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Topical vitamin D analogue Pregnancy: The safety of this medicinal product in human pregnancy has not been established; evaluation of animal studies does not indicate direct or indirect harmful effects on embryo/foetal development, gestation, or peri- or postnatal development. Avoid use in pregnancy unless there are no safer alternatives. Lactation: the breast area should not be treated; it is not known whether tacalcitol is excreted in human breast milk.

Tacalcitol

Brand names: Curatoderm

Tacalcitol is a topical vitamin D analogue used for the treatment of plaque psoriasis.

Adult dose

Dose: Psoriasis (topical, adults and the elderly): apply sparingly to the affected areas
Route: Topical — ointment, applied to the affected areas. May be used on all areas of the body, including face, hairline, scalp, axilla and other flexures. When used on the scalp the ointment can be shampooed out the next morning. Avoid contact with the eyes when applying to the face, and wash the hands after application to avoid inadvertent transfer to other parts of the body.
Frequency: Once daily, preferably at bedtime
Max: 10 g of ointment per day — SPC section 4.2 states 'The amount applied should not exceed l0g of ointment/day' (the leading character is a rendering of the digit 1, i.e. 10 g).
Duration of treatment normally depends on the severity of the lesions and should be decided by the physician; there is clinical trial experience with continuous and intermittent treatment in adults up to twelve months. UVB radiation can be combined with the ointment — this increases efficacy and shortens the radiation period; give UV in the morning and the ointment at bedtime. There has been only limited experience of concomitant use with topical corticosteroids, urea, emollients, dithranol cream and PUVA. PAEDIATRIC: the safety and efficacy of Curatoderm Ointment in children and adolescents under 18 years have not been established — verify any under-18 use against a children's formulary. FIRE HAZARD: instruct patients not to smoke or go near naked flames; fabric (clothing, bedding, dressings) that has been in contact with this product burns more easily. Source product: Curatoderm 4 microgram/g Ointment (UK SPC) — section 4.2 was retrieved complete (no truncation); section 4.1 was not fetched, but sections 4.4 and 4.8 of the quoted text refer to psoriasis (generalised pustular or erythrodermic psoriasis; worsening of psoriasis).

Dose independently re-sourced from UK Summary of Product Characteristics (SPC) via the eMC — clinician-reviewed. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Hypersensitivity to the active substance or to any of the excipients listed in section 6.1
  • Patients with hypercalcaemia or other known disorders of calcium metabolism

Side effects

  • Skin irritation, e.g. burning and erythema (rare) — generally mild and transient
  • Itching (rare) — generally mild and transient
  • Contact dermatitis (rare)
  • Worsening of psoriasis (rare)
  • Hypercalcaemia (frequency not known)
  • Hypersensitivity reactions including swelling, oedema and face oedema (frequency not known)
  • Rash — erythematous, macular, papular or vesicular (frequency not known)
  • Butylhydroxytoluene (E321) in the white soft paraffin base may cause local skin reactions such as contact dermatitis, or irritation of the eyes and mucous membranes

Interactions

  • Multivitamin preparations containing up to 500 IU vitamin D — no interaction is likely; monitor albumin-corrected serum calcium if higher vitamin D intake is taken
  • UVB radiation — can be combined with the ointment (UV in the morning, ointment at bedtime); this increases efficacy and shortens the radiation period
  • Topical corticosteroids, urea, emollients, dithranol cream and PUVA — only limited experience of concomitant use

Monitoring

  • In patients at risk of hypercalcaemia, or taking high vitamin D preparations (in excess of 500 IU vitamin D), monitor albumin-corrected serum calcium closely at the doctor's discretion
  • Stop treatment if hypercalcaemia occurs
  • Monitor serum calcium in patients with renal impairment
  • Exercise care in generalised pustular or erythrodermic psoriasis, where the risk of hypercalcaemia may be enhanced

Clinical monograph

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.

Reference: NICE CG153; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Pathways