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Calcitriol (Topical)

Medically reviewed by Drugs.com. Last updated on Aug 16, 2020.

Pronunciation

(kal si TRYE ole)

Index Terms

  • 1,25 Dihydroxycholecalciferol

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Ointment, External:

Vectical: 3 mcg/g (100 g)

Generic: 3 mcg/g (100 g)

Brand Names: U.S.

  • Vectical

Pharmacologic Category

  • Vitamin D Analog

Pharmacology

The mechanism by which calcitriol is beneficial in the treatment of psoriasis has not been established.

Metabolism

Primarily to calcitroic acid and a lactone metabolite

Onset of Action

Topical: ~2 weeks (Lebwohl 2007).

Use: Labeled Indications

Plaque psoriasis: Management of mild to moderate plaque psoriasis in adults and pediatric patients ≥2 years of age.

Contraindications

There are no contraindications listed in the US manufacturer's labeling.

Canadian labeling: Hypersensitivity to calcitriol or any component of the formulation; ophthalmic or internal use; hypercalcemia or a history of abnormal calcium metabolism; concurrent systemic treatment of calcium homeostasis; severe renal impairment or end-stage renal disease; hepatic impairment.

Dosing: Adult

Psoriasis: Topical: Apply twice daily to affected areas (maximum: 200 g weekly)

Dosing: Pediatric

Plaque psoriasis, mild to moderate: Topical: Ointment:

Children ≥2 years to <7 years: Apply twice daily to affected area(s); maximum weekly dose: 100 g/week.

Children ≥7 years and Adolescents: Apply twice daily to affected areas; maximum weekly dose: 200 g/week.

Administration

Topical: Apply externally; not for ophthalmic, oral, or intravaginal use. Do not apply to eyes, lips, or facial skin. Rub in gently so that no medication remains visible. Limit application to only the areas of skin affected by psoriasis.

Storage

Store at 20°C to 25°C (68°F to 77°F); excursions permitted to 15°C to 30°C (59°F to 86°F); do not refrigerate; do not freeze.

Drug Interactions

Aluminum Hydroxide: Vitamin D Analogs may increase the serum concentration of Aluminum Hydroxide. Specifically, the absorption of aluminum may be increased, leading to increased serum aluminum concentrations. Avoid combination

Aminolevulinic Acid (Systemic): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Systemic). Avoid combination

Aminolevulinic Acid (Topical): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Topical). Monitor therapy

Burosumab: Vitamin D Analogs may enhance the adverse/toxic effect of Burosumab. Avoid combination

Calcium Salts: May enhance the adverse/toxic effect of Vitamin D Analogs. Monitor therapy

Cardiac Glycosides: Vitamin D Analogs may enhance the arrhythmogenic effect of Cardiac Glycosides. Monitor therapy

Multivitamins/Fluoride (with ADE): May enhance the adverse/toxic effect of Vitamin D Analogs. Avoid combination

Multivitamins/Minerals (with ADEK, Folate, Iron): May enhance the adverse/toxic effect of Vitamin D Analogs. Avoid combination

Porfimer: Photosensitizing Agents may enhance the photosensitizing effect of Porfimer. Monitor therapy

Sucralfate: Vitamin D Analogs may increase the serum concentration of Sucralfate. Specifically, the absorption of aluminum from sucralfate may be increased, leading to an increase in the serum aluminum concentration. Avoid combination

Thiazide and Thiazide-Like Diuretics: May enhance the hypercalcemic effect of Vitamin D Analogs. Monitor therapy

Verteporfin: Photosensitizing Agents may enhance the photosensitizing effect of Verteporfin. Monitor therapy

Vitamin D Analogs: May enhance the adverse/toxic effect of other Vitamin D Analogs. Avoid combination

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%: Endocrine: Hypercalcemia (24%)

1% to 10%: Dermatologic: Skin pain (3%)

Postmarketing: Dermatologic: Bullous dermatitis (acute), burning sensation of skin, erythema of skin

Warnings/Precautions

Concerns related to adverse effects:

• Hypercalcemia: May cause hypercalcemia; if alterations in calcium occur, discontinue treatment until levels return to normal. Use with caution in patients receiving calcium supplements, high doses of vitamin D, or medications known to cause hypercalcemia (eg, thiazide diuretics).

Other warnings/precautions:

• Appropriate use: For external use only; not for ophthalmic, oral, or intravaginal use. Do not apply to facial skin, eyes, or lips. Absorption may be increased with occlusive dressings. The safety and effectiveness have not been evaluated in patients with known or suspected disorders of calcium metabolism.

Pregnancy Considerations

Topical agents are recommended for the treatment of psoriasis in pregnancy; however, agents with information specific to use in pregnant patients is preferred (Babalola 2013; Bae 2012).

Patient Education

What is this drug used for?

• It is used to treat plaque psoriasis.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Itching

• Skin irritation

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• High calcium like weakness, confusion, feeling tired, headache, upset stomach and throwing up, constipation, or bone pain

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.