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DERMATOLOGICALS › ANTIPSORIATICS › ANTIPSORIATICS FOR TOPICAL USE › Other antipsoriatics for topical use
calcipotriol, combinations
D05AX52
Forms & Strengths
- Topical ointment: calcipotriol 50 mcg plus betamethasone dipropionate 0.5 mg per gram
- Topical suspension/gel: calcipotriol 50 mcg plus betamethasone dipropionate 0.5 mg per gram
- Topical cream: calcipotriol 50 mcg plus betamethasone dipropionate 0.5 mg per gram
Adult Dosing
- Plaque psoriasis: Apply a thin layer to affected areas once daily for up to 4 weeks (scalp) or 8 weeks (body)
- Maximum weekly dose: Do not exceed 100 grams per week
- Maximum body surface area: Do not treat more than 30% of body surface area
Pediatric Dosing
- Safety and efficacy in pediatric patients under 18 years have not been established
- Use in adolescents is generally discouraged due to the risk of systemic absorption and calcium metabolism disruption
Indications
- Topical treatment of plaque psoriasis vulgaris in adults
- Treatment of scalp psoriasis in adults
Mechanism of Action
- Calcipotriol acts as a synthetic vitamin D3 analogue, binding to vitamin D receptors to inhibit keratinocyte proliferation and promote differentiation
- Betamethasone dipropionate acts as a potent topical corticosteroid with anti-inflammatory, immunosuppressive, and antiproliferative properties
- Combination provides synergistic control over hyperproliferation and cutaneous inflammation in psoriatic lesions
Contraindications
- Hypersensitivity to calcipotriol, betamethasone, or any excipients
- Erythrodermic, exfoliative, or pustular psoriasis
- Known disorders of calcium metabolism
- Viral (e.g., varicella, herpes simplex), fungal, or bacterial skin infections and tuberculosis or syphilis of the skin
Adverse Reactions
- Pruritus, skin irritation, burning, and stinging at application site
- Dry skin, dermatitis, and worsening of psoriasis
- Skin atrophy, striae, telangiectasia, and folliculitis from prolonged corticosteroid exposure
- Hypercalcemia and hypercalciuria with excessive use
- Hypothalamic-pituitary-adrenal (HPA) axis suppression
Drug Interactions
- Calcium and vitamin D supplements may increase the risk of hypercalcemia
- Thiazide diuretics may decrease urinary calcium excretion, increasing the risk of hypercalcemia when used with vitamin D analogues
- Concurrent use of other potent topical corticosteroids may increase systemic absorption and toxicity
Curated Content: Needs Vetting Before Put to Clinical Use