Medication Information Leaflet

What is this medication for?

Your doctor has prescribed one of the following medications for you:

• Calcipotriol (Daivonex®)
• Calcipotriol with betamethasone diproprionate steroid (Daivobet®,Enstilar Foam®)
   

Topical vitamin D derivatives can be used to treat psoriasis, an inflammatory condition of the skin with increased turnover of skin cells, creating red, scaly patches of skin.  The medication works by slowing down cell growth in the skin. The addition of steroids in the medication helps to reduce the signs of inflammation (such as redness, swelling) at the same time.  

This medication may also be used for other conditions as determined by your doctor.

How should I take or use this medication?

For use on your skin (Daivonex®, Daivobet®):
 

1. Clean the skin before applying this medication

2. Shake bottle well before use and remove the cap (for Daivobet® gel only)

3. Apply on the affected areas as directed by your doctor and rub in gently with your fingertips. 

4. Wash your hands thoroughly after each application
 

• For Daivonex®: Do not apply more than 100g in one week.
• For Daivobet®: Do not apply more than 15g in one day or 100g in one week, and the treated areas should not exceed 30% of your entire body surface. 
• Applying more than the recommended amounts can increase calcium levels in the body and lead to serious side effects.
• Do not wrap, bandage or cover the affected area after applying the medicine unless directed by the doctor
• For best results, do not shower immediately after applying the medication. Let the medication stay on the skin during the day or night.
• Avoid application of medicines to face, genitals or mucous membranes unless specified by your doctor.
• For Daivobet® gel: The medication may be used up to 8 weeks and thereafter as needed under medical supervision
• For Daivobet® ointment: The medication may be used up to 4 weeks and thereafter as needed under medical supervision

For use on the scalp (Daivobet® gel):

1. Shake bottle well before use and remove the cap. 

2. Comb your hair first to remove any loose scales. It may help to part your hair before applying the medication. Washing your hair before applying the medication is not necessary. 

3. Apply on the affected areas as directed by your doctor and rub in gently with your fingertips. If the medication accidentally gets onto your face or into your eyes, wash it off immediately. 
 

• Usually an amount between 1g and 4g per day is sufficient for treatment of the scalp (4g is approximately one teaspoon). 
• For best results, do not wash the hair immediately after applying the medication. Let the medication stay on the scalp for a few hours, such as overnight or during the day.
• To wash off the medication, apply shampoo to dry hair and leave on for a few minutes before rinsing off. 
   
• The medication may be used up to 4 weeks and thereafter as needed under medical supervision
   

For use on the skin and scalp (Enstilar Foam®):

1. Wash and dry hands before starting

2. Remove the cap and shake for a few seconds before use

3. Spray onto the skin/scalp from at least 3 cm away. A 2-second application delivers approximately 0.5 g of medication. The foam can be sprayed holding the can in any orientation except horizontally.

4. Apply to the affected areas and rub gently into the skin. A 2-second application (0.5 g of medication) is generally enough to cover the area of a flat adult hand.
 

• For Enstilar Foam®: Do not apply more than 15g in one day, 100g in one week and the treated areas should not exceed 30% of your entire body surface. 
• Wash your hands after applying the medication
• The medication may be used up to 4 weeks and thereafter as needed under medical supervision
   

Note: 

• For application to scalp: Do not use the medication 12 hours before or after any chemical hair treatments (e.g. dyes, perms)
• For application to skin: Medication should be applied on the skin at least 2 hours before going for any light treatments. 

What should I do if I forget to take or use this medication?

If you forgot to apply a dose of this medication, apply it as soon as you remember. Skip the dose if it is almost time for the next dose. Apply your next dose at the usual time. Do not apply two doses to make up for the missed dose. 
 

What precautions should I take when taking or using this medication?

Inform your healthcare professional if: 

• You are allergic to this medication or any of the other ingredients of this medication
• You are pregnant, planning to become pregnant, or breastfeeding 
• You have high blood calcium levels, skin infections, diabetes, liver or kidney disease
   

What are some common side effects of this medication?

Certain side effects of this medication are common and may even disappear during treatment. If the side effects do not go away or becomes severe, consult your doctor. 

These side effects include:

• Skin irritation such as itch, redness, peeling (most common) 
• Burning sensation of skin
• Rashes
• Increased risk of sunburn
  • Avoid staying directly under sunlight for long durations. Use a broad-spectrum sunscreen product with Sun Protection Factor (SPF) of at least 30 and wear protective clothing when you are exposed to direct sunlight.
     

For Daivobet® gel and ointment as well as Enstilar Foam®, using this medication for long durations may cause additional side effects from the steroid ingredient. Some of these additional side effects include thinning of the skin, easy bruising, reddish stretch marks and acne.

What are some rare but serious side-effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following: 

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body
   

Uncommon side effect of the medication include:
 

• Worsening of psoriasis. Symptoms include red, scaly and thick patches of skin.
   

Some rare side effects of the medication include: 

• Adrenal glands (glands that release hormones important for body function) may stop working properly. Symptoms include weakness, fatigue, weight loss, increased urination and thirst.
   
• Pustular psoriasis (red area with yellowish pustules usually on the hands or feet) may develop

Some very rare side effects of the medication include:

• High blood calcium levels in the body. Symptoms include fatigue, depression, mental confusion, loss of appetite, nausea, vomiting, constipation, increased urination, thirst
   

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.
 

What food or medication should I avoid when I take or use this medication?

Avoid applying this medication with salicylic acid preparations as they will make calcipotriol medications less effective.
 

How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children. 

For Daivobet® gel and Enstilar Foam®: Throw the bottle away 6 months after first opening.
 

For Daivobet® ointment: Throw 12 months after first opening of the container
 

How do I throw away this medication safely?

Pack this medication into a black trash bag and seal it tightly before throwing into the rubbish chute or bin. 
 

Disclaimer

Please take note that the above is not a complete list of all possible side effects. If you have any concerns about your medication or if you have other side effects that you think are caused by this medication, please consult your doctor or pharmacist.

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

Last updated on Nov 2022