CALCIPOTRIENE

CALCIPOTRIENe
(cal-ci'po-tri-een)
Dovonex
Classifications: vitamin d analog;
Therapeutic: vitamin d analog

Prototype: Calcitriol
Pregnancy Category: C

Availability

0.005% ointment and cream

Action

Calcipotriene is a synthetic vitamin D3 analog for the treatment of moderate plaque psoriasis. The scaly red patches of psoriasis are caused by abnormal growth and production of skin cells known as keratinocytes.

Therapeutic Effect

Calcipotriene controls psoriasis by inhibiting proliferation of psoiatic skin, reducing the number of polymorphonuclear leukocytes (PMNs) in the skin cells, and decreasing the number of epithelial cells.

Uses

Treatment of moderate plaque psoriasis.

Contraindications

Hypersensitivity to calcipotriene, hypercalcemia or vitamin D toxicity, history of nephrolithiasis; pregnancy (category C), lactation.

Cautious Use

Dermatoses other than psoriasis; patients >65 y. Safety and efficacy in children not established.

Route & Dosage


Adult: Topical Apply a thin layer to affected area once or twice daily

Administration

Topical
  • A thin layer should be applied to the affected skin and rubbed in gently and completely.
  • Calcipotriene should not be applied to the face.
  • Wash hands before and after application of medication.

Adverse Effects (≥1%)

Skin: Facial dermatitis, burning, stinging, erythema, folliculitis, mild transient itching.

Interactions

No clinically significant interactions established.

Pharmacokinetics

Absorption: 6% absorbed systemically. Onset: 1 wk. Peak: 8 wk. Duration: 4 wk. Metabolism: Recycled via liver. Elimination: In bile.

Nursing Implications

Assessment & Drug Effects

  • Observe reductions in scaling, erythema, and lesion thickness indicating a positive therapeutic response.
  • Significant reduction in psoriatic lesions usually occurs following 1 wk of treatment. Marked improvement is generally noted by the 8th wk of treatment.
  • Lab tests: Monitor periodically serum calcium, phosphate, and calcitriol levels, during long-term therapy.

Patient & Family Education

  • Treatment with calcipotriene may be indefinite, as reappearance of psoriatic lesions is common following discontinuation of the drug.
  • Adverse effects may include burning and stinging with drug application; these are usually transient.
  • Do not mix calcipotriene with any other topical medicine.
  • Report appearance of facial dermatitis (erythema and scaling around mouth and nose).

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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