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Calcipotriol

Calcipotriol, also known as calcipotriene, is a synthetic derivative of calcitriol, a form of vitamin D.

Trade name Dovonex.

It is used in the treatment of psoriasis, and vitiligo.

Routes of administratio- Topical administration

Bioavailability 5 to 6%

Metabolism

Liver

Excretion

It is also available with the synthetic corticosteroids.

Chronic plaque psoriasis is the chief medical use and has also been used successfully in the treatment of alopecia areata, and vitiligo.

Cautions include exposure to excessive natural or artificial light, due to the potential for calcipotriol to cause photosensitivity.

Adverse effects

Common: 

Very common (> 10% frequency)

Burning

Itchiness

Skin irritation

Common (1–10% frequency)

Dermatitis

Dry skin

Erythema

Peeling

Worsening of psoriasis 

Rash

Uncommon (0.1–1% frequency)

Exacerbation of psoriasis

Rare (< 0.1% frequency)

Allergic contact dermatitis

Hypercalcaemia

Photosensitivity

Changes in pigmentation

Skin atrophy

No drug interactions are known.

Calcipotriol has affinity with calcitriol for the vitamin D receptor (VDR), while being less than 1% as active as the calcitriol in regulating calcium metabolism. 

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.

 As psoriasis is typically thought to be partially driven by Th1/Th17 inflammatory cytokines, calcipotriol treatment at appropriate concentrations may alleviate psoriasis symptoms by repressing Th1/Th17 inflammation through TSLP production, which is linked to a Th2 response. 

After application and systemic uptake, calcipotriol undergoes rapid hepatic metabolism to calcitroic acid.

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