Version July 2025
Plaque psoriasis: Topical: Apply twice daily to affected areas (maximum: 200 g weekly).
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
(For additional information see "Calcitriol (topical): Pediatric drug information")
Plaque psoriasis, mild to moderate: Topical: Ointment:
Children ≥2 years to <7 years: Apply twice daily to affected area(s); maximum weekly dose: 100 g/week.
Children ≥7 years and Adolescents: Apply twice daily to affected areas; maximum weekly dose: 200 g/week.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
>10%: Endocrine & metabolic: Hypercalcemia (24%)
1% to 10%: Dermatologic: Skin pain (3%)
Postmarketing: Dermatologic: Bullous dermatitis (acute), burning sensation of skin, erythema of skin
There are no contraindications listed in the US manufacturer's labeling.
Canadian labeling: Hypersensitivity to calcitriol or any component of the formulation; ophthalmic or internal use; hypercalcemia or a history of abnormal calcium metabolism; concurrent systemic treatment of calcium homeostasis; severe renal impairment or end-stage renal disease; hepatic impairment.
Concerns related to adverse effects:
• Hypercalcemia: May cause hypercalcemia; if alterations in calcium occur, discontinue treatment until levels return to normal. Use with caution in patients receiving calcium supplements, high doses of vitamin D, or medications known to cause hypercalcemia (eg, thiazide diuretics).
Other warnings/precautions:
• Appropriate use: For external use only; not for ophthalmic, oral, or intravaginal use. Do not apply to facial skin, eyes, or lips. Absorption may be increased with occlusive dressings. The safety and effectiveness have not been evaluated in patients with known or suspected disorders of calcium metabolism.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Ointment, External:
Vectical: 3 mcg/g (100 g)
Generic: 3 mcg/g (100 g)
Yes
Ointment (Calcitriol External)
3 mcg/g (per gram): $7.03 - $10.29
Ointment (Vectical External)
3 mcg/g (per gram): $11.45
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Ointment, External:
Silkis: 3 mcg/g (5 g, 30 g, 60 g, 100 g)
Topical: Apply externally; not for ophthalmic, oral, or intravaginal use. Do not apply to eyes, lips, or facial skin. Rub in gently so that no medication remains visible. Limit application to only the areas of skin affected by psoriasis.
Topical: For external use only; not for ophthalmic, oral, or intravaginal use. Do not apply to eyes, lips, or facial skin. Rub in gently so that no medication remains visible. Limit application to only the areas of skin affected by psoriasis.
Plaque psoriasis: Management of mild to moderate plaque psoriasis in adults and pediatric patients ≥2 years of age.
Calcitriol may be confused with alfacalcidol, Calciferol, calcitonin, calcium carbonate, captopril, colestipol, paricalcitol, ropinirole.
Substrate of CYP3A4 (Minor); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential;
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.
Aminolevulinic Acid (Systemic): Photosensitizing Agents may increase photosensitizing effects of Aminolevulinic Acid (Systemic). Risk X: Avoid
Aminolevulinic Acid (Topical): Photosensitizing Agents may increase photosensitizing effects of Aminolevulinic Acid (Topical). Risk C: Monitor
Burosumab: Vitamin D Analogs may increase adverse/toxic effects of Burosumab. Risk X: Avoid
Calcium Salts: May increase adverse/toxic effects of Vitamin D Analogs. Risk C: Monitor
Cardiac Glycosides: Vitamin D Analogs may increase arrhythmogenic effects of Cardiac Glycosides. Risk C: Monitor
Methoxsalen (Systemic): Photosensitizing Agents may increase photosensitizing effects of Methoxsalen (Systemic). Risk C: Monitor
Multivitamins/Fluoride (with ADE): May increase adverse/toxic effects of Vitamin D Analogs. Risk X: Avoid
Multivitamins/Minerals (with ADEK, Folate, Iron): May increase adverse/toxic effects of Vitamin D Analogs. Risk X: Avoid
Porfimer: Photosensitizing Agents may increase photosensitizing effects of Porfimer. Risk X: Avoid
Thiazide and Thiazide-Like Diuretics: May increase hypercalcemic effects of Vitamin D Analogs. Risk C: Monitor
Verteporfin: Photosensitizing Agents may increase photosensitizing effects of Verteporfin. Risk C: Monitor
Vitamin D Analogs: May increase adverse/toxic effects of Vitamin D Analogs. Risk X: Avoid
Topical agents are recommended for the treatment of psoriasis in pregnancy; however, agents other than calcitriol are preferred. When alternatives are not appropriate, limit use to smallest possible area (AAD-NPF [Elmets 2021]; Maul 2021; Simionescu 2021).
It is not known if calcitriol is present in breast milk following topical application.
According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and the benefits of treatment to the mother; do not apply directly to the nipple and surrounding area if breastfeeding. If maternal use is needed, the breastfed infant should avoid contact with the treated area.
The mechanism by which calcitriol is beneficial in the treatment of psoriasis has not been established.
Onset of action: Topical: ~2 weeks (Lebwohl 2007).
Metabolism: Primarily to calcitroic acid and a lactone metabolite.
