Overview of Dovonex (Caclipotriene)

woman applying cream to rash on arm
BSIP/UIG/Getty Images

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).

How It Works

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 receptor 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 these receptors, Dovonex can temper the inflammatory response triggered by autoimmune antibodies, thereby slowing the buildup of skin cells in the outer layer of skin (called the epidermis).

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

When combined with betamethasone dipropionate, around 60 percent 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.

Who Can Take It

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. Because children have smaller skin surface areas, there is a greater likelihood of drug overexposure and adverse side effects.

Dosage

Dovonex is applied once or twice daily to the affected area of skin. Apply only a thin layer and rub gently until fully absorbed. Results can generally be seen within two weeks. By eight weeks, there should be a noticeable improvement in the itching, scaling, and redness.

As a rule of thumb, Dovonex should be applied to no more than 20 percent of the body. While overuse may not cause toxicity per se, doing so is likely to cause elevated calcium levels in the blood. Too much blood calcium, referred to as hypercalcemia, can weaken your bones and increase the risk of kidney stones.

Dovonex should not be applied to the face or near the eyes. While it may be used to treat psoriasis of the scalp, test the cream on a small area of skin for 24 hours to see if irritation develops.

Side Effects

As with any drug, Dovonex may cause side effects. Most involve the skin and may occur either immediately or with ongoing use. The most common side effects of Dovonex use (affecting at least 1 percent of users) are:

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

Less commonly, Dovonex may cause a rash or the worsening of psoriasis symptoms. In rare cases (less than 0.1 percent), Dovonex may cause an allergy, hypercalcemia, photosensitivity, or changes in skin color.

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.

Interactions

There are no known drug interactions associated with Dovonex use.

Contraindications and Considerations

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.

Was this page helpful?

Article Sources