|
|
Line 1: |
Line 1: |
| {{Drugbox|
| |
| | IUPAC_name = (1''R'',3''S'')-5-[2-[(1''R'',3a''R'',7a''S'')-1-[(2''S'')-5-<br>cyclopropyl-5-hydroxy-pent-3-en-2-yl]-<br>7a-methyl-2,3,3a,5,6,7-hexahydro-1''H''-<br>inden-4-ylidene]ethylidene]-4-methylidene-<br>cyclohexane-1,3-diol
| |
| | image=Calcipotriol.svg
| |
| | CAS_number=112965-21-6
| |
| | ATC_prefix=D05
| |
| | ATC_suffix=AX02
| |
| | PubChem=443875
| |
| | DrugBank=
| |
| | C = 27 |H = 40 |O = 3
| |
| | molecular_weight = 412.605 g/mol
| |
| | bioavailability= 5 to 6%
| |
| | metabolism = [[Liver|Hepatic]]
| |
| | elimination_half-life=
| |
| | excretion = Biliary
| |
| | pregnancy_category = B3 <small>([[Australia|Au]])</small>, C <small>([[United States|US]])</small>
| |
| | legal_UK = POM
| |
| | legal_US = Rx-only
| |
| | routes_of_administration = Topical
| |
| }}
| |
| '''Calcipotriol''' ([[International Nonproprietary Name|INN]]) or '''calcipotriene''' ([[United States Adopted Name|USAN]]) is a synthetic derivative of [[calcitriol]] or [[Vitamin D]]. It is used in the treatment of [[psoriasis]], marketed under the trade name '''Dovonex®'''.
| |
|
| |
|
| ==Mechanism==
| |
| The efficacy of calcipotriol in the treatment of psoriasis was first noticed by the observation of patients receiving various forms of Vitamin D in an osteoporosis study. Unexpectedly, a patient's psoriasis lesions dramatically disappeared. <ref>Morimoto, S., Kumahara, Y. A patient with psoriasis cured by 1-α-hydroxyvitamin D<sub>3</sub>. ''Med. J. Osaka Univ.'', '''1985''', 35:51-54</ref>
| |
|
| |
| The precise mechanism of calcipotriol in remitting psoriasis is not well-understood. However, it has been shown to have comparable affinity with calcitriol (Vit D) for the Vitamin D receptor, while being less than 1% as active as the calcitriol in regulating calcium metabolism. The Vitamin D receptor (VDR) belongs to the steroid/thyroid receptor superfamily, and is found on the cells of many different tissues including the thyroid, bone, kindney, and [[T cell|T cells]] of the immune system. T cells are known to play a role in psoriasis, and it is thought that the binding of calcipotriol to the VDR modulates the T cells gene transcription of cell differentiation and proliferation related genes.
| |
|
| |
| ==Usage and Efficacy==
| |
|
| |
| Available as a cream, ointment or scalp solution (50mcg/mL), Calcipotriol is applied twice daily to plaque psoriasis on the body or scalp, but not the face. Improvement is usually detectable within 2 weeks. Most patients show some improvement, slightly more so than is seen with the use of corticosteroids alone. [[Tachyphylaxis]] does not occur, an improvement over glucocorticoid therapy.<ref>Kragbelle, K. Treatment of psoriasis with calcipotriol and other Vitamin D analogues. ''J. Am. Acad. Dermatol.,'' '''1992''', 27:1001-1008.</ref>
| |
|
| |
| ==Side effects==
| |
|
| |
| Calcipotriol has been shown in clinical trials to have an excellent safety profile. <ref>Brunton, Laurence. Goodman and Gilman's The Pharmacological Basis of Therapeutics, 11th ed. McCraw-Hill, 2006. p. 1664. p. 1704-5.</ref> Reports of hypercalcemia are rare.<ref>Hardman ''et al.'' Hypercalcemia associated with calcipotriol (DOVONEX) treatment. ''Br Med J., '''1993,''' 306:896.</ref>
| |
|
| |
|
| |
| It is also available in combination with the synthetic glucocorticoid [[betamethasone]] under the trade name '''Dovobet®'''.
| |
|
| |
| ==References==
| |
| <references/>
| |
|
| |
| ==External links==
| |
|
| |
| *[http://www.leopharma.ca/C1256AD9004FA5C9/sysOakFil/DVX%20PM/$File/DVX-PM-E-15-FEB02.pdf Leo Pharmaceuticals Product Monograph]- Detailed information from the manufacturers, includes the blood testing recommendation (.pdf document).
| |
|
| |
| *[http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202730.html Calcipotriene information] - U.S. [[National Library of Medicine|NLM]]/[[National Institute of Health|NIH]]
| |
|
| |
| [[Category:Dermatological preparations]]
| |
|
| |
| {{Pharma-stub}}
| |
| {{Antipsoriatics}}
| |