Betamethasone + Calcipotriol

Topical/Cutaneous
Psoriasis vulgaris

Known or suspected disorder of Ca metabolism. Erythrodermic, exfoliative and pustular psoriasis; viral lesions of the skin, fungal or bacterial skin infections, parasitic infections, skin manifestations in relation to TB, perioral dermatitis, atrophic skin, striae atrophicae, fragility of skin veins, ichthyosis, acne vulgaris, rosacea, ulcers and wounds.

Patient w/ DM. Pregnancy and lactation.

Allergic contact dermatitis, pruritus, headache, nasopharyngitis, psoriasis, rash, influenza, erythema, pain, burning sensation, eye irritation, dry skin, skin atrophy, folliculitis; reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, manifestations of Cushing’s syndrome, hyperglycaemia and glucosuria. Rarely, hypercalcaemia or hypercalciuria, angioedema, facial oedema.

Topical: C

Avoid exposure to natural or artificial sunlight. Avoid application under occlusive dressings.

Monitor serum Ca level at baseline and periodically during treatment in patients at risk of hypercalcaemia.

Symptoms: Polyuria, constipation, muscle weakness, confusion, and coma; adrenal insufficiency. Management: Symptomatic treatment.

Additive adverse effects when used w/ other steroids.

Description:
Mechanism of Action: Betamethasone is a synthetic corticosteroid that has anti-inflammatory, antipruritic and vasoconstrictive properties. Calcipotriol is a vit D analogue. It induces differentiation and suppresses proliferation of keratinocytes. However, the exact mechanism of their actions in psoriasis vulgaris are uncertain.
Pharmacokinetics:
Absorption: <1% is systemically absorbed through normal skin.
Distribution: Enters breast milk (betamethasone). Plasma protein binding: Approx 64%.
Metabolism: Rapidly and extensively metabolised in the liver.
Excretion: Betamethasone: Via urine. Calcipotriol: Via faeces.

Source: National Center for Biotechnology Information. PubChem Database. Betamethasone, CID=9782, https://pubchem.ncbi.nlm.nih.gov/compound/Betamethasone (accessed on Jan. 21, 2020)

Source: National Center for Biotechnology Information. PubChem Database. Calcipotriol, CID=5288783, https://pubchem.ncbi.nlm.nih.gov/compound/Calcipotriol (accessed on Jan. 21, 2020)

Store between 20-25°C.

Psoriasis, Seborrhea & Ichthyosis Preparations

D07XC01 - betamethasone ; Belongs to the class of potent (group III) corticosteroids in other combinations. Used in the treatment of dermatological diseases.
D05AX02 - calcipotriol ; Belongs to the class of other antipsoriatics for topical use.
D07AC01 - betamethasone ; Belongs to the class of potent (group III) corticosteroids. Used in the treatment of dermatological diseases.
D05AX52 - calcipotriol, combinations ; Belongs to the class of other antipsoriatics for topical use.

Anon. Calcipotriene and Betamethasone. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 08/09/2016.

Calcipotriene 0.005% and Betamethasone dipropionate (Sandoz Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 08/09/2016.

Joint Formulary Committee. Calcipotriol with Betamethasone. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/09/2016.

McEvoy GK, Snow EK, Miller J et al (eds). Calcipotriene (Topical). AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 08/09/2016.

Taclonex Ointment (Warner Chilcott US, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 08/09/2016.