Dovonex


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Related to Dovonex: Dovobet

calcipotriene

(kal-si-poe-try-een) ,

Dovonex

(trade name),

Sorilux

(trade name)

Classification

Therapeutic: antipsoriatics
Pharmacologic: synthetic vitamin d3 analogues
Pregnancy Category: C

Indications

Management of plaque psoriasis.

Action

Modulates skin cell development and production by acting as a synthetic form of vitamin D.

Therapeutic effects

Decreased extent and severity of psoriatic lesions.

Pharmacokinetics

Absorption: 6% (cream and ointment) and 1% (scalp solution) is systemically absorbed from psoriatic lesions.
Distribution: Unknown.
Metabolism and Excretion: Metabolized and recycled by the liver; excreted in bile.
Half-life: Unknown.

Time/action profile (improvement in psoriatic lesions)

ROUTEONSETPEAKDURATION
Topical2–8 wkunknownunknown

Contraindications/Precautions

Contraindicated in: Hypersensitivity to calcipotriene or other components in the base (petrolatum and mineral oil in cream (U.S.), propylene glycol in scalp solution (U.S.), paraffin in Canadian product); Hypercalcemia; Vitamin D toxicity.
Use Cautiously in: Geriatric: ↑ incidence of local reactions; Obstetric / Lactation / Pediatric: Safety not established.

Adverse Reactions/Side Effects

Dermatologic

  • burning (most frequent)
  • itching (most frequent)
  • skin irritation (most frequent)
  • dry skin
  • erythema
  • peeling
  • rash
  • worsening/spreading of psoriatic lesions

Fluid and Electrolyte

  • hypercalcemia

Interactions

Drug-Drug interaction

None significant at recommended doses.

Route/Dosage

Topical (Adults) Apply twice daily.

Availability (generic available)

Cream: 0.005%
Ointment: 0.005%
Scalp solution: 0.005%
Foam: 0.005%
In combination with: betamethasone dipropionate (Taclonex).

Nursing implications

Nursing assessment

  • Assess skin before and periodically during therapy.
  • Lab Test Considerations: Monitor serum calcium concentrations before and periodically during therapy. May cause transient, rapidly reversible hypercalcemia. If hypercalcemia occurs, discontinue calcipotriene and monitor calcium levels weekly until normal serum calcium levels are restored.
  • Excessive use may cause hypercalcemia because sufficient amounts may be absorbed from topical application.

Potential Nursing Diagnoses

Risk for impaired skin integrity (Indications)
Disturbed body image (Indications)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)

Implementation

  • Topical: Apply a thin layer to affected skin twice daily and rub in gently and completely. Apply sparingly in skin folds to prevent irritation from natural occlusion. Do not apply occlusive dressings. If calcipotriene is used in combination with ultraviolet B light (UVB) phototherapy, apply calcipotriene after phototherapy.
    • For solution, prepare scalp before applying by combing and removing scaly debris and parting hair for easy access to scalp lesions. Apply only to visible scalp lesions and rub in gently and completely. Do not apply to acute psoriatic eruptions.

Patient/Family Teaching

  • Instruct patient to use medication as directed. If a dose is missed, apply as soon as possible, unless almost time for next dose. Calcipotriene is for external use only; contact with face or eyes should be avoided. Wash hands after application.
  • Advise patient not to use calcipotriene for any disorder other than that for which it was prescribed.
  • Instruct patient to report any signs of local adverse reactions, persistent irritation, or facial rash to health care professional. Calcipotriene may cause irritation of lesions and surrounding skin. Discontinuation of the drug may be required.
  • Advise patient to avoid excessive exposure of natural or artificial light to treated area.
  • Emphasize the importance of regular lab tests to monitor calcium concentrations.
  • Instruct patient to consult health care professional if skin problem has not improved within 2–8 wk or if skin condition worsens.

Evaluation/Desired Outcomes

  • Improvement or resolution of skin lesions in psoriasis. Improvement usually begins after 2 wk of therapy, with marked improvement by 8 wk.

calcipotriene

A topical vitamin-D analogue with minimum effects on vitamin-D metabolism, which is FDA-approved for treating mild-to-moderate psoriasis; it is similar in efficacy to topical corticosteroids.

Adverse effects
Rarely, hypercalcaemia.

Dovonex

A brand name for CALCIPOTRIOL.
References in periodicals archive ?
The UK's Medicines and Healthcare products Regulatory Agency (MHRA) has given approval for Dovonex Psoriasis Ointment to switch from being a prescription-only drug to one that is available in pharmacies over-the-counter (OTC), Pharma Times reported on Friday.
Dovonex Psoriasis Ointment contains calcipotriol, a vitamin D analogue and the medication will be supplied as ointment in a 60gtube.
Anticipated Generic Availability Brand Name (generic name) Common Uses (2008) Tegretol XR Seizures January-March (carbamazepine extended-release) Fosamax and Fosamax Weekly Osteoporosis February (alendronate sodium) Requip (ropinirole Hcl) Parkinson's/Restless May Legs Syndrome Risperdal (risperidone) Mental/mood disorders June/July Dovonex (calcipotriene) Psoriasis July-September Cipro HC (ciprofloxacin/ External ear July-September hydrocortisone solution) infections Severent Diskus and Inhaler Asthma/chronic July-September (salmeterol) obstructive pulmonary disease Altace (ramipril) Cardiovascular October Paxil CR (paroxetine Anxiety, depression October hydrochloride) Imitrex (sumatriptan) Migraines To Be Determined Sources: LifeWise; Premera Blue Cross; University of Michigan; U.
Dovonex (calcipotriol; Leo Pharma): original product withdrawal encourages switching but damages company reputation
Following a successful public consultation, Dovonex Psoriasis Ointment will be available through pharmacies without a prescription.
Stubborn cases may need a steroid lotion or a new product, Dovonex scalp lotion, available on prescription.
Dovonex and Curatoderm, have no odour and are easy to apply, but may cause temporary irritation if you use them daily for up to a year.
LEO Pharma's Dovonex (calcipotriol) is the most widely prescribed topical therapy, and methotrexate (MTX) is the preferred first and second line oral systemic agent across the EU5.
005%, a generic equivalent of Dovonex Scalp Solution 0.
Like many psoriasis creams, Dovonex contains a vitamin D derivative that, when swallowed, creates a massive increase in blood calcium levels.
In May 2008 Hi-Tech announced that it entered into a distribution and supply agreement with a subsidiary of Warner Chilcott to market the authorized generic version of Warner Chilcott's Dovonex scalp solution (calcipotriene solution, 0.
Newer preparations such as Dovonex, Calcipotriol and Curatoderm tacalcitol are less staining than coal tar products or Dithranol in Lassar's paste, which was traditionally used.