Betamethasone / Calcipotriene Topical Dosage

Usual Adult Dose for Psoriasis

Topical ointment:
Psoriasis vulgaris: Apply to the affected areas once a day for up to 4 weeks. The maximum weekly dose should not exceed 100 g. Treatment of more than 30% body surface area is not recommended.

Topical suspension:
Plaque psoriasis of the scalp and body: Apply to the affected areas once a day for up to 8 weeks; treatment may be discontinued earlier if cleared. The maximum weekly dose should not exceed 100 g.

Renal Dose Adjustments

Safety and effectiveness have not been established in patients with severe renal insufficiency.

Liver Dose Adjustments

Safety and effectiveness have not been established in patients with severe hepatic disorders.

Precautions

Betamethasone-calcipotriene topical should not be applied to the face, axilla, or groin. It should not be used if skin atrophy is present at the treatment site. It is not for oral, ophthalmic, or intravaginal use.

Hypercalcemia and hypercalciuria have been reported with betamethasone-calcipotriene topical. If either occurs, treatment should be discontinued until parameters of calcium metabolism normalize.

Safety and effectiveness have not been established in patients with known or suspected disorders of calcium metabolism.

Reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing's syndrome, hyperglycemia, and unmasking of latent diabetes can result from systemic absorption of topical corticosteroids. HPA axis suppression may occur during treatment or upon withdrawal of the topical corticosteroid. Use of more potent steroids, use over large surface areas, prolonged use, use under occlusion, use on altered skin barrier, and liver failure may predispose patients using a topical corticosteroid to HPA axis suppression. A cosyntropin stimulation test may be useful in the periodic evaluation of patients for HPA axis suppression. If HPA axis suppression develops, the use of betamethasone-calcipotriene topical should be modified (e.g., attempt to withdraw drug, reduce application frequency, or substitute less potent steroid).

Local side effects may be more likely with occlusive use, prolonged use, or use of higher potency corticosteroids.

Safety and effectiveness have not been established in patients with erythrodermic, exfoliative, or pustular psoriasis.

Concomitant skin infections should be treated with an appropriate antimicrobial agent. If the infection persists, betamethasone-calcipotriene topical should be discontinued until the infection has been adequately treated.

If skin irritation develops, betamethasone-calcipotriene topical ointment should be discontinued and appropriate therapy started.

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age). Due to a higher ratio of skin surface area to body mass, pediatric patients are at greater risk of systemic adverse effects when treated with a topical medication.

Dialysis

Data not available

Other Comments

Betamethasone-calcipotriene topical should be rubbed in gently and completely. Patients should wash their hands after application of the product.

Betamethasone-calcipotriene topical suspension may cause eye irritation. Eye exposures should be avoided.

Patients who apply betamethasone-calcipotriene topical to exposed skin should avoid excessive exposure to either natural or artificial sunlight. Physicians may wish to limit or avoid use of phototherapy in such patients.