Calcipotriene

Pronunciation: KAL-si-poe-TRYE-een
Class: Antipsoriatic agent

Trade Names

Calcitrene
- Ointment, topical 0.005%

Dovonex
- Cream, topical 0.005%
- Solution, topical 0.005%

Sorilux
- Foam, topical 0.005%

Pharmacology

Calcipotriene, a synthetic vitamin D 3 analog, regulates skin cell production and development.

Slideshow: Psoriasis: Treatment Options to Manage Your Symptoms

Pharmacokinetics

Absorption

Foam

Plasma concentrations were below the limit of quantitation (10 pg/mL).

Ointment

Approximately 6% of the topically applied dose is absorbed.

Solution

Less than 1% of applied dose is absorbed through the scalp.

Distribution

Vitamin D and its metabolites are transported in the blood, bound to specific plasma proteins.

Metabolism

Absorbed amount is rapidly converted to inactive metabolites within 24 h of application.

Elimination

The active form of the vitamin, 1,25-dihydroxy-vitamin D 3 (calcitriol), is known to be recycled via the liver and excreted in the bile.

Indications and Usage

Cream, foam, ointment

Treatment of plaque psoriasis in adults (18 y and older).

Solution

Topical treatment of chronic, moderately severe psoriasis of the scalp.

Contraindications

Acute psoriatic eruptions (scalp solution); hypersensitivity to any component of the product; patients with hypercalcemia or evidence of vitamin D toxicity; use on the face (cream/ointment).

Dosage and Administration

Adults
Cream/Foam

Topical Apply a thin layer to affected skin twice daily.

Ointment

Topical Apply a thin layer once or twice daily.

Scalp solution

Topical Apply twice daily only to scalp lesions.

General Advice

  • For topical use only. Not for ophthalmic, oral, or intravaginal use.
  • Wash hands thoroughly after use, unless treatment area involves the hands.
  • Do not apply ointment, cream, or solution to face.
  • Avoid contact with the eyes or mucus membranes. If medication comes into contact with the eyes, wash them with large amounts of cool water.
  • Apply cream, foam, or ointment sparingly, but in sufficient quantity to cover affected area(s), and rub in gently.
  • To treat scalp lesions, comb hair to remove scaly debris, part the hair, apply a small amount of scalp solution only on lesions, and rub in gently and completely. Avoid application of scalp solution to uninvolved scalp lesions and take care to prevent the solution from spreading onto the forehead.
  • Foam and scalp solution are flammable. Keep away from open flame. Foam contents are under pressure; do not puncture or incinerate. Do not expose to heat or store at temperatures above 120°F.

Storage/Stability

Store between 59° and 77°F. Protect from freezing. Do not place foam in refrigerator. Protect scalp solution from exposure to sunlight.

Drug Interactions

None well documented.

Adverse Reactions

Dermatologic

Cream

Skin irritation (10% to 15%); dermatitis, pruritus, rash, worsening of psoriasis (1% to 10%).

Foam

Erythema (more than 1%).

Ointment

Burning, itching, skin irritation (10% to 15%); dermatitis, dry skin, erythema, peeling, rash, worsening of psoriasis including development of facial/scalp psoriasis (1% to 10%).

Solution

Transient burning, stinging, and tingling (23%); rash (11%); dry skin, irritation and worsening of psoriasis (1% to 5%).

Precautions

Monitor

Monitor serum calcium during treatment of large surface areas or during prolonged therapy. Assess skin and scalp condition before initial application and periodically throughout treatment.


Pregnancy

Category C .

Lactation

Undetermined.

Children

Safety and efficacy not established.

Elderly

May experience more severe skin-related adverse reactions when using ointment.

Hypercalcemia

Can develop during therapy. If hypercalcemia occurs, discontinue treatment until normal calcium levels are restored.

Local irritation

May occur.

Overdosage

Symptoms

Elevated serum calcium.

Patient Information

  • Caution patient not to apply in greater quantity or more frequently than prescribed by health care provider.
  • Caution patient to avoid application of scalp solution to uninvolved scalp lesions.
  • Warn patient that foam and scalp solution are flammable and to keep away from open flame.
  • Caution patient not to apply ointment, cream, or scalp solution to face.
  • Caution patient to avoid contact with the eyes. Advise patient that if medication comes into contact with the eyes to wash them with large amounts of cool water and to contact health care provider if eye irritation occurs.
  • Caution patient to avoid exposing treatment areas to excessive natural or artificial sunlight (eg, tanning booths, sunlamps).
  • Advise patient that symptoms should begin to improve within 2 wk after starting treatment and to notify health care provider if condition does not improve, worsens, or if application-site reactions (eg, burning, stinging, redness, itching) develop.

Copyright © 2009 Wolters Kluwer Health.

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