DIPROFOS INJECTION

Diprofos Injection is a combined corticosteroid formulation containing two esters of Betamethasone: Betamethasone Sodium Phosphate (the soluble, fast-acting component providing rapid onset within hours) and Betamethasone Dipropionate (the sparingly soluble depot component providing prolonged anti-inflammatory action lasting weeks).

This dual-ester design gives Diprofos both immediate and sustained anti-inflammatory and immunosuppressive effects from a single injection.

In Kenya, Diprofos is used in hospitals and specialist outpatient clinics for acute flares of rheumatoid arthritis, osteoarthritis, bursitis, tendinitis, severe allergic reactions, asthma exacerbations, dermatological conditions such as keloids and alopecia areata, and as systemic steroid therapy where oral steroids are not feasible.

It is more potent than hydrocortisone and methylprednisolone on a mg-per-mg basis and requires careful clinical judgement in its use.

Administration

Administered ONLY by a trained healthcare professional under sterile conditions. NOT for intravenous (IV) or subcutaneous use.

IM Systemic Dose

1–2ml (7–14mg) IM as a single dose. May be repeated every 3–4 weeks based on clinical response.

Intra-articular Dose

0.25–2ml depending on joint size. Large joints (knee): 1–2ml; Small joints (fingers): 0.25–0.5ml.

Intradermal / Intralesional

0.2ml per injection site for skin lesions such as keloids; maximum 1ml per session.

Missed / Repeat Dose

Repeat dosing schedule is determined entirely by the prescribing clinician based on clinical response.

Common Side Effects

·       Transient post-injection pain or flare at injection site

·       Facial flushing

·       Elevated blood glucose (especially in diabetics, may persist 2–4 weeks)

·       Mood changes (euphoria, irritability, insomnia)

·       Menstrual irregularities after systemic dosing

Uncommon Side Effects

·       Skin atrophy or depigmentation at injection site (with intradermal use)

·       Weight gain and fluid retention

·       Hypertension

·       Cushing's syndrome features with repeated doses

Serious Side Effects, Seek Immediate Medical Attention

·       Septic arthritis if injection performed under non-sterile conditions

·       Adrenal suppression with repeated systemic use

·       Avascular necrosis of bone (femoral head) with prolonged high-dose use

·       Tendon rupture (avoid injecting directly into tendons)

·       Anaphylaxis (rare)

·       Severe immunosuppression and susceptibility to opportunistic infections

·       DIABETES: Betamethasone causes marked, prolonged blood glucose elevation; monitor diabetics closely for 2–4 weeks post-injection and adjust antidiabetic therapy accordingly.

·       INFECTION RISK: Steroids mask signs of infection and impair immune response; screen carefully before injecting and monitor post-injection.

·       PREGNANCY: Crosses the placenta; use only when clearly indicated. Repeated doses may suppress fetal adrenal function.

·       ADRENAL SUPPRESSION: Repeated systemic injections suppress the HPA axis, do not stop abruptly after multiple doses.

·       PAEDIATRICS: Use with caution, may impair growth. Use lowest effective dose.

·       OSTEOPOROSIS: Long-term use increases fracture risk, supplement with calcium and Vitamin D.

·       NOT FOR IV: IV administration of betamethasone dipropionate can cause fatal cardiovascular collapse.

NSAIDs (ibuprofen, diclofenac): Additive GI ulceration risk, consider proton pump inhibitor cover.

Antidiabetics / Insulin: Hyperglycaemic effect of betamethasone, increase monitoring and adjust doses.

Warfarin / Anticoagulants: Corticosteroids may alter INR, monitor closely.

CYP3A4 inhibitors (ketoconazole, erythromycin): Increase betamethasone plasma levels, risk of enhanced steroid effects.

Rifampicin / Phenytoin (CYP3A4 inducers): Reduce betamethasone efficacy.

Live vaccines: Do not administer live vaccines during or within 3 months of corticosteroid therapy.

Immunosuppressants (cyclosporine): Additive immunosuppression, increased infection risk.

·       Store at 15–25°C. Do NOT freeze.

·       Protect from light, store in original packaging until use.

·       Do not use if the suspension appears discoloured or contains foreign particles.

·       For healthcare facility storage only.

·       Keep out of reach of children.

·       Shelf life: as indicated on the vial label.

Diprofos Injection is a prescription-only injectable medicine (POM) in Kenya. It must be prescribed by a registered medical practitioner and administered by a trained healthcare professional. Available at Pharmily for dispensing to licensed health facilities and practitioners with a valid prescription.

Diprofos (dual-ester betamethasone) is a more potent and longer-acting depot corticosteroid than Depo-Medrol (methylprednisolone acetate). Dispense only to licensed healthcare facilities with a valid prescription and confirmed indication. The soluble phosphate ester provides rapid symptom relief while the dipropionate ester sustains effect; counsel the clinician on this pharmacokinetic profile.

Strict sterile technique is non-negotiable for intra-articular injections; document dispensing for traceability. Diabetic patients will require blood glucose monitoring and likely temporary antidiabetic dose adjustment for 2–4 weeks.

Flag the absolute contraindication to IV administration; this is a common and potentially fatal error. For patients on long-term or repeat injections, recommend concurrent calcium, Vitamin D, and a bone density assessment.

Q1: What is Diprofos Injection used for?

A: Diprofos is used to treat inflammatory and allergic conditions, including joint inflammation in arthritis, bursitis, tendinitis, severe allergic reactions, skin conditions like keloids, and acute asthma exacerbations.

Q2: How long does a Diprofos injection last?

A: The fast-acting component (betamethasone sodium phosphate) provides relief within hours, while the depot component (betamethasone dipropionate) sustains the effect for 3–4 weeks or longer depending on the condition.

Q3: Can Diprofos be given intravenously?

A: No. Diprofos must NEVER be given intravenously (into a vein). It is given intramuscularly, into joints, or into skin lesions only. IV administration is dangerous and potentially fatal.

Q4: How often can Diprofos be given?

A: Frequency depends on the condition being treated and the prescriber's judgment. Intra-articular injections are generally limited to 3–4 times per year in the same joint to prevent joint damage.