Betamethasone + Calcipotriol


Concise Prescribing Info
Indications/Uses
Psoriasis vulgaris.
Dosage/Direction for Use
Adult : Topical As gel, oint, foam or susp containing betamethasone dipropionate 0.05% and calcipotriol 0.005%: Apply to affected area once daily for up to 4 wk (scalp area) or 8 wk (non-scalp area). Max: 15 g/day.
Dosage Details
Topical/Cutaneous
Psoriasis vulgaris
Adult: As gel, oint, foam or susp containing betamethasone dipropionate 0.05% and calcipotriol 0.005%: Apply to affected area once daily. Duration of therapy: Up to 4 wk (scalp area) or 8 wk (non-scalp area). Treatment may be continued or repeated if necessary, after medical review and under regular medical supervision. Max: 15 g daily. Apply to max 30% of body surface.
Contraindications
Known or suspected disorder of Ca metabolism. Erythrodermic, exfoliative and pustular psoriasis; viral lesions of the skin, fungal or bacterial skin infections, parasitic infections, skin manifestations in relation to TB, perioral dermatitis, atrophic skin, striae atrophicae, fragility of skin veins, ichthyosis, acne vulgaris, rosacea, ulcers and wounds.
Special Precautions
Patient w/ DM. Pregnancy and lactation.
Adverse Reactions
Allergic contact dermatitis, pruritus, headache, nasopharyngitis, psoriasis, rash, influenza, erythema, pain, burning sensation, eye irritation, dry skin, skin atrophy, folliculitis; reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, manifestations of Cushing’s syndrome, hyperglycaemia and glucosuria. Rarely, hypercalcaemia or hypercalciuria, angioedema, facial oedema.
Patient Counseling Information
Avoid exposure to natural or artificial sunlight. Avoid application under occlusive dressings.
MonitoringParameters
Monitor serum Ca level at baseline and periodically during treatment in patients at risk of hypercalcaemia.
Overdosage
Symptoms: Polyuria, constipation, muscle weakness, confusion, and coma; adrenal insufficiency. Management: Symptomatic treatment.
Drug Interactions
Additive adverse effects when used w/ other steroids.
Action
Description: Betamethasone is a synthetic corticosteroid that has anti-inflammatory, antipruritic and vasoconstrictive properties. Calcipotriol is a vit D analogue. It induces differentiation and suppresses proliferation of keratinocytes. However, the exact mechanism of their actions in psoriasis vulgaris are uncertain.
Pharmacokinetics:
Absorption: <1% is systemically absorbed through normal skin.
Distribution: Enters breast milk (betamethasone). Plasma protein binding: Approx 64%.
Metabolism: Rapidly and extensively metabolised in the liver.
Excretion: Betamethasone: Via urine. Calcipotriol: Via faeces.
Chemical Structure

Chemical Structure Image
Betamethasone

Source: National Center for Biotechnology Information. PubChem Database. Betamethasone, CID=9782, https://pubchem.ncbi.nlm.nih.gov/compound/Betamethasone (accessed on Jan. 21, 2020)


Chemical Structure Image
Calcipotriol

Source: National Center for Biotechnology Information. PubChem Database. Calcipotriol, CID=5288783, https://pubchem.ncbi.nlm.nih.gov/compound/Calcipotriol (accessed on Jan. 21, 2020)

Storage
Store between 20-25°C.
ATC Classification
D07XC01 - betamethasone ; Belongs to the class of potent (group III) corticosteroids in other combinations. Used in the treatment of dermatological diseases.
D05AX02 - calcipotriol ; Belongs to the class of other antipsoriatics for topical use.
D07AC01 - betamethasone ; Belongs to the class of potent (group III) corticosteroids. Used in the treatment of dermatological diseases.
D05AX52 - calcipotriol, combinations ; Belongs to the class of other antipsoriatics for topical use.
References
Anon. Calcipotriene and Betamethasone. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 08/09/2016.

Calcipotriene 0.005% and Betamethasone dipropionate (Sandoz Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 08/09/2016.

Joint Formulary Committee. Calcipotriol with Betamethasone. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/09/2016.

McEvoy GK, Snow EK, Miller J et al (eds). Calcipotriene (Topical). AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 08/09/2016.

Taclonex Ointment (Warner Chilcott US, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 08/09/2016.

Disclaimer: This information is independently developed by MIMS based on Betamethasone + Calcipotriol from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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