Products
Calcipotriol is commercially available as a fixed combination with betamethasone dipropionate as a gel, ointment, and foam (Xamiol, Daivobet, Enstilar, generics).
Structure and properties
Calcipotriol (C27H40O3, Mr = 412.60 g/mol) is a synthetic derivative of natural vitamin D3 (cholecalciferol). It exists as a white crystalline powder.
Effects
Calcipotriol (ATC D05AX02) has antiproliferative, anti-inflammatory, and immunomodulatory properties. It inhibits keratinocyte proliferation and promotes their normal differentiation, but is not cytotoxic. The maximum effect is reached after a few weeks. The effects are based on binding to the vitamin D3 receptor. The fixed combination with betamethasone dipropionate is more effective than monopreparations. Betamethasone also reduces the local side effects of calcipotriol. Other precautions affecting the topical glucocorticoid must be observed with the combination.
Indications
For the treatment of chronic plaque psoriasis vulgaris (psoriasis) and psoriasis of the scalp. Other potential indications are described in the literature due to the antiproliferative properties, but have not yet been approved.
Dosage
According to the drug label. The maximum doses indicated should not be exceeded to avoid systemic side effects. Hands should be washed well after application to avoid spread to other areas of the body.
Contraindications
- Hypersensitivity
- Hypercalcemia
- Disorders of calcium metabolism
For complete precautions, see the drug label.
Interactions
Salicylic acid inactivates calcipotriol and should not be used with calcipotriol.
Adverse effects
The most common adverse effects include local skin reactions such as a burning and stinging sensation, itching, dry skin, rash, and skin redness. Very rarely and especially in overdose, systemic adverse reactions, increased blood and urinary calcium concentrations (hypercalcemia, hypercalcuria), may occur.
