Avoid contact with the eyes or mucous membranes. Discontinue
use if a sensitivity reaction occurs or if excessive irritation develops on
uninvolved skin areas.
Drug product is flammable. Keep away from open flame.
Use of Dovonex® (calcipotriene solution) Scalp Solution, 0.005%, may cause transient
irritation of both lesions and surrounding uninvolved skin. If irritation
develops, Dovonex® (calcipotriene solution) Scalp Solution, 0.005%, should be discontinued.
For external use only. Keep out of the reach of children.
Always wash hands thoroughly after use.
Reversible elevation of serum calcium has occurred with use
of topical calcipotriene. If elevation in serum calcium outside the normal
range should occur, discontinue treatment until normal calcium levels are
Carcinogenesis, Mutagenesis, Impairment of Fertility
When calcipotriene was applied topically to mice for up to
24 months at dosages of 3, 10 and 30 μg/kg/day (corresponding to 9, 30 and
90 μg/m²/day), no significant changes in tumor incidence were observed
when compared to control.In a study in which albino hairless mice were exposed
to both UVR and topically applied calcipotriene, a reduction in the time
required for UVR to induce the formation of skin tumors was observed
(statistically significant in males only), suggesting that calcipotriene may
enhance the effect of UVR to induce skin tumors. Patients that apply Dovonex® (calcipotriene solution)
to exposed portions of the body should avoid excessive exposure to either
natural or artificial sunlight (including tanning booths, sun lamps, etc.).
Physicians may wish to limit or avoid use of phototherapy in patients that use
Dovonex® (calcipotriene solution) .
Calcipotriene did not elicit any mutagenic effects in an Ames mutagenicity assay, a mouse lymphoma TK locus assay, a human lymphocyte chromosome
aberration assay, or in a micronucleus assay conducted in mice.
Studies in rats at doses up to 54 μg/kg/day (324
μg/m²/day) of calcipotriene indicated no impairment of fertility or
general reproductive performance.
Teratogenic Effects: Pregnancy Category C
Studies of teratogenicity were done by the oral route where
bioavailability is expected to be approximately 40-60% of the administered
dose. Increased rabbit maternal and fetal toxicity was noted at 12 μg/kg/day
(132 μg/m²/day). Rabbits administered 36 μg/kg/day (396
μg/m²/day) resulted in fetuses with a significant increase in the
incidences of pubic bones, forelimb phalanges, and incomplete bone
ossification. In a rat study, oral doses of 54 μg/kg/day (318
μg/m²/day) resulted in a significantly higher incidence of skeletal
abnormalities consisting primarily of enlarged fontanelles and extra ribs. The
enlarged fontanelles are most likely due to calcipotriene's effect upon calcium
metabolism. The maternal and fetal calculated no-effect exposures in the rat
(43.2 μg/m²/day) and rabbit (17.6 μg/m²/day) studies are greater than
the expected human systemic exposure level (0.13 μg/m²/day) from dermal
application. There are no adequate and well-controlled studies in pregnant women.
Therefore, Dovonex® (calcipotriene solution) Scalp Solution, 0.005%, should be used during pregnancy
only if the potential benefit justifies the potential risk to the fetus.
There is evidence that maternal 1,25-dihydroxy vitamin D3
(calcitriol) may enter the fetal circulation, but it is not known whether it is
excreted in human milk. The systemic disposition of calcipotriene is expected
to be similar to that of the naturally occurring vitamin. Because many drugs
are excreted in human milk, caution should be exercised when Dovonex®
(calcipotriene solution) Scalp Solution, 0.005%, is administered to a nursing
Safety and effectiveness of Dovonex® (calcipotriene solution) Scalp Solution, 0.005%,
in pediatric patients have not been specifically established. Because of a
higher ratio of skin surface area to body mass, pediatric patients are at
greater risk than adults of systemic adverse effects when they are treated with
Of the total number of patients in clinical studies of
calcipotriene solution, approximately 16% were 65 or older, while approximately
4% were 75 and over. The results of an analysis of severity of skinrelated adverse
events showed no differences for subjects over 65 years compared to those under
65 years, but greater sensitivity of some older individuals cannot be ruled