What to Know About Dovonex (Caclipotriene)

This topical derivative of vitamin D may relieve psoriasis symptoms

In This Article

Dovonex (calcipotriene) is a topical cream containing calcipotriene monohydrate, a synthetic vitamin D derivative. It was approved for use in 1991 by the U.S. Food and Drug Administration (FDA) for the treatment of chronic plaque psoriasis. Dovonex is generally well tolerated with few side effects. It is sometimes combined with betamethasone dipropionate, a topical steroid, to treat plaque psoriasis (also known as psoriasis vulgaris).

Results can generally be seen within two weeks. By eight weeks, there should be a noticeable improvement in the itching, scaling, and redness.

Uses

Dovonex is approved for the treatment of chronic plaque psoriasis in adults. The safety and efficacy of the drug have not been established in children.

To this day, no one knows for sure how Dovonex works in reducing plaque psoriasis symptoms. However, as a vitamin D derivative, calcipotriene monohydrate is known to bind to vitamin D receptors on skin cells when applied topically.

Vitamin D receptors belong to a larger superfamily of steroid receptors that help modulate immune function. It is presumed that, by binding to them, Dovonex can temper the inflammatory response triggered by autoimmune antibodies, thereby slowing the buildup of skin cells in the outer layer of skin (epidermis).

According to the FDA, preclinical studies reported a 50% reduction in psoriasis symptoms after eight weeks of Dovonex use, although only 4% of users achieved complete clearance.

When combined with betamethasone dipropionate, around 60% of users will experience a significant reduction of symptoms (described as "mild" or "very mild") after 52 weeks of use, according to a 2015 study from Belgium.

Off-Label Uses

Since its introduction in 1991, Dovonex has been used by clinicians for a variety of off-label purposes (meaning that it hasn't been approved for such use by the FDA). Some of the more common off-label uses include:

The safety and effectiveness of Dovonex in treating other skin conditions has not been established.

Before Taking

Dovonex is indicated for the treatment of mild to moderate plaque psoriasis for adults over 18. It can also be used in adults with moderately severe scalp psoriasis.

Many health experts recommend the combination of Dovonex and betamethasone dipropionate for the first-line treatment of psoriasis given that it doesn't cause skin thinning or suppress adrenal function like topical steroids can.

Others endorse a more conservative approach, particularly if the symptoms are mild. In cases like these, over-the-counter hydrocortisone cream and anti-itch medications may be more appropriate first-line options before prescription drugs like Dovonex are considered.

Dosage

Dovonex is applied once or twice daily to affected areas of skin. Apply only a thin layer and rub gently until fully absorbed. Never use Dovonex more frequently than recommended by your doctor.

Dovonex should never be applied to the face or near the eyes. While Dovonex can be effective in treating scalp psoriasis, test the cream on a small area of skin for 24 hours to see if irritation occurs before applying elsewhere. Always wash your hands thoroughly after use.

All listed dosages are according to the drug manufacturer. Check your prescription and talk to your doctor to make sure you are taking the right dose for you.

How to Take and Store

Dovonex should be applied to no more than 20% of the body. While overuse may not cause toxicity, per se, doing so is likely to cause hypercalcemia (elevated blood calcium levels). This can weaken your bones and increase the risk of kidney stones.

Dovonex may cause photosensitivity, increasing the risk of sunburn. Avoid excessive exposure to natural or artificial sunlight after applying Dovonex (including tanning booths and sun lamps). Sunscreen and sun-protective clothing can also help.

Dovonex can be stored safely at room temperature, ideally between 59 and 77 degrees F.

Side Effects

As with any drug, Dovonex may cause side effects. Most involve the skin and may occur either immediately or with ongoing use.

Common

The most common side effects of Dovonex use (affecting at least 1% of users) are:

  • Burning
  • Itchiness
  • Skin irritation
  • Eczema
  • Dry skin
  • Redness
  • Peeling

Less Common

Dovonex may cause a rash or the worsening of psoriasis symptoms. In rare cases (less than 0.1%), Dovonex may cause an allergy and changes in skin color, in addition to aforementioned hypercalcemia and photosensitivity.

If skin irritation is significant and/or does not resolve within the first few days of treatment, discontinue Dovonex use.

Call your doctor if you experience a rash, especially if occurs with the first use of Dovonex. While anaphylaxis, a severe whole-body allergy, is rare, any immediate or severe reaction should be seen without delay.

Warnings and Interactions

There are no known drug interactions associated with Dovonex use. The only absolute contraindication to Dovonex use is a known hypersensitivity to calcipotriene monohydrate or any of the other ingredients in the drug.

Dovonex is classified as a Pregnancy Category C drug, meaning that animal studies have suggested possible harm to a fetus but that the benefits of treatment typically outweigh the risks. Most of the animal studies involving Dovonex demonstrated harm whenever the drug was taken orally rather than topically.

It is unknown if calcipotriene monohydrate is excreted in breastmilk and what harm, if any, this may cause to a nursing baby. Speak with your doctor if you are pregnant, nursing, or planning to get pregnant to fully weigh the benefits and risks of treatment.

Because children have smaller skin surface areas, there is a greater likelihood of drug overexposure and adverse side effects if they use Dovonex. This is why the drug is not recommended for use in people under age 18.

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  1. Kin KC, Hill D, Feldman SR. Calcipotriene and betamethasone dipropionate for the topical treatment of plaque psoriasis. Expert Rev Clin Pharmacol. 2016 Jun;9(6):789-97. doi:10.1080/17512433.2016.1179574

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