Calcipotriol with betamethasone

How it works

Calcipotriol acts on the vitamin D receptor to regulate excessive keratinocyte proliferation and differentiation, while betamethasone provides anti-inflammatory and immunosuppressive effects, giving complementary plaque clearance.

Prescribing in practice

• Restrict the weekly quantity and the treated surface area, since excessive calcipotriol absorption can cause hypercalcaemia and the potent corticosteroid adds risks of skin atrophy and adrenal suppression.
• Avoid the face, flexures, broken skin and occlusion.
• Not indicated for guttate, erythrodermic or generalised pustular psoriasis.

Monitoring

Reassess the plaques periodically and stay within the recommended maximum weekly amount to limit hypercalcaemia and corticosteroid effects.

Counselling the patient

• Use once daily on the affected patches only, avoiding healthy skin and the face.
• Wash your hands after applying and do not use more than the weekly limit advised.

Evidence & guidelines

NICE recommends a combined potent corticosteroid and vitamin D analogue as first-line topical treatment for plaque psoriasis on the body.