Calcipotriene is a topical medicine that can be used to treat plaque psoriasis symptoms on the skin, scalp, and nails. It is only available by prescription and is sold in the United States under the brand name Dovonex1.
Dovonex is a type of medicine called a vitamin D3 analog or vitamin D synthetic. It contains synthetic vitamin D3, meaning that it is made in a laboratory and is different than the type of vitamin D available in food and nutritional supplements. Vitamin D analogues have been used to treat psoriasis since the early 1990s2.
Dovonex is applied directly to the skin, nails, or scalp, usually in the form of a cream or scalp solution. It is generally prescribed for use twice per day for a period of 6 to 8 weeks, although your healthcare provider may advise that you can use it for a longer period of time3.
How does calcipotriene work?
The symptoms of plaque psoriasis are caused by inflammation that triggers the production of new skin cells. These new cells grow more quickly than old skin cells can be shed by the body. The active ingredient in Dovonex, calcipotriene, is formulated to slow down the process that produces new skin cells1. It also speeds up the life cycle of the new skin cells that are produced, so that they can be shed more quickly from the skin. The medicine also reduces the amount of inflammation that is the source of the symptoms.
Together, the effects of calcipotriene can flatten psoriasis plaques and remove scale on the surface of plaques. Many people with psoriasis find treatment with the medication to be quite effective4. The results of two large studies showed that almost three-quarters of patients treated with calcipotriene had significant improvement in their symptoms5. The same studies reported that 60% of patients with psoriasis symptoms on the scalp had similar improvement in symptoms.
What are the common side effects of taking calcipotriene?
Using Dovonex is generally quite safe, and has no serious side effects that are known. A small number of people may have an increase in the level of calcium in the blood, especially if the medicine is applied to large areas of the body1. However, your healthcare provider will monitor your calcium levels during treatment with Dovonex, and calcium levels will return to normal after stopping treatment with the medicine for a while.
About 20% of patients who use Dovonex report that it causes skin irritation, burning, and/or stinging4. A smaller number of patients report side effects of dry skin, skin peeling, stinging, tingling, skin rash, or worsening of psoriasis symptoms. Let your healthcare provider know if you experience any of those side effects that are severe or do not go away.
Some people find that Dovonex causes more irritation to the skin than topical corticosteroids do, especially in sensitive areas6. Your healthcare provider may recommend that you dilute the Dovonex before use in sensitive areas, or use topical corticosteroids in those areas instead. Be sure to check with your healthcare provider to make sure that you are using a topical corticosteroid that does not affect the way that Dovonex works, however.
Can calcipotriene be used with other treatments?
Dovonex is safe for use with various other psoriasis treatments, although you should always check with your healthcare provider before combining medicines. If you are using more than one type of topical medicine, you will usually be advised to apply them at different times of the day.
Some people may be advised to combine Dovonex with stronger forms of corticosteroids1. The active ingredient in Dovonex, calcipotriene, is available in an ointment called Taclonex and a foam called Enstilar, both of which also contain a very powerful corticosteroid called betamethasone. Many people find that this combination ointment works more effectively than calcipotriene alone.
Patients with more severe symptoms may be advised to try Dovonex in combination with oral systemic medicines that affect the entire body, such as cyclosporine, acitretin, or methotrexate2. This combination of treatments can be more effective and cause fewer side effects because it contains smaller doses of each treatment.
Studies have reported that using Dovonex can make light therapy treatments more effective in reducing symptoms. However, it is important to apply Dovonex after light therapy treatments, not before them, to make sure it is as effective as possible.