A fixed-dose combination topical preparation containing a super-potent synthetic corticosteroid (Clobetasol propionate) and the active hormonal form of Vitamin D (Calcitriol). This combination is designed for the topical treatment of chronic, stable plaque psoriasis. Clobetasol provides rapid anti-inflammatory, immunosuppressive, and antiproliferative effects, while Calcitriol modulates keratinocyte differentiation and proliferation, offering a synergistic and potentially steroid-sparing effect for better long-term management with reduced risk of steroid-induced atrophy.
Adult: Apply a thin layer once or twice daily to the affected areas only. The total weekly dose should not exceed 60 grams. Treatment duration should be limited, typically 2-4 weeks. A 4-week treatment-free period is recommended before initiating another course.
Note: Wash and dry the affected area gently. Apply a thin film and rub in lightly until absorbed. Do not bandage or occlude unless specifically directed by a physician. Wash hands thoroughly after application unless hands are the treatment area. Avoid contact with eyes, mouth, and mucous membranes.
The combination exerts a synergistic effect on psoriatic plaques. Clobetasol propionate binds to glucocorticoid receptors, leading to the synthesis of anti-inflammatory proteins (lipocortins) and inhibition of pro-inflammatory mediators (cytokines, leukotrienes, prostaglandins). It causes vasoconstriction, reduces leukocyte migration, and inhibits keratinocyte hyperproliferation. Calcitriol binds to the nuclear Vitamin D Receptor (VDR) in keratinocytes and immune cells, modulating gene expression to promote normal keratinocyte differentiation, inhibit proliferation, and exert immunomodulatory effects by suppressing T-cell activation and cytokine production.
Pregnancy: Category C (US FDA). Topical corticosteroids, especially potent ones, should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Not recommended for long-term use or large areas. Avoid during first trimester unless absolutely necessary.
Driving: No known effects on driving ability.
| Other Topical Corticosteroids | Increased risk of skin atrophy and systemic steroid effects. | Major |
| Oral Calcium Supplements or Vitamin D analogues (e.g., Calcitriol capsules) | Increased risk of hypercalcemia and hypercalciuria. | Major |
| Thiazide Diuretics (e.g., Hydrochlorothiazide) | May potentiate hypercalcemic effect of calcitriol. | Moderate |
| Systemic Corticosteroids (e.g., Prednisolone) | Additive risk of adrenal suppression and Cushingoid symptoms. | Major |
| CYP3A4 Inhibitors (e.g., Ketoconazole, Itraconazole, Clarithromycin) | May increase systemic levels of clobetasol, increasing steroid side effects. | Moderate |
Same composition (Calcitriol (0.0003% w/w) + Clobetasol (0.05% w/w)), different brands: