Tacalcitol

How it works

It binds the vitamin D receptor in keratinocytes to inhibit excessive proliferation and promote normal differentiation, reducing the scaling and thickening of psoriatic plaques.

Prescribing in practice

• Limit the total amount applied and the treated body surface area to avoid disturbances of calcium metabolism such as hypercalcaemia.
• Use with caution in disorders of calcium metabolism and avoid getting the preparation on the face or in the eyes.
• Combining several vitamin D analogue products simultaneously increases the risk of hypercalcaemia.

Monitoring

Routine monitoring is not usually needed within recommended limits, but check serum calcium if extensive or prolonged use or symptoms of hypercalcaemia occur.

Counselling the patient

• Apply once daily to affected areas and wash hands after use unless treating the hands.
• Do not exceed the recommended maximum weekly amount.
• Mild local irritation may occur, particularly on the face if accidentally applied.

Evidence & guidelines

Topical vitamin D analogues including tacalcitol are an established treatment option for chronic plaque psoriasis in UK practice and NICE guidance.