Calcipotriol
Other dermatological medicines
Other dermatological medicines
A vitamin D analogue cream or ointment for plaque psoriasis that slows skin cell overgrowth. Too much can raise blood calcium; it is kept off the face.
Also called: calcipotriene
Quick facts
- Group
- Other dermatological medicines
- Target
- Vitamin D receptor (VDR), a nuclear receptor
- Used for
- Plaque psoriasis of the body and scalp
- Key effects
- Burning · Redness · Temporary worsening of psoriasis
- Monitor
- Irritation of plaques
- ATC
- D05AX02
No doses: the clinician sets them by the current guideline.
Mechanism of action
The figure shows the ligand-binding domain of the human vitamin D receptor with calcipotriol bound.
Calcipotriol is a synthetic analogue of vitamin D3. In keratinocytes it binds the vitamin D receptor; the drug-receptor complex pairs with the retinoid X receptor and binds vitamin D response elements on DNA. The genes it switches slow the excessive proliferation of psoriatic keratinocytes, push them to differentiate normally and damp local inflammation, so plaques thin and scale less. Only a small part of a topical dose is absorbed, but above the recommended weekly amount it can raise serum calcium.
- Calcipotriol binds the vitamin D receptor in keratinocytes
- VDR-RXR binds vitamin D response elements on DNA
- Keratinocytes proliferate less and differentiate normally
- Psoriatic plaques thin, with less scale and inflammation
Indications
- Plaque psoriasis of the body and scalp, often combined with a topical corticosteroid Psoriasis →
Adverse effects
Common
- Burning, stinging, itching or irritation of the plaques and nearby skin
- Redness, dryness and rash
- Temporary worsening of psoriasis
- Mild photosensitivity
Contraindications
- Hypercalcaemia or vitamin D toxicity
- Use on the face
- Erythrodermic or pustular psoriasis (may not be suitable)
- Hypersensitivity to any component
Key interactions
- Salicylic acid or other acidic topical products
- Can inactivate calcipotriol.
- Vitamin D or calcium supplements, thiazide-type diuretics
- Add to the risk of high blood calcium.
- Topical corticosteroids
- Used together on purpose: better effect and less irritation.
- Ultraviolet phototherapy and sun exposure
- Skin is more easily irritated by UV light; exposure is limited.
What is monitored
- Serum calcium if large areas are treated or symptoms of hypercalcaemia appear
- Irritation of plaques and surrounding skin
- The total amount used each week
Administration and safety
- Applied thinly to the plaques only; hands are washed afterwards so it is not carried to the face or eyes.
- The weekly amount stays within the limit on the product leaflet.
- Some forms are flammable: kept away from flames and cigarettes.
Pregnancy and breastfeeding
Not usually used in pregnancy because safety is not established; during breastfeeding it is not applied to the breasts.
Nursing care
- Ask about kidney disease, high calcium and vitamin D or calcium supplements before starting.
- Teach the signs of high calcium: thirst, frequent urination, metallic taste, muscle weakness.
- Teach sun and UV protection on treated skin.
- Explain that it is not used on the face, where it irritates.
Pharmacokinetics
- Absorption
- A small fraction of a topical dose is absorbed, a little more from psoriatic plaques than from normal skin.
- Metabolism
- Absorbed drug is quickly converted to inactive metabolites, by a pathway like that of natural vitamin D.
- Onset and duration
- Improvement usually starts after about two weeks and continues for several more.
Test yourself
Think of the answer, then tap the question to see it.
Which receptor does calcipotriol act on, and what does it pair with?
The vitamin D receptor, which pairs with the retinoid X receptor (RXR) to bind vitamin D response elements on DNA.
What systemic problem can follow overuse of calcipotriol?
Hypercalcaemia and hypercalciuria; they resolve within days of stopping.
Why is calcipotriol often combined with a topical corticosteroid?
The combination works better and the steroid reduces calcipotriol's irritation.
Connections
← Back to the class: Other dermatological medicines
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Calcipotriene Topical: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); DailyMed - CALCIPOTRIENE cream (DailyMed (U.S. National Library of Medicine), 2026); Calcipotriol: a medicine for plaque psoriasis (NHS, 2026); Crystal structure of VDR ligand binding domain complexed to calcipotriol. (RCSB Protein Data Bank, 2026).
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Representative model, for educational purposes only.