Daivobet® (Calcipotriol, Betamethasone) Ointment, 30 g

What is Daivobet® (Calcipotriol, Betamethasone) Ointment?

Daivobet® is a topical medication designed to treat chronic plaque psoriasis in adults. It combines two active ingredients: Calcipotriol, a vitamin D analogue, and Betamethasone dipropionate, a potent corticosteroid. Calcipotriol helps regulate skin cell growth, while Betamethasone provides anti-inflammatory effects to reduce symptoms like redness, itching, and irritation. This combination is effective for managing the symptoms of psoriasis but does not cure the condition.

How Should Daivobet® Ointment Be Used?

Daivobet® ointment is intended for external use only, typically applied once daily to the affected skin areas. The maximum daily dose should not exceed 15 grams, and treatment should continue for up to 4 weeks or as prescribed by a healthcare professional. It is crucial to avoid bathing immediately after applying the ointment to ensure optimal absorption. To avoid systemic absorption and unwanted side effects, no more than 30% of the body surface area should be treated at any given time.

What Are the Ingredients of Daivobet®?

Each gram of Daivobet® ointment contains:

• Calcipotriol monohydrate: 0.052 mg (equivalent to 0.05 mg of Calcipotriol).
• Betamethasone dipropionate: 0.643 mg (equivalent to 0.5 mg of Betamethasone).

The ointment also contains liquid paraffin, polypropylene glycol stearate, alpha-tocopherol, and soft white paraffin as inactive ingredients. Some ingredients may have additional components, such as alpha-tocopherol at 10 ppm and butylated hydroxytoluene (BHT) at 0.1%.

What Are the Benefits of Using Daivobet® Ointment?

Daivobet® combines the effects of a vitamin D analogue and a corticosteroid to treat psoriasis effectively:

• Calcipotriol: This ingredient helps normalize the production of skin cells by promoting differentiation and suppressing excessive proliferation, which is beneficial in managing psoriasis plaques.
• Betamethasone Dipropionate: A powerful corticosteroid that offers anti-inflammatory, anti-itching, and immune-suppressing properties, helping reduce the visible symptoms of psoriasis, such as redness and scaling.

Who Should Not Use Daivobet®?

Daivobet® is contraindicated for individuals with:

• Allergies to its components.
• Certain types of psoriasis, such as pustular or exfoliative psoriasis.
• Calcium metabolism disorders.
• Viral skin infections (e.g., herpes, chickenpox), as well as fungal, bacterial, or parasitic skin infections.
• Tuberculosis or syphilis of the skin, and conditions like rosacea, acne, or skin ulcers.

Daivobet® should also be used with caution by patients with conditions involving impaired calcium metabolism or who have significant skin damage.

What Are the Possible Side Effects of Daivobet®?

The side effects of Daivobet® vary in frequency and severity:

• Common Side Effects (1% to 10%): Itching, rash, burning sensation on the skin.
• Uncommon Side Effects (0.1% to 1%): Psoriasis exacerbation, skin irritation, folliculitis, pigmentation changes, and dermatitis.
• Rare Side Effects (0.01% to 0.1%): Pustular psoriasis, skin thinning, stretch marks.

Very rarely, systemic effects such as increased calcium levels (hypercalcemia) or adrenal suppression might occur, especially with prolonged use or if used on large body areas under occlusive dressings.

How Should Daivobet® Be Stored?

Store Daivobet® at temperatures not exceeding 25°C (77°F), out of reach of children. Once opened, the product should be used within 12 months. Always check the expiry date before using, and do not use if the product is out of date.

What Precautions Should Be Taken When Using Daivobet®?

• Avoid Large Areas and Occlusion: Do not use Daivobet® on more than 30% of your body or under occlusive dressings, as this increases the risk of systemic absorption and associated side effects.
• Sensitive Areas: Avoid applying the ointment on the face, genitals, or broken skin, as these areas are particularly sensitive to corticosteroids, which could lead to adverse reactions.
• Sunlight Exposure: During treatment, limit exposure to both natural and artificial sunlight. Combining Daivobet® with UV therapy should be done cautiously, under medical supervision.
• Interaction With Other Steroids: Since Daivobet® contains a strong corticosteroid, avoid using other steroid-based products simultaneously to minimize the risk of side effects like adrenal suppression.
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Can Daivobet® Be Used During Pregnancy or Breastfeeding?

The safety of Daivobet® during pregnancy has not been established, so it should be used only if the potential benefits justify the possible risks to the fetus. During breastfeeding, it is advised to avoid applying the ointment to the breast area to prevent accidental ingestion by the infant. Consult a healthcare professional for detailed guidance if you are pregnant or breastfeeding.

How Does Daivobet® Work on Psoriasis?

Daivobet® works by combining the beneficial effects of two distinct mechanisms:

• Calcipotriol: As a vitamin D analogue, it promotes healthy skin cell turnover, reducing the thickening and scaling typical of psoriasis.
• Betamethasone: Provides rapid relief from inflammation, itching, and discomfort by suppressing the immune response and reducing the inflammatory process in the skin.

What Should I Do in Case of Overdose?

An overdose of Daivobet®, especially with prolonged use or on large skin areas, may lead to:

• Increased calcium levels in the blood.
• Suppression of the adrenal glands, resulting in secondary adrenal insufficiency.

In case of suspected overdose, discontinue use immediately and seek medical attention. Symptomatic treatment may be necessary, and if corticosteroids have been used chronically, they should be tapered off gradually to avoid withdrawal symptoms.

Can Daivobet® Affect My Daily Activities?

Daivobet® generally does not impair the ability to drive or operate machinery. However, if you experience any side effects that could affect concentration or physical capabilities, it's best to avoid these activities until you feel comfortable.

Final Tips for Using Daivobet® Ointment

• Use as directed by your healthcare provider to avoid potential side effects.
• Avoid using on broken or damaged skin to minimize systemic absorption.
• Wash your hands after each application to prevent accidental spread to sensitive areas like the face, eyes, or mouth.