Calcipotriol for psoriasis

About calcipotriol

Calcipotriol is used to treat plaque psoriasis - this is the most common type of psoriasis. It is a condition where red scaly patches called plaques develop on your skin. The most common areas affected are over your elbows and knees, the scalp, and the lower part of your back. The patches may vary in size from time to time and can be itchy. Treatment for psoriasis aims to clear the plaques as much as possible.

Psoriasis is caused by cells in the outer layer of your skin multiplying faster than normal. This causes the older and dead skin cells to build up on the surface of your skin, causing the scaly patches. Calcipotriol works by slowing this overproduction of skin cells which eases the inflamed, scaly areas. It is similar to vitamin D, which is a vitamin essential for healthy skin.

Sometimes calcipotriol is used in combination with a steroid medicine called betamethasone (as in a brand called Dovobet®). It is not recommended that a steroid be used long-term, so this combination is often used for around a month, followed by treatment with calcipotriol alone.

To make sure that this is the right treatment for you, before you start using calcipotriol it is important that your doctor knows:

• If you are pregnant, trying for a baby or breastfeeding.

• If you have been told you have a form of psoriasis known as erythrodermic or pustular psoriasis. This is because more severe forms of psoriasis like these should only be treated by a skin specialist doctor.

• If you have been told you have high calcium levels in your blood, or if your body has problems processing calcium.

• If you are taking any other medicines or using any other skin preparations. This includes any medicines which are available to buy without a prescription, as well as herbal and complementary medicines.

• If you have ever had an allergic reaction to a medicine.

• Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about applying calcipotriol and will provide you with a full list of the side-effects which you could experience from using it.

• Your doctor will tell you how often to use the preparation you are given but as a guide:

  • Calcipotriol ointment is usually applied once or twice each day. If you have been told to use it twice a day, use it in the morning and in the evening.

  • Calcipotriol ointment which also contains betamethasone (brand name Dovobet® Ointment) should be applied only once a day. It is important that you do not use Dovobet® on areas of your skin which you think might be infected, and that you do not cover any treated areas with a bandage or dressing.

  • Calcipotriol scalp solution should be applied twice each day, in the morning and evening. The solution will quickly dry after it has been applied.

  • Calcipotriol with betamethasone gel (brand name Dovobet® Gel) should be applied once each day. For the best effect, leave it on during the day if you have applied it in the morning, or overnight if you have used it in the evening. It is suitable to be used on patches of psoriasis on your skin and on your scalp. It is important that you do not use Dovobet® on areas of your skin which you think might be infected, and that you do not cover any treated areas with a bandage or dressing.

  • Calcipotriol with betamethasone foam (brand name Enstilar®) should be applied once daily for four weeks. After that it can be used twice each week for long-term prevention. You should leave at least two days between applications.

• The manufacturer's instructions state that you should not use more than a maximum amount of calcipotriol, as otherwise you may get too much calcium in your blood which can cause side-effects. Do not use more than:

  • 100 g of calcipotriol ointment per week for adults.

  • 75 g of calcipotriol ointment per week for children aged over 12 years.

  • 50 g of calcipotriol ointment per week for children aged between 6 and 12 years.

  • 60 ml of calcipotriol scalp solution per week for adults.

  • 15 g per day of Dovobet® Ointment or Gel for adults.

  • 15 g per day of Ensilar® cutaneous foam for adults

Important: if you are using more than one preparation which contains calcipotriol, the total amount of all products you use should not be more than the amounts stated above.

• Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.

• You should start to see an improvement in your skin within a week or so and this improvement should continue for several weeks before you feel the full benefit. Continue to apply the preparation regularly for as long as you have been recommended so that you get the full benefit.

• If you are also using a moisturiser for your skin, use this first and then wait until it has soaked into your skin before you apply calcipotriol.

• Calcipotriol can cause skin irritation. Because of this, you should not use it on your face.

• Wash your hands well after using any calcipotriol preparation. This will help to prevent calcipotriol getting on to any areas of your skin which are unaffected by psoriasis, and causing irritation.

• Your skin may become more sensitive to sunlight than normal while you are using calcipotriol. Try to avoid sitting out in the sun and do not use sunbeds.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with calcipotriol. You will find a full list in the manufacturer's information leaflet supplied with the medicine. The unwanted effects often improve as your body adjusts to the new medicine but speak with your doctor or pharmacist if any of the following continue or become troublesome.

If you experience any other symptoms which you think may be due to the preparation, please speak with your doctor or pharmacist for further advice.

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.