Dovobet Gel

Psoriasis Doctor Service

Dovobet®50 micrograms/g + 0.5 mg/g Gel - calcipotriol/betamethasone.

Dovobet gel is used as topical treatment of scalp psoriasis in adults and on the skin of other body areas to treat mild to moderate plaque psoriasis (psoriasis vulgaris) in adults.

Psoriasis is caused by your skin cells being produced too quickly. This causes redness, scaling and thickness of your skin. Dovobet ointment contains calcipotriol and betamethasone.

• Calcipotriol helps to bring the rate of skin cell growth back to normal.
• Betamethasone acts to reduce inflammation.

Suitable For Adults From Age of 18 Years & Above

What Should I Expect When I Use Dovobet?

Most patients see obvious results after 2 weeks, even if the psoriasis is not yet cleared at that point.

You can order Dovobet online from our UK registered online pharmacy and doctor service. To see if you are suitable for this treatment, complete the online assessment and checkout. Our UK registered doctors will review the order and after approval pass the prescription to the Pharmacy team. We will then dispense and dispatch your order to your chosen address.

About Psoriasis

If the cells in your skin grow too much you may get psoriasis. Psoriasis is a condition where your skin develops raised red patches and silver coloured scaly patches. The scaly patches are dead cells that would normally fall off your skin without you noticing.

These patches normally appear on your elbows, knees, scalp and lower back, but can appear anywhere on your body.  Most people are only affected with small patches. In some cases, the patches can be itchy or sore.

Psoriasis affects around 2% of people in the UK. It can start at any age, but most often develops in adults under 35 years old, and affects men and women equally.

The severity of psoriasis varies greatly from person to person. For some it's just a minor irritation, but for others it can majorly affect their quality of life.

Psoriasis is a long-lasting (chronic) disease that usually involves periods when you have no symptoms or mild symptoms, followed by periods when symptoms are more severe.

A good self care guide and information for psoriasis is available on the NHS website. 

NHS - Psoriasis

Psoriasis Triggers

Many people's psoriasis symptoms start or get worse because of a certain event, called a trigger. Knowing your triggers may help you avoid a flare-up.

Common Psoriasis Triggers Include:

• an injury to your skin, such as a cut, scrape, insect bite or sunburn – this is called the Koebner response
• drinking excessive amounts of alcohol
• smoking
  stress
• hormonal changes, particularly in women – for example, during puberty and the menopause
• certain medicines – such as lithium, some antimalarial medicines, anti-inflammatory medicines including
• ibuprofen, and ACE inhibitors (used to treat high blood pressure)
• throat infections – in some people, usually children and young adults, a form of psoriasis called guttate psoriasis develops after a streptococcal throat infection, but most people who have streptococcal throat infections don't develop psoriasis
• other immune disorders, such as HIV, which cause psoriasis to flare up or appear for the first time.

Psoriasis is not contagious, so it cannot be spread from person to person.

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Tell your doctor/nurse immediately or as soon as possible if any of the following happens. You may have to stop your treatment.

The following serious side effects have been reported for Dovobet:

Uncommon (may affect up to 1 in 100 people)

• Worsening of your psoriasis. If your psoriasis gets worse, tell your doctor as soon as possible.

Some serious side effects are known to be caused by Betamethasone (a strong steroid), one of the ingredients in Dovobet:

You should tell your doctor as soon as possible if any of the serious side effects occur. These side effects are more likely to happen after long-term use, use in skin folds (e.g. groin, armpits or under breasts), use under occlusion or use on large areas of skin.

The side effects include the following:

• Your adrenal glands may stop working properly. Signs are tiredness, depression and anxiety.
• Cataracts (signs are cloudy and foggy vision, difficulty seeing at night and sensitivity to light) or an increase in pressure inside the eye (signs are eye pain, red eye, decreased or cloudy vision
• Infections (because your immune system which fights infections may be suppressed or weakened)
• Pustular psoriasis (a red area with yellowish pustules usually on the hands or feet). If you notice this, stop using Dovobet and tell your doctor as soon as possible.
• Impact on the metabolic control of diabetes mellitus (if you have diabetes you may experience fluctuations in the blood glucose levels).

Some serious side effects known to be caused by Calcipotriol, one of the ingredients in Dovobet:

• Allergic reactions with deep swelling of the face or other parts of the body such as the hands or feet. Swelling of the mouth/throat and trouble breathing may occur. If you have an allergic reaction, stop using Dovobet, tell your doctor immediately or go to the casualty department at your nearest hospital.

Treatment with this gel may cause the level of calcium in your blood or urine to increase (usually when too much gel has been used). Signs of increased calcium in bloodare excessive secretion of urine, constipation,muscle weakness, confusion and coma. This can be serious, and you should contact your doctor immediately. However, when the treatment is stopped, the levels return to normal.

Less serious side effects have been reported for Dovobet:

Common side effects (may affect up to 1 in 10 people):

• Itching.

Uncommon side effects (may affect up to 1 in 100 people):

• Eye irritation
• Burning sensation of the skin
• Skin pain or irritation
• Inflammation or swelling of the hair root (folliculitis)
• Rash with inflammation of the skin (dermatitis)
• Redness of the skin due to widening of the small blood vessels (erythema)
• Acne (pimples)
• Dry skin
• Rash
• Pustular rash
• Infection of the skin.

Less serious side effects have been reported for Betamethasone, especially for a long time, including the following. You should tell your doctor or nurse as soon as possible if you notice any of them:

• Thinning of the skin
• Appearance of surface veins or stretch marks
• Changes in hair growth
• Red rash around the mouth (perioral dermatitis)
• Skin rash with inflammation or swelling (allergic contact dermatitis)
• Golden coloured gel-filled bumps (colloid milia)
• Lightening of skin colour (depigmentation)
• Inflammation or swelling of the hair root (folliculitis).

Less serious side effects known to be caused by Calcipotriol include the following:

• Dry skin
• Sensitivity of the skin to light resulting in a rash
• Eczema
• Itching
• Skin irritation
• Burning and stinging sensation
• Redness of the skin due to widening of the small blood vessels (erythema)
• Rash
• Rash with inflammation of the skin (dermatitis)
• Worsening of psoriasis.

For a full list of side effects, please read the Patient Information Leaflet.

If you get any side effects, talk to your doctor, our Rightdose pharmacists or nurse. This includes any possible side effects not listed in this leaflet.

You can help to make medicines safer by reporting any side-effects to the Yellow Card Scheme at www.mhra.gov.uk/yellowcard.

Before taking any medication, it is important to read the Patient Information Leaflet. You can find information leaflets for your medicines by typing them into the search bar at medicines.org, or by contacting us.

Patient Information Leaflet Dovobet Gel 60g

Other medicines and Dovobet Gel

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before using this medicine. If your doctor has agreed that you can breast-feed, take care and do not apply Dovobet to the breast area.

Driving and using machines

This medicine should not have any effect on your ability to drive or use machines.

Dovobet Gel contains butylated hydroxytoluene (E321), which may cause local skin reactions (e.g. contact dermatitis), or irritation to the eyes and mucous membrane.

• Please ask your doctor if you are worried about any of the ingredients in this medicine.

How to store Dovobet

• Do not use this medicine after the expiry date, which is stated on the bottle after EXP. The expiry date refers to the last day of that month.
• Do not refrigerate.
• Keep the bottle in the outer carton in order to protect from light.
• Discard the bottle with any remaining gel 6 months after first opening.
• Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

Keep this medicine out of the sight and reach of children.

Dovobet is not recommended for the use in children below the age of 18 years.

How to use Dovobet Gel

Always use Dovobet exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.

• This medicine is only for using on your skin. Use only on your psoriasis and do not use it on skin which does not have psoriasis.
• Do not put it inside your body.
• Do not swallow it.
• Never put this medicine on your face as it may cause irritation.

Directions:

1. Shake the bottle before use and remove the cap.
2. Squeeze the gel onto a clean finger or directly onto the area affected by psoriasis.
3. Apply Dovobet to the affected area with your fingertips, and rub it in gently until the area affected by psoriasis is covered by a thin layer of gel.
4. Do not bandage, tightly cover or wrap the treated skin area.
5. Wash your hands well after using Dovobet. This will avoid accidentally spreading the gel to other parts of your body (especially the face, mouth and eyes).
6. Do not worry if some gel accidentally gets on normal skin near your psoriasis, but wipe it off if it spreads too far.
7. In order to achieve optimal effect, it is recommended not to take a shower or bath immediately after application of Dovobet gel.
8. After applying the gel, avoid contact with textiles which are easily stained by grease (e.g. silk).

Duration of treatment

Use the ointment once a day. It may be more convenient to use the gel in the evening.

The normal initial treatment period is 8 weeks for non-scalp areas. Your doctor may decide on a different treatment period. Your doctor may decide on repeated treatment.

Do not use more than 15 grams in one day. If you use other calcipotriol containing medicines, the total amount of calcipotriol medicines must not exceed 15 grams per day and the area treated should not exceed 30% of the total body surface.

If you use more Dovobet than you should

Contact your doctor if you have used more than 15 grams in one day.

Excessive use of Dovobet may cause a problem with calcium in your blood, which usually normalises when discontinuing treatment. Your doctor may need to carry out blood tests to check that using too much ointment has not caused a problem with calcium in your blood.

Excessive prolonged use can also cause your adrenal glands to stop working properly (these are found near the kidneys and produce hormones).

If you forget to use Dovobet

Do not take a double dose to make up for a forgotten dose.

If you stop using Dovobet

The use of Dovobet should be stopped as indicated by your doctor. It may be necessary for you to stop this medicine gradually, especially if you have used it for a long time.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

Dovobet is not recommended for the use in children below the age of 18 years.

Do not use Dovobet

• If you are allergic (hypersensitive) to calcipotriol, betamethasone or any of the other ingredients of this medicine.
• If you have problems with calcium levels in the body (ask your doctor).
• If you have certain types of psoriasis: these are erythrodermic, exfoliative and pustular (ask your doctor).

As Dovobet contains a strong steroid DO NOT USE it:

• on skin affected by skin infections caused by viruses (e.g. cold sores or chicken pox)
• skin infections caused by a fungus (e.g. athlete’s foot or ringworm
• skin infections caused by bacteria
• skin infections caused by parasites (e.g. scabies)
• tuberculosis (TB)
• perioral dermatitis (red rash around the mouth)
• thin skin, easily damaged veins, stretch marks
• ichthyosis (dry skin with fish-like scales)
• acne (pimples)
• rosacea (severe flushing or redness of the skin on the face)
• ulcers or broken skin.

Warnings and precautions

Talk to your doctor/nurse/pharmacist before and during use of Dovobet if:

• you are using other medicines that contain corticosteroids, as you may get side effects
• you have used this medicine for a long time and plan to stop (as there is a risk your psoriasis will get worse or ‘flare up’ when steroids are stopped suddenly
• you have diabetes mellitus (diabetes), as your blood sugar/glucose level may be affected by the steroid
• your skin becomes infected, as you may need to stop your treatment
• you have a certain type of psoriasis called guttate psoriasis
• you experience blurred vision or other visual disturbances.

Special precautions

• Avoid use on more than 30% of your body or using more than 15 grams per day.
• Avoid using under bandages or dressings as it increases the absorption of the steroid.
• Avoid use on large areas of damaged skin, on mucous membranes or in skin folds (groin, armpits, under breasts) as it increases the absorption of the steroid.
• Avoid use on the face or genitals (sex organs) as they are very sensitive to steroids.
• Avoid excessive sunbathing, excessive use of solarium and other forms of light treatment.
• Do not smoke or go near naked flames - risk of severe burns. Fabric (clothing, bedding, dressings etc) that has been in contact with this product burns more easily and is a serious fire hazard. Washing clothing and bedding may reduce product build-up but not totally remove it.

What Dovobet Gel contains

The active substances are: Calcipotriol and Betamethasone. One gram of gel contains 50 micrograms of calcipotriol (as monohydrate) and 0.5 mg of betamethasone (as dipropionate).

The other ingredients are: paraffin, liquid, polyoxypropylene stearyl ether, castor oil, hydrogenated, butylhydroxytoluene (E321), all-rac-α-tocopherol.

What Dovobet looks like and contents of the pack

Dovobet is an almost clear, colourless to slightly off-white gel filled in high-density polyethylene bottles with a low-density polyethylene nozzle and a high-density polyethylene screw cap.

The bottles are placed in cartons. Pack sizes: 15 g, 30 g, 60 g, 80 g, 2 x 60 g, 2 x 80 g and 3 x 60 g. Not all pack sizes may be marketed.