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Prednisolone and Betamethasone in Bell's Palsy

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  • Prednisolone and Betamethasone in Bell's Palsy

    A mother of 10 day old twins was diagnosed with Bell's Palsy and was prescribed 45mg of Prednisolone (15mg PO TID) daily and Diprofos (Betamethasone Aqueous Suspension Injection)Intramuscular (5mg Betamethasone dipropionate sustained release and 2mg Betamethasone sodium phosphate immediate release) Once . She received the injection more than 12 hours ago and since then all milk was pumped and discarded.

    Is the prednisolone safe in this dose and are there any effects expected from the betamethasone considering that the injection is in suspension form?

  • #2

    The transfer of corticosteroids into human is rather poor. In your situation, we'd suggest you continue to breastfeed. With the oral doses, we'd suggest you wait 3-4 hours following the dose to breastfeed or pump. This allows for rapid absorption and disposition out of the plasma compartment into tissues. This reduces milk levels.

    For the Injectable preparation, there's no way to avoid the steroid, as it is slowly absorbed into the plasma. So we'd suggest you continue to breastfeed. However, chronic use, say weeks and weeks, should be avoided if possible.

    Lastly, we'd suggest that your pediatrician follow the infants closely for signs of steroid use (decreased linear growth, skin changes, etc). These are really unlikely, but could arise following long-term therapy.

    Tom Hale Ph.d.