Betamethasone enema belongs to the group of medications known as corticosteroids. It is used to treat ulcerative colitis and works by reducing inflammation.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

The usual recommended dose of betamethasone enema is one enema used each night for 2 to 4 weeks. Your doctor may recommend that you continue treatment beyond 4 weeks if you are responding well to treatment.

To use an enema: Lie on your side in a horizontal position and hold the container about 1 or 2 inches above the hips while inserting the tip into the rectum to allow free but not forcible flow of the fluid from the container. Use as directed by your health professional and as instructed on the package insert.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose of this medication, skip the missed dose and continue with your regular schedule. Do not double a dose to make up for a missed dose. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light, and keep it out of the reach of children.

Each disposable plastic bag of 100 mL contains betamethasone 5 mg (as betamethasone sodium phosphate) in buffered solution.

Do not use betamethasone enema if you:

• are allergic to betamethasone or to any of the ingredients of the medication
• have been vaccinated with a vaccine containing live virus
• have systemic (throughout the body) infections

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• dizziness
• increased sweating
• thin, fragile skin
• unusual weight gain

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Stop taking the medication and seek immediate medical attention if any of the following occur:

• seizures

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Infections: This medication may mask some signs of infection, and new infections may appear while you are using it. Viral infections such as chickenpox, measles, or herpes can be more serious for people who are taking betamethasone. If you have not had these diseases, you should take particular care to avoid exposure. Contact your doctor if you notice any symptoms of an infection (e.g., fever, chills, cough, sore throat), or if you are in contact with someone who has measles or chickenpox.

Illness and stress: If you experience unusual stress (e.g., trauma, infection), your doctor may prescribe a corticosteroid taken by mouth before, during, and after the stressful situation.

Medical conditions: Tell your doctor if you have any history of the following medical conditions, as treatment with betamethasone may worsen these conditions or may require that you be monitored more closely by your doctor:

• depression
• diabetes
• epilepsy
• glaucoma
• heart failure
• herpes infections of the eye
• high blood pressure
• kidney disease
• liver disease
• myasthenia gravis
• osteoporosis
• psychosis
• stomach problems
• tuberculosis
• underactive thyroid

Prolonged treatment: Prolonged use of corticosteroids such as betamethasone may cause cataracts, glaucoma, eye infections, and stomach ulcers. Your doctor may monitor you for these problems during treatment.

Stopping treatment: If you have been using this medication for longer than 2 weeks, do not stop using this medication without first checking with your doctor. Your doctor may want you to reduce gradually the amount you are using.

Vaccines: Live vaccines (e.g., BCG, yellow fever, measles, mumps, rubella) should not be given to people taking this medication. Other vaccines such as inactivated vaccines may not be as effective for people who are taking this medication. 

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while using this medication, contact your doctor immediately.

Breast-feeding: This medication may pass into breast milk. If you are breast-feeding and are using betamethasone enema, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: Treatment with corticosteroids such as betamethasone can affect the growth and development of infants, children, and adolescents. Treatment should be given at the lowest dose for the shortest period of time.

Seniors: Seniors should discuss the risk and benefits of using this medication with their doctor as they may be more at risk for side effects and complications.

There may be an interaction between betamethasone enema and any of the following:

• apalutamide
• aprepitant
• "azole" antifungals (e.g., fluconazole, itraconazole, ketoconazole, voriconazole)
• BCG
• baricitinib
• calcitriol
• carbamazepine
• other corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
• cladribine
• deferasirox
• denosumab
• donepezil
• echinacea
• enzalutamide
• furosemide
• galantamine
• HIV protease inhibitors (atazanavir, darunavir, indinavir, lopinavir, nelfinavir, ritonavir)
• immune checkpoint inhibitors (durvalumab, nivolumab)
• isoniazid
• leflunomide
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• mifepristone
• natalizumab
• phenobarbital
• phenytoin
• pimecrolimus
• primidone
• pyridostigmine
• rifampin
• rivastigmine
• ruxolitinib
• testosterone
• tofacitinib
• upadacitinib
• tacrolimus
• vaccines
• warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.