BMA Concise Guide to Medicine & Drugs

Calcipotriol

Brand name Dovonex

Used in the following combined preparations Dovobet, Xamiol

QUICK REFERENCE

Drug group Drug for psoriasis

Overdose danger rating Low

Dependence rating Low

Prescription needed Yes

Available as generic No

GENERAL INFORMATION

Calcipotriol is a synthetic derivative of vitamin D used in the treatment of plaque psoriasis affecting the skin and scalp. Although similar to vitamin D, outside the skin calcipotriol is weak compared to vitamin D. In the skin, it is thought to work by reducing production of the skin cells that cause skin thickening and scaling, which are the most common symptoms of psoriasis. Because this drug is related to vitamin D, excessive use can lead to a rise of calcium levels in the body, although this is very uncommon; otherwise calcipotriol is unlikely to cause any serious adverse effects.

Calcipotriol is applied to the affected areas in the form of cream, ointment, or scalp solution. It should not be used on the face, and it is important to wash the hands following application to the affected area to avoid accidental transfer of the drug to unaffected areas. Local irritation may occur during the early stages of treatment. Excessive exposure to sunlight should be avoided while using calcipotriol.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Cream, ointment, scalp solution.

Frequency and timing of doses 1–2 x daily.

Adult dosage range Maximum 100g each week (cream, ointment); maximum 60ml each week (scalp solution): less if both preparations are used together.

Onset of effect Improvement is seen within 2 weeks.

Duration of action One application lasts up to 12 hours. Beneficial effects are longer lasting.

Diet advice None.

Storage Store in original container at room temperature out of the reach of children.

Missed dose Apply the next dose at the scheduled time.

Stopping the drug Do not stop the drug without consulting your doctor; symptoms may recur.

Exceeding the dose Excessive prolonged use may lead to an increase in blood calcium levels, which can cause nausea, constipation, thirst, abdominal pain, weakness, tiredness, and frequent urination. Notify your doctor.

POSSIBLE ADVERSE EFFECTS

Temporary local irritation and itching may occur when treatment is started, and the skin may become dry. Other adverse effects are usually due to heavy or prolonged use, leading to high calcium levels in the blood. Such effects include a rash (which may be light-sensitive), thirst, frequent urination, nausea, and constipation. If you develop abdominal pain, weakness, tiredness, confusion, or worsening of psoriasis, stop taking the drug and contact your doctor.

INTERACTIONS

None known.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have a metabolic disorder.

· You have previously had a hypersensitivity reaction to the drug.

· You have long-term liver or kidney problems.

· You are taking other medicines.

Pregnancy Safety in pregnancy not established. Discuss with your doctor.

Breast-feeding Not known if excreted into breast milk. Discuss with your doctor.

Infants and children Cream/ointment not recommended under 6 years. Scalp solution, only under specialist advice.

Over 60 No problems expected.

Driving and hazardous work No problems expected.

Alcohol No problems expected.

PROLONGED USE

No problems expected from use of calcipotriol in low doses. If the effects of the skin preparation decline after several weeks, they may be regained by suspending use for a few weeks and then recommencing treatment.

Monitoring Regular checks on calcium levels in the blood or urine are required only during prolonged or heavy use.