How does this medication work? What will it do for me?

Calcitriol topical belongs to the class of medications known as vitamin D analogues. It is also known as a nonsteroidal antipsoriatic agent. Calcitriol topical is used to treat mild to moderate plaque-type psoriasis (skin condition) involving up to 35% of the body surface area.

This medication works by controlling the excessive production of skin cells seen in psoriasis, thereby eliminating the red, scaly patches seen in the skin condition. You may notice an improvement after about 2 weeks of treatment.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each g of white, translucent, ointment contains 3 µg (0.0003% w/w) of calcitriol. Nonmedicinal ingredients: vitamin E (dL-α-tocopherol), mineral oil, and white petrolatum.

How should I use this medication?

Calcitriol topical should be applied to the affected areas with psoriasis twice daily, morning and evening. Do not use more than 30 g of this medication daily, and only use this medication if the affected body area is 35% or less.

Wash and gently dry the affected area. Gently rub in the ointment until it is no longer visible. Do not cover the area with bandage or any other materials. Wash your hands thoroughly with soap and water after each application. Once the psoriasis improves, your doctor may advise you to stop using calcitriol. Your doctor may advise you to use the medication again if the psoriasis lesions reappear.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, apply it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not apply a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Calcitriol topical should not be used by anyone who:

  • is allergic to calcitriol or to any of the ingredients of the medication
  • is being treated for conditions affecting normal calcium levels
  • has high calcium levels in the blood or is known to have abnormal calcium metabolism
  • has severe kidney dysfunction or end-stage renal disease
  • has liver dysfunction

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • abnormal laboratory test results, including urine tests
  • flu-like symptoms
  • high amounts of calcium in urine
  • itch
  • psoriasis symptoms
  • skin discomfort

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • skin infection

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • rashes or blisters over the body
  • signs of an allergic reaction (e.g., swelling of the hands, feet, ankles, face, lips, mouth, or throat; difficulty breathing or swallowing)
  • symptoms of high blood calcium levels (e.g., nausea, vomiting, excessive urination, excessive thirst)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Kidney or liver function: People with kidney or liver disease should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. People with severely reduced kidney dysfunction, end-stage renal disease, or reduced liver function should not use calcitriol topical.

Monitoring calcium levels: If you are at risk for having high calcium levels, your doctor will advise you to do blood tests regularly to check your calcium levels. If calcium levels in your blood are high, your doctor may advise you to stop using this medication and monitor you until your calcium levels return to normal.

Sun sensitivity: Calcitriol topical used alone does not cause cancer, but it may increase the risk of developing skin tumours caused by ultraviolet (UV) radiation. Limit your exposure to sunlight, tanning booths, and sun lamps. Use a sunscreen with a sun protection factor (SPF) of at least 15.

Use of medication: Calcitriol topical is for external use on the skin only. It is not to be used internally. Do not apply this medication to facial skin, eyes, or lips. This medication should also not be used for severe psoriasis that involves more than 35% of the body surface area. Certain medications can increase the absorption of calcitriol topical into the body, which can affect your blood calcium levels. Your doctor or pharmacist may advise you to avoid using these medications (see also, "What medications can interact with this medication?").

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while you are on this medication, contact your doctor immediately.

Breast-feeding: It is not known if calcitriol passes into breast milk. If you are a breast-feeding mother and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children under 18 years of age.

What other drugs could interact with this medication?

There may be an interaction between calcitriol topical and any of the following:

  • aluminum hydroxide
  • aminolevulinic acid
  • calcium supplements
  • digoxin
  • methoxsalen
  • multivitamin/mineral supplements
  • peeling agents, astringents, or irritant products
  • porfimer
  • sucralfate
  • thiazide diuretics (e.g., hydrochlorothiazide, indapamide)
  • verteporfin
  • vitamin D analogues (e.g., alfacalcidol, cholecalciferol)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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