soluble tablets (administration).
lPROFESSION SPECIFIC INFORMATION
Dental practitioners’formularyBetamethasone Soluble
Tablets 500 micrograms may be prescribed for oral
ulceration.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Soluble tablet
CAUTIONARY AND ADVISORY LABELS10, 13, 21(not for use as
mouthwash for oral ulceration)
▶Betamethasone (Non-proprietary)
Betamethasone (as Betamethasone sodium phosphate)
500 microgramBetamethasone 500 microgram soluble tablets sugar
free sugar-free| 100 tabletP£ 51. 12 DT = £ 51. 12Hydrocortisone 21-Dec-2017
lINDICATIONS AND DOSE
Oral and perioral lesions
▶TO THE LESION USING BUCCAL TABLET
▶Child 1 month–11 years:Only on medical advice
▶Child 12–17 years: 1 lozenge 4 times a day, allowed to
dissolve slowly in the mouth in contact with the ulcerlUNLICENSED USEHydrocortisone mucoadhesive buccal
tabletslicensed for use in children (under 12 years—on
medical advice only).IMPORTANT SAFETY INFORMATION
MHRA/CHM ADVICE: CORTICOSTEROIDS: RARE RISK OF CENTRAL
SEROUS CHORIORETINOPATHY WITH LOCAL AS WELL AS SYSTEMIC
ADMINISTRATION (AUGUST 2017)
See Corticosteroids, general use p. 434.lCONTRA-INDICATIONSUntreated local infection
lINTERACTIONS→Appendix 1 : corticosteroids
lSIDE-EFFECTSDiabetic control impaired.infection
exacerbated
lPROFESSION SPECIFIC INFORMATION
Dental practitioners’formulary
Mucoadhesive buccal tablets may be prescribed as
Hydrocortisone Oromucosal Tablets.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Muco-adhesive buccal tablet
▶Hydrocortisone (Non-proprietary)
Hydrocortisone (as Hydrocortisone sodium succinate)
2.5 mgHydrocortisone 2. 5 mg muco-adhesive buccal tablets sugar
free sugar-free| 20 tabletp£ 8. 30 DT = £ 7. 70SALICYLIC ACID AND DERIVATIVES
Choline salicylate
lINDICATIONS AND DOSE
Mild oral and perioral lesions
▶TO THE LESION
▶Child 16–17 years:Apply 0. 5 inch, apply with gentle
massage, not more often than every 3 hourslCONTRA-INDICATIONSChildren under 16 years
CONTRA-INDICATIONS, FURTHER INFORMATION
▶Reye’s syndromeThe CHM has advised that topical oral pain
relief products containing salicylate salts should not be
used in children under 16 years, as a cautionary measure
due to the theoretical risk of Reye’s syndrome.
lCAUTIONSFrequent application, especially in children,
may give rise to salicylate poisoning
lINTERACTIONS→Appendix 1 : choline salicylate
lSIDE-EFFECTSBronchospasm
lPRESCRIBING AND DISPENSING INFORMATIONWhen
prepared extemporaneously, the BP states Choline
Salicylate Dental Gel, BP consists of choline salicylate
8. 7 %inaflavoured gel basis.
lPROFESSION SPECIFIC INFORMATION
Dental practitioners’formulary
Choline Salicylate Dental Gel may be prescribed.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Oromucosal gel
▶Bonjela(Reckitt Benckiser Healthcare (UK) Ltd)
Choline salicylate 87 mg per 1 gramBonjela Cool Mint gel sugar-
free| 15 gramG£ 3. 55 DT = £ 2. 58
Bonjela Original gel sugar-free| 15 gramG£ 2. 58 DT = £ 2. 58Salicylic acid with rhubarb extract
lINDICATIONS AND DOSE
Mild oral and perioral lesions
▶TO THE LESION
▶Child 16–17 years:Apply 3 – 4 times a day maximum
duration 7 dayslCONTRA-INDICATIONSChildren under 16 years
CONTRA-INDICATIONS, FURTHER INFORMATION
▶Reye’s syndromeThe CHM has advised that topical oral pain
relief products containing salicylate salts should not be
used in children under 16 years, as a cautionary measure
due to the theoretical risk of Reye’s syndrome.
lCAUTIONSFrequent application, especially in children,
may give rise to salicylate poisoning
lSIDE-EFFECTS
▶Common or very commonOral disorders
lPATIENT AND CARER ADVICEMay cause temporary
discolouration of teeth and oral mucosa.708 Oral ulceration and inflammation BNFC 2018 – 2019
Ear, nose and oropharynx12