Dovobet

Dovobet (also known as Daivobet) is a combination topical treatment for psoriasis vulgaris. It contains calcipotriol, a vitamin D3 analogue, and betamethasone dipropionate, a potent corticosteroid.

The two components act through different mechanisms and together provide more effective plaque clearance than either agent used alone.

Calcipotriol binds to vitamin D receptors on keratinocytes and modulates their proliferation and differentiation, helping to normalise the accelerated skin cell turnover that characterises psoriatic plaques.

Betamethasone suppresses the underlying inflammatory response, reducing redness, thickness, and scaling.

The rapid symptom relief provided by the steroid component is complemented by the sustained disease-modifying effect of calcipotriol.

Dovobet is available as an ointment and a gel formulation. The gel is particularly suited to scalp psoriasis.

Clinical trials have shown that once-daily application of Dovobet achieves faster and greater plaque clearance than calcipotriol or betamethasone monotherapy.

Apply a thin layer to the affected psoriatic plaques once daily. For body plaques, use the ointment; for scalp psoriasis, the gel formulation is more practical.

Do not apply to more than 30% of the body surface area. Wash hands after application. Do not use on the face, skin folds, or genital area, as these sites are more susceptible to steroid side effects.

Treatment should be reviewed after four weeks for body psoriasis and eight weeks for scalp psoriasis.

Adults: apply once daily to affected areas. Maximum recommended duration is four weeks for body psoriasis (ointment) and eight weeks for scalp psoriasis (gel).

The maximum weekly dose should not exceed 100 g. After an initial treatment course, intermittent maintenance therapy may be used under medical supervision.

Re-treatment courses should be initiated under medical guidance.

Common (1 in 10 to 1 in 100): pruritus, skin irritation, burning or stinging at the application site.

Uncommon: folliculitis, skin atrophy, striae, telangiectasia, and dermatitis at the application site.

The calcipotriol component may cause local irritation, particularly on facial or flexural skin, which is why these areas should be avoided.

Prolonged use of the betamethasone component carries the usual risks of potent topical corticosteroids including thinning and rebound flares on withdrawal.

Do not exceed 100 g per week to minimise the risk of hypercalcaemia from systemic calcipotriol absorption. Avoid application to the face, axillae, and groin.

Prolonged continuous use increases the risk of steroid-related skin atrophy; follow the recommended treatment durations.

If a skin infection develops in the treated area, appropriate antimicrobial therapy should be started.

Monitor calcium levels if the patient is using calcipotriol on large areas or has renal impairment.

Contraindicated in patients with known calcium metabolism disorders, severe renal or hepatic insufficiency, hypersensitivity to calcipotriol, betamethasone, or any excipient.

Do not use in pustular or erythrodermic psoriasis. Not suitable for viral, fungal, or bacterial skin infections, or for skin conditions such as rosacea, acne, or perioral dermatitis.