calcipotriene

Absorption: 6% (cream and ointment) and 1% (scalp solution) is systemically absorbed from psoriatic lesions.

Distribution: Unknown.

Metabolism/Excretion: Metabolized and recycled by the liver; excreted in bile.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

(improvement in psoriatic lesions)

ROUTE	ONSET	PEAK	DURATION
Topical	2–8 wk	unknown	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity to calcipotriene or other components in the base (petrolatum and mineral oil in cream (U.S.), propylene glycol in scalp solution (U.S.), paraffin in Canadian product);
Hypercalcemia;
Vitamin D toxicity.

Use Cautiously in:

OB: Safety not established in pregnancy;
Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
Pedi: Children <4 yr (safety and effectiveness not established);
Geri: ↑incidence of local reactions in older adults.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: burning, itching, skin irritation, contact dermatitis, dry skin, erythema, peeling, rash, worsening/spreading of psoriatic lesions

F and E: hypercalcemia

Interactions ⬆ ⬇

Drug-drug:

None reported.

Route/Dosage ⬆ ⬇

(Adults and Children ≥4 yr): Apply twice daily.

Availability ⬆ ⬇

(Generic available)

Cream: 0.005%
Foam: 0.005%
Ointment: 0.005%
Scalp solution: 0.005%
In combination with: betamethasone dipropionate (Enstilar, Taclonex, Wynzora).

Assessment ⬆ ⬇

Assess skin before and periodically during therapy.

Lab Test Considerations:

Monitor serum calcium concentrations before and periodically during therapy. May cause transient, rapidly reversible hypercalcemia. If hypercalcemia occurs, discontinue calcipotriene and monitor calcium levels weekly until normal serum calcium levels are restored.

Toxicity and Overdose:

Excessive use may cause hypercalcemia; sufficient amounts may be absorbed from topical application.

Implementation ⬆ ⬇

Topical Apply a thin layer to affected skin twice daily and rub in gently and completely. Apply sparingly in skin folds to prevent irritation from natural occlusion. Do not apply occlusive dressings. If calcipotriene is used in combination with ultraviolet B light (UVB) phototherapy, apply calcipotriene after phototherapy.
- For solution, prepare scalp before applying by combing and removing scaly debris and parting hair for easy access to scalp lesions. Apply only to visible scalp lesions and rub in gently and completely. Do not apply to acute psoriatic eruptions.

Patient/Family Teaching ⬆ ⬇

Instruct patient to use medication as directed. If a dose is missed, apply as soon as possible, unless almost time for next dose. Calcipotriene is for external use only; contact with face or eyes should be avoided. Wash hands after application. Advise patient propellant in Sorilux foam is flammable. Avoid use near fire, flame, or smoking during and immediately following application.
Advise patient not to use calcipotriene for any disorder other than that for which it was prescribed.
Instruct patient to report any signs of local adverse reactions, persistent irritation, or facial rash to health care professional. Calcipotriene may cause irritation of lesions and surrounding skin. Discontinuation of the drug may be required.
Advise patient to avoid excessive exposure of natural or artificial light (tanning beds, sunlamps) to treated area.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
Emphasize the importance of regular lab tests to monitor calcium concentrations.
Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
Instruct patient to consult health care professional if skin problem has not improved within 2–8 wk or if skin condition worsens.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇