Calcipotriol is a synthetic vitamin D3 analogue used topically for the treatment of plaque psoriasis. It acts as a modulator of keratinocyte differentiation and proliferation, and as an immunomodulator. In the Indian context, it is a first-line topical treatment for mild to moderate psoriasis, valued for its efficacy and non-steroidal nature, which avoids the risks of skin atrophy and systemic absorption associated with potent topical corticosteroids.
Adult: Apply a thin layer to the affected areas once or twice daily. Maximum recommended dose is 100 grams per week.
Note: Wash hands before and after application. Apply only to psoriatic plaques, avoiding surrounding healthy skin. Do not apply on the face, flexures, or genital areas. Do not occlude with bandages unless directed by a physician. For scalp solution, part hair and apply directly to lesions on the scalp.
Calcipotriol binds to the vitamin D receptor (VDR), a nuclear receptor expressed in keratinocytes, Langerhans cells, fibroblasts, and activated T-lymphocytes. The drug-receptor complex heterodimerizes with the retinoid X receptor (RXR) and binds to vitamin D response elements (VDREs) in the promoter regions of target genes, modulating their transcription.
Pregnancy: Category C: Animal studies have shown fetotoxicity at high systemic doses. No adequate and well-controlled studies in pregnant women. Use only if the potential benefit justifies the potential risk to the fetus. Systemic absorption is minimal with topical use at recommended doses.
Driving: No effect on ability to drive or use machines.
| Other topical Vitamin D analogues (e.g., Tacalcitol) | Additive risk of hypercalcemia and local irritation. | Major |
| Topical corticosteroids (e.g., Betamethasone) | Often used in combination for synergistic effect. However, potent corticosteroids may increase systemic absorption of calcipotriol. Fixed-dose combinations (e.g., Calcipotriol + Betamethasone dipropionate) are available and preferred for sequential therapy. | Moderate |
| Topical salicylic acid | Salicylic acid inactivates calcipotriol by altering the pH. Should not be applied concurrently. | Major |
| Systemic drugs affecting calcium (e.g., Thiazide diuretics, Calcium supplements, Vitamin D) | Increased risk of hypercalcemia. | Moderate |
| Photosensitizing drugs (e.g., Tetracyclines, Fluoroquinolones, Thiazides) | Increased risk of photosensitivity reactions. | Moderate |