Drug Guide
Calcipotriene
Classification
Therapeutic: Antipsoriatic agent
Pharmacological: Vitamin D3 analog
FDA Approved Indications
- Plaque psoriasis of the scalp and body
Mechanism of Action
Calcipotriene modulates skin cell production and proliferation by binding to vitamin D receptors in skin cells, inhibiting keratinocyte proliferation and differentiation, which helps reduce psoriatic plaques.
Dosage and Administration
Adult: Apply a thin layer to affected areas twice daily. Use caution to avoid overuse.
Pediatric: Safety and effectiveness not established in children under 18 years.
Geriatric: No specific dosage adjustments; monitor for adverse effects.
Renal Impairment: No specific adjustments necessary.
Hepatic Impairment: No specific adjustments necessary.
Pharmacokinetics
Absorption: Limited systemic absorption when used topically.
Distribution: Primarily localized in skin tissues.
Metabolism: Metabolized in skin; minimal systemic metabolism.
Excretion: Minimal systemic excretion.
Half Life: Not formally established for topical use.
Contraindications
- Hypersensitivity to calcipotriene or any component of the formulation.
Precautions
- Avoid excessive application, which may lead to hypercalcemia.
- Use with caution in patients with pre-existing hypercalcemia or vitamin D toxicity.
Adverse Reactions - Common
- Itching, irritation, or burning at application site (Common)
Adverse Reactions - Serious
- Hypercalcemia (rare) (Serious or rare)
Drug-Drug Interactions
- Systemic corticosteroids may increase risk of hypercalcemia.
Drug-Food Interactions
- No significant interactions
Drug-Herb Interactions
- No significant interactions
Nursing Implications
Assessment: Monitor skin for improvement and adverse reactions.
Diagnoses:
- Impaired skin integrity
Implementation: Apply as directed; avoid occlusive dressings unless specified.
Evaluation: Assess reduction in psoriatic plaques and adverse skin reactions.
Patient/Family Teaching
- Avoid applying to face or intertriginous areas unless specified.
- Do not cover treated areas with tight clothing or bandages.
- Report signs of hypercalcemia ( nausea, vomiting, weakness).
Special Considerations
Black Box Warnings:
- None specifically for calcipotriene.
Genetic Factors: No known genetic contraindications.
Lab Test Interference: Potentially alter serum calcium levels.
Overdose Management
Signs/Symptoms: Symptoms of hypercalcemia such as nausea, vomiting, weakness, and confusion.
Treatment: Discontinue use; symptomatic treatment; in severe cases, hospitalization and calcium-lowering therapy may be required.
Storage and Handling
Storage: Store at room temperature away from moisture and heat.
Stability: Stable under standard storage conditions.