Version April 2023
Plaque psoriasis: Topical: Apply twice daily to affected areas (maximum: 200 g weekly).
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
(For additional information see "Calcitriol (topical): Pediatric drug information")
Plaque psoriasis, mild to moderate: Topical: Ointment:
Children ≥2 years to <7 years: Apply twice daily to affected area(s); maximum weekly dose: 100 g/week.
Children ≥7 years and Adolescents: Apply twice daily to affected areas; maximum weekly dose: 200 g/week.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Ointment, External:
Vectical: 3 mcg/g (100 g)
Generic: 3 mcg/g (100 g)
Yes
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Ointment, External:
Silkis: 3 mcg/g (5 g, 30 g, 60 g, 100 g)
Topical: Apply externally; not for ophthalmic, oral, or intravaginal use. Do not apply to eyes, lips, or facial skin. Rub in gently so that no medication remains visible. Limit application to only the areas of skin affected by psoriasis.
Topical: For external use only; not for ophthalmic, oral, or intravaginal use. Do not apply to eyes, lips, or facial skin. Rub in gently so that no medication remains visible. Limit application to only the areas of skin affected by psoriasis.
Plaque psoriasis: Management of mild to moderate plaque psoriasis in adults and pediatric patients ≥2 years of age.
Calcitriol may be confused with alfacalcidol, Calciferol, calcitonin, calcium carbonate, captopril, colestipol, paricalcitol, ropinirole.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
>10%: Endocrine & metabolic: Hypercalcemia (24%)
1% to 10%: Dermatologic: Skin pain (3%)
Postmarketing: Dermatologic: Bullous dermatitis (acute), burning sensation of skin, erythema of skin
There are no contraindications listed in the US manufacturer's labeling.
Canadian labeling: Hypersensitivity to calcitriol or any component of the formulation; ophthalmic or internal use; hypercalcemia or a history of abnormal calcium metabolism; concurrent systemic treatment of calcium homeostasis; severe renal impairment or end-stage renal disease; hepatic impairment.
Concerns related to adverse effects:
• Hypercalcemia: May cause hypercalcemia; if alterations in calcium occur, discontinue treatment until levels return to normal. Use with caution in patients receiving calcium supplements, high doses of vitamin D, or medications known to cause hypercalcemia (eg, thiazide diuretics).
Other warnings/precautions:
• Appropriate use: For external use only; not for ophthalmic, oral, or intravaginal use. Do not apply to facial skin, eyes, or lips. Absorption may be increased with occlusive dressings. The safety and effectiveness have not been evaluated in patients with known or suspected disorders of calcium metabolism.
Substrate of CYP3A4 (minor); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Aluminum Hydroxide: Vitamin D Analogs may increase the serum concentration of Aluminum Hydroxide. Specifically, the absorption of aluminum may be increased, leading to increased serum aluminum concentrations. Management: Consider avoiding chronic use of aluminum and aluminum-containing products in patients who are also taking vitamin D analogs. If coadministered, monitor aluminum status and for signs and symptoms of aluminum-related toxicities. Risk D: Consider therapy modification
Aminolevulinic Acid (Systemic): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Systemic). Risk X: Avoid combination
Aminolevulinic Acid (Topical): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Topical). Risk C: Monitor therapy
Burosumab: Vitamin D Analogs may enhance the adverse/toxic effect of Burosumab. Risk X: Avoid combination
Calcium Salts: May enhance the adverse/toxic effect of Vitamin D Analogs. Risk C: Monitor therapy
Cardiac Glycosides: Vitamin D Analogs may enhance the arrhythmogenic effect of Cardiac Glycosides. Risk C: Monitor therapy
Methoxsalen (Systemic): Photosensitizing Agents may enhance the photosensitizing effect of Methoxsalen (Systemic). Risk C: Monitor therapy
Multivitamins/Fluoride (with ADE): May enhance the adverse/toxic effect of Vitamin D Analogs. Risk X: Avoid combination
Multivitamins/Minerals (with ADEK, Folate, Iron): May enhance the adverse/toxic effect of Vitamin D Analogs. Risk X: Avoid combination
Porfimer: Photosensitizing Agents may enhance the photosensitizing effect of Porfimer. Risk C: Monitor therapy
Sucralfate: Vitamin D Analogs may increase the serum concentration of Sucralfate. Specifically, the absorption of aluminum from sucralfate may be increased, leading to an increase in the serum aluminum concentration. Management: Consider avoiding chronic use of aluminum and aluminum-containing products, such as sucralfate, in patients who are also taking vitamin D analogs. If combined, monitor for signs and symptoms of aluminum-related toxicities. Risk D: Consider therapy modification
Thiazide and Thiazide-Like Diuretics: May enhance the hypercalcemic effect of Vitamin D Analogs. Risk C: Monitor therapy
Verteporfin: Photosensitizing Agents may enhance the photosensitizing effect of Verteporfin. Risk C: Monitor therapy
Vitamin D Analogs: May enhance the adverse/toxic effect of other Vitamin D Analogs. Risk X: Avoid combination
Topical agents are recommended for the treatment of psoriasis in pregnancy; however, agents other than calcitriol are preferred. When alternatives are not appropriate, limit use to smallest possible area (AAD-NPF [Elmets 2021]; Maul 2021; Simionescu 2021).
It is not known if calcitriol is present in breast milk following topical application.
According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and the benefits of treatment to the mother; do not apply directly to the nipple and surrounding area if breastfeeding. If maternal use is needed, the breastfed infant should avoid contact with the treated area.
The mechanism by which calcitriol is beneficial in the treatment of psoriasis has not been established.
Onset of action: Topical: ~2 weeks (Lebwohl 2007).
Metabolism: Primarily to calcitroic acid and a lactone metabolite.
Ointment (Calcitriol External)
3 mcg/g (per gram): $7.03
Ointment (Vectical External)
3 mcg/g (per gram): $10.90
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
