betamethasone dipropionate + calcipotriol: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
betamethasone dipropionate + calcipotriol: clinical details
Prescribing considerations
- Confirm plaque psoriasis and exclude untreated infection or a contraindicated psoriasis subtype.
- Avoid the face, genitals, mucosa, skin folds, damaged skin and occlusion because absorption and local toxicity may increase.
- Safety and efficacy are not established below 18 years or in severe renal or hepatic impairment.
- Review unexpected early relapse for rebound or topical steroid withdrawal.
- Advise limited natural or artificial UV exposure and provide paraffin-related fire-safety counselling.
Contraindications and cautions
- Hypersensitivity to either active ingredient or an excipient.
- Erythrodermic, exfoliative or pustular psoriasis.
- Known calcium-metabolism disorders.
- Viral, fungal, bacterial or parasitic skin infection at the treatment site.
- Tuberculous skin lesions, perioral dermatitis, atrophic skin, striae, fragile skin veins, ichthyosis, acne, rosacea, ulcers or wounds.
Monitoring
- Check for local irritation, infection, atrophy, telangiectasia, striae and rebound disease.
- Consider calcium disturbance after excessive exposure or with compatible symptoms.
- Consider HPA-axis effects where systemic absorption is increased or steroid toxicity is suspected.
- Assess visual disturbance and refer for ophthalmic evaluation when appropriate.
- Consider effects on diabetes control with clinically relevant systemic absorption.
Clinical pharmacology
Calcipotriol inhibits keratinocyte proliferation, promotes differentiation and modifies inflammatory T-cell responses. Betamethasone activates glucocorticoid receptors and suppresses inflammatory signalling. Systemic exposure is generally low but can increase with extensive, damaged or occluded skin.
Formulation and product differences
- This page is specific to Wynzora cream; other formulations may have different licences, excipients and application instructions.
- The cream contains paraffin and carries a serious fabric-flammability warning.
- Butylhydroxyanisole may cause contact dermatitis or irritation of eyes and mucosa; macrogolglycerol hydroxystearate may cause skin reactions.
betamethasone dipropionate + calcipotriol preparations and strengths
Cream
Route: Cutaneous
Strengths: 50 micrograms/g + 0.5 mg/g
betamethasone dipropionate + calcipotriol interactions
Formal interaction studies have not been performed. Tell the prescriber about all skin treatments, supplements and phototherapy.
Other topical corticosteroids on the same area
Avoid concurrent use because local and systemic corticosteroid adverse effects may increase.
Ultraviolet phototherapy or excessive sunlight
Combination with UV treatment requires an individual benefit–risk decision.
Calcium or vitamin D supplements
These may add to the risk of raised calcium and should be reviewed by the prescriber.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.