Daivonex (Calcipotriol 50mcg/g) Ointment 120g

Daivonex Ointment general information

What is Daivonex Ointment used for?

The immune system is your body’s defensive barrier that protects you from invasion with harmful organisms such as bacteria and viruses, and is a complex structure of cells, proteins, and chemicals.  Its job is to destroy foreign microorganisms recognised as non-self, also foreign cells such as in an organ transplant and a tumour.  When working well, the immune system keeps you safe from harmful pathogens and recognises the difference between the invaders and your own cells.  However, sometimes the immune system attacks the body’s cells for no apparent reason, and this causes a variety of autoimmune disorders.  Psoriasis is a chronic inflammatory skin disease that is immune-mediated and is considered to be an autoimmune disorder.  Daivonex Ointment is a topical treatment for psoriasis to help relieve symptoms.  You may also be prescribed other medications to take while you are using Daivonex Ointment.  These include oral retinoids like acitretin and the immunosuppressive cyclosporin.

Psoriasis

Most autoimmune diseases have a genetic predisposition, which means that genetic factors increase the risk of developing an autoimmune disease like psoriasis.  Also, it is likely that other members of the family will also have the same condition.  Psoriasis is a non-allergic skin condition that affects people of any age. Although there is no cure, psoriasis can be treated.  Plaque psoriasis (or psoriasis vulgaris) is the most common type of psoriasis.  Psoriatic plaques are raised, rough, reddened areas of skin, covered with fine, dry, silvery scales.  Symptoms range from mild to severe and include pain, itching, and flaking skin.  Severe psoriasis can affect your quality of life and lead to other problems like depression and alcohol dependency.  Psoriatic plaques are usually found on the skin of the elbows, knees, and lower back; also, the scalp.  It is thought that the immune system changes leading to psoriasis may be kick-started by a trigger such as trauma, stress, an infection, or an injury.  Also, drug dependency, such as to alcohol or nicotine, may trigger or aggravate the skin changes seen in psoriasis. 

How does a psoriatic plaque develop?

Autoimmune diseases are caused by an overactive immune system that mistakes the body’s cells as foreign.  The cells of the immune system attack otherwise healthy tissue, making autoantibodies to the body’s cells, destroying that tissue.  An overactive immune response mediates psoriasis. However, no autoantibodies to skin cells have been found.  In plaque psoriasis the skin cells (keratinocytes) of the upper skin layer (epidermis) grow too rapidly.  They also develop abnormally and do not differentiate properly into mature skin cells.  The skin becomes infiltrated with immune cells that produce chemicals called cytokines, such as interleukins.  These chemicals cause abnormal keratinocyte behaviour and also induce inflammation in the skin.  Small skin blood vessels increase in number and become leaky, allowing more immune cells into the already inflamed skin, to promote further inflammation.  Histamine is released by infiltrating immune cells, which contributes to the development of a psoriatic plaque.  The skin thickens as more and more abnormal keratinocytes get pushed towards the skin surface.  The thickened skin becomes reddened, leathery, flaky, and can result in cracks causing painful fissures in the skin.

How does Daivonex Ointment work?

Daivonex Ointment 50mcg contains calcipotriol that is used to treat psoriasis.  Calcipotriol is derived from calcitriol, which is the natural form Vitamin D (also known as 1,25 dihydroxycholecalciferol or 1,25(OH)2D3). 

The primary role that vitamin D plays is in the regulation of calcium metabolism.  However, it does have other important actions in the body.  These include inhibition of cell proliferation, stimulation of cell differentiation, and immunomodulation, meaning that it modulates the actions of immune cells.  There are Vitamin D receptors in many cells of the body, including keratinocytes (skin cells).  Calcipotriol binds to the Vitamin D receptor and has similar actions as vitamin D. 

The action of calcipotriol in Daivonex Ointment 50mcg reverses the abnormal changes in growth and differentiation of skin cells that lead to psoriasis.  Calcipotriol also helps dampen down the inflammatory response that causes unpleasant symptoms of psoriasis.  These combined actions of calcipotriol in Daivonex Ointment 50mcg restore normal cell growth and development of skin cells.  This reduces the scaling and thickening of the psoriatic plaques and relieves symptoms of psoriasis.

What does Daivonex Ointment contain?

Daivonex Ointment contains the active ingredient calcipotriol, a derivative of calcitriol, which is the natural form Vitamin D (also known as 1,25 dihydroxycholecalciferol or 1,25(OH)2D3), that is used to treat psoriasis.  It also contains dibasic sodium phosphate dihydrate, disodium edetate dihydrate, dl-alpha tocopherol, liquid paraffin, polyoxyethylene stearyl ether (also known as steareth-2), propylene glycol, purified water, white soft paraffin.

What are the side effects of Daivonex Ointment?

Most medications have some side effects, but they are not experienced by everyone.  Some side effects are commonly experienced when taking Daivonex Ointment, but others are not so common, and you should discuss any problems or concerns with your primary care physician. 

Common side effects when taking Daivonex Ointment include exacerbation of symptoms of psoriasis, and local skin irritation, including itching, burning and rash.  Less common side effects include sensitivity of the skin to light (photosensitivity), skin discolouration, and dermatitis.

When should Daivonex Ointment not be used?

Have a talk with your primary healthcare physician before taking Daivonex Ointment so that you have a full understanding of what this medicine is for and how to use it.  There are some reasons for not taking a medication; these are called contraindications, and for Daivonex Ointment you should consider the following before taking Daivonex Ointment:

• Have you ever had an unusual reaction or an allergy when taking Daivonex Ointment?
• Are you pregnant or breastfeeding?
• Do you have any problems with your kidneys or your liver?
• Do you have any calcium metabolism disorders?

What medications interact with Daivonex Ointment?

Some medicines interact with Daivonex Ointment and may affect the way it works, or are affected by Daivonex Ointment or increase side effects; you should discuss possible interactions with your primary care physician.  These may include calcium or vitamin D supplements, or drugs which enhance the systemic availability of calcium. 

If other medications may interact with Daivonex Ointment, your doctor will discuss these with you. 

How should Daivonex Ointment be taken and for how long?

You should use your Daivonex Ointment 50mcg by applying to the affected area twice daily, morning and evening.  You should not apply your Daivonex Ointment 50mcg to any other area, particularly the face, and avoid contact with your eyes.  You should continue to use your Daivonex Ointment 50mcg until the affected skin has cleared up or as recommended by your doctor.

Missed dose of Daivonex Ointment

If you miss a dose of Daivonex Ointment apply it as soon as you remember, unless it is time to apply the next dose, then skip the missed dose.  Do not apply a double dose.

How should Daivonex Ointment be stored?

You should store your Daivonex Ointment below 25°C in a cool dry place.