Calcipotriol/Betamethasone

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[edit] BRAND NAMES

[edit] STRUCTURE

[edit] MECHANISM OF ACTION

  • Calcipotriol is a Vitamin D derivative. In vitro data suggest that calcipotriol induces differentiation and supresses proliferation of keratinocytes. This is the proposed basis for its effect in psoriasis.
  • Betamethasone is a potent corticosteroid with anti-inflammatory, anti-pruritic, and vasoconstrictive properties. Corticosteroids are thought to induce phospholipase A2 inhibitor proteins, preventing arachidonic acid release and the biosynthesis of potent mediators of inflammation.

[edit] INDICATIONS

Adults: Topical treatment of plaque psoriasis of the scalp and body. Calcipotriol/Betamethasone combination should not be used on the face since this may give rise to itching and erythema of the facial skin

[edit] DOSAGE

Apply to affected areas once daily for up to 8 weeks. Treatment may be discontinued earlier, if cleared. If recurrence takes place after discontinuation, treatment may be reinstituted.

[edit] CONTRAINDICATIONS

None

[edit] WARNINGS AND PRECAUTIONS

  • Hypercalcemia and hypercalciuria have been reported. If either occurs, discontinue until parameters of calcium metabolism normalize
  • Topical corticosteroids can produce reversible hypothalamic-pituitary adrenal (HPA) axis suppression, Cushing’s syndrome and unmask latent diabetes. . Factors that predispose a patient using a topical corticosteroid to HPA axis suppression include the use of more potent steroids, use over large surface areas, use over prolonged periods, use under occlusion, use on an altered skin barrier, and use in patients with liver failure.
  • Local adverse reactions may include atrophy, striae, irritation, acneiform eruptions, hypopigmentation, and allergic contact dermatitis and may be more likely with occlusive use or more potent corticosteroids. Do not use on face, axillae, or groin. Do not use if atrophy is present at the treatment site.
  • Children may be more susceptible to systemic toxicity when treated with topical corticosteroids

[edit] PREGNANCY AND LACTATION

  • Pregnancy Category C (US). Calcipotriol/Betamethasone combination should be used during pregnancy only if the potential benefit to the patient justifies the potential risk to the fetus.
  • Nursing Mothers: Systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects. It is not known whether topically administered calcipotriene or corticosteroids could result in sufficient systemic absorption to produce detectable quantities in human milk. Because many drugs are excreted in human milk, caution should be exercised when Calcipotriol/Betamethasone is administered to a nursing woman. The patient should be instructed not to use Calcipotriol/Betamethasone combination on the breast when nursing.

[edit] SIDE EFFECTS

The most common adverse reactions (•1%) are folliculitis and burning sensation of skin

[edit] RELATED LINKS

[edit] BIBLIOGRAPHY

[edit] REFERENCES