Enstilar
Enstilar (calcipotriene / betamethasone) is used to treat plaque psoriasis in people 12 years and older. It's a topical foam that contains two medications: calcipotriene (a form of vitamin D) and betamethasone (a corticosteroid). It's applied to the skin once a day, for up to 1 month. Side effects aren't common, but can include irritation and itching where you apply the medication. Enstilar (calcipotriene / betamethasone) is brand name only and not available as a generic.
What is Enstilar (calcipotriene / betamethasone)?
What is Enstilar (calcipotriene / betamethasone) used for?
How Enstilar (calcipotriene / betamethasone) works
Enstilar (calcipotriene / betamethasone) is a combination of two medications that help treat psoriasis.
- Calcipotriene is a form of vitamin D. It works by slowing down the growth of skin cells to prevent skin patches in psoriasis.
- Betamethasone is a topical corticosteroid (meaning it's applied to the outside of your body). It blocks swelling (inflammation) to relieve redness and itching.
Drug facts
Side effects of Enstilar (calcipotriene / betamethasone)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Less Common Side Effects
Less than 1%:
- Irritation at the application site
- Itching at the application site
- Inflamed hair pores (folliculitis)
- Lightening of skin color at the site of application
- High calcium levels
- Hives
- Worsening of psoriasis
The following Enstilar (calcipotriene / betamethasone) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Burning, itching, crusting, or peeling of treated skin
- Change in vision
- High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
- High calcium level—increased thirst or amount of urine, nausea, vomiting, confusion, unusual weakness or fatigue, bone pain
- Low adrenal gland function—nausea, vomiting, loss of appetite, unusual weakness or fatigue, dizziness
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Mild skin irritation, redness, or dryness
- Small, red, pus-filled bumps on skin around hair follicles
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Pros and cons of Enstilar (calcipotriene / betamethasone)
Pros
- Only applied once a day
- Foam, might be easier to apply than other formulations
- Might see results in as early as 3 days
Cons
- No lower-cost generic available
- Not approved for children under 12 years old
- Not meant for long-term use
Pharmacist tips for Enstilar (calcipotriene / betamethasone)
- Wash your hands before and after you use Enstilar (calcipotriene / betamethasone), unless you're treating your hands.
- Shake the Enstilar (calcipotriene / betamethasone) can each time before you use it. You can spray the foam out in any orientation except for horizontally, because it might not come out this way.
- Don't use Enstilar (calcipotriene / betamethasone) on areas of your body that have thinner skin, such as your face, underarms, or groin, unless your prescriber told you to do so.
- If you accidentally get Enstilar (calcipotriene / betamethasone) in your eyes or on your face, wash the area well with water as soon as possible. If you continue to have irritation, contact your prescriber.
- Don't cover any affected areas with bandages or dressings unless your prescriber tells you it's okay. This can cause more medication to be absorbed and can lead to more side effects, such as skin iritaiton.
- Avoid spending too much time in the sunlight, tanning beds, and sunlamps, since Enstilar (calcipotriene / betamethasone) can make your skin more sensitive to the sun. If you need to be in the sun, you should wear sunscreen and protective clothing.
- Don't use other medications containing calcipotriene or a corticosteroid at the same time as Enstilar (calcipotriene / betamethasone) without consulting your prescriber first. Doing so can cause more side effects.
- Speak to your prescriber about how long you should use Enstilar (calcipotriene / betamethasone). Typically, it should be used for the shortest time possible to treat your psoriasis symptoms, no longer than 1 month.
- Tell your care team if you become pregnant while using Enstilar (calcipotriene / betamethasone). It's unclear whether this medication is safe to use during pregnancy. Based on animal studies of calcipotriene and on reports from people using high-potency topical corticosteroids, there's a chance that Enstilar (calcipotriene / betamethasone) might cause harm during pregnancy.
- It's unclear whether Enstilar (calcipotriene / betamethasone) is safe to use during nursing. Talk with your dermatologist about the risks and benefits of using this medication if you're breastfeeding. If you choose to breastfeeding while using Enstilar (calcipotriene / betamethasone), avoid applying the medication to the nipple or area around it to lower your baby's risk of exposure to the medication.
Common questions about Enstilar (calcipotriene / betamethasone)
One of the medications in Enstilar (calcipotriene / betamethasone), betamethasone, is a topical steroid. Betamethasone lowers inflammation in the skin and can help relieve psoriasis symptoms, such as redness, itching, and swelling.
An one-month clinical study showed that 54% of people who used Enstilar (calcipotriene / betamethasone) saw clear or almost clear skin at the end of the study compared to 5% of people who experienced the same with placebo (a foam with no active medication in it). Before this study, the majority of the people had moderate psoriasis. A different study showed that people started to notice improvements in some symptoms, such as itching and scaling, after using Enstilar (calcipotriene / betamethasone) for 3 days. But a long-term study suggests that psoriasis symptoms might return after a couple months in people who experienced good results with Enstilar (calcipotriene / betamethasone) during the first month of treatment. Keep in mind that Enstilar (calcipotriene / betamethasone) should be used only until your psoriasis symptoms are under control, for no longer than 4 weeks.
No, don't use Enstilar (calcipotriene / betamethasone) on your face unless your prescriber gave you instructions to do so. This is because the steroid medication in Enstilar, betamethasone, is considered a medium-to-high potency corticosteroid. Typically, this type of steroid shouldn't be used on or near sensitive skin areas, like the face, because the skin is thinner and doing so can result in more side effects. If you need a corticosteroid for the face, your dermatologist might recommend a low-potency corticosteroid to minimize the risk of side effects.
Yes, Enstilar (calcipotriene / betamethasone) can expire. Check the expiration date on your medication, or ask your pharmacist if you aren't sure. Once you've opened Enstilar (calcipotriene / betamethasone), it's only good for 6 months. Don't use the medication past the expiration date or 6 months after from opening it because it's unclear whether it will still work well or be safe after this date. If your Enstilar (calcipotriene / betamethasone) is expired, throw it away and ask your prescriber or pharmacist about a refill.
No, Enstilar (calcipotriene / betamethasone) isn't available over the counter (OTC). You can only get it with a prescription from your dermatologist or other healthcare professional. There are treatments for psoriasis that are available OTC, such as hydrocortisone 1%, which is a low-potency corticosteroid.
No. Enstilar (calcipotriene / betamethasone) is only available as a brand name medication. But there are other forms of topical betamethasone/calcipotriene, such as ointment and topical suspension, that are available as generics. Talk with your dermatologist if you've questions about these generic medications.
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Risks and warnings for Enstilar (calcipotriene / betamethasone)
Enstilar (calcipotriene / betamethasone) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Flammable
Enstilar (calcipotriene / betamethasone) can catch on fire easily. Avoid fire, flames, or smoking during and right after applying it. Store the can at room temperature and don't let it get hotter than 120 degrees F.
High calcium levels
Enstilar (calcipotriene / betamethasone) can cause high calcium levels in your blood or urine. Your healthcare team might order lab tests to check your calcium levels while you're taking this medication to make sure they're within a safe range. If your calcium levels are too high, they might ask you to stop this medication until the levels return to a safe range. If you have concerns, speak to your care team.
Changes in stress hormone levels
- Risk factors: Using high potency (strong) corticosteroids | Large treatment areas | Long-term use | Using more than one corticosteroid product | Liver failure | Children | Broken skin | Using occlusive dressings
Enstilar contains betamethasone, a corticosteroid. This is a man-made version of cortisol, the stress hormone naturally made by the body. Using Enstilar (calcipotriene / betamethasone) for a long time can lead to symptoms of too much stress hormone, including weight gain and higher blood sugar levels. Children are at a higher risk, since more medication might be absorbed.
In addition, using Enstilar (calcipotriene / betamethasone) over a longer period of time can cause your body to stop making its own stress hormone. When you stop this medication, it takes a while for the body to ramp up making its own stress hormone again. During this time, you might experience topical steroid withdrawal symptoms, such as itchy or burning skin. If you need to stop Enstilar (calcipotriene / betamethasone), your healthcare team can help you do so safely by lowering your dose slowly over time.
Talk with your healthcare team if you're concerned about any of these side effects.
Allergic skin reaction
Some people can experience an allergic skin reaction to the ingredients in Enstilar (calcipotriene / betamethasone). Speak to your prescriber if you develop a skin rash from using Enstilar (calcipotriene / betamethasone), or if your symptoms aren't getting better.
Cataracts and glaucoma
Enstilar (calcipotriene / betamethasone) might raise your risk of glaucoma (raised pressure in your eye) and cataracts. You should avoid using this medication near your eyes. If you notice any vision changes, such as blurred vision, eye pain, or tunnel vision, let your care team know.
Enstilar (calcipotriene / betamethasone) dosage
Carton| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 60g foam of 0.005%/0.064% | 1 carton | $1,317.56 | $1,317.56 |
| 120g foam of 0.005%/0.064% | 1 carton | $2,631.12 | $2,631.12 |
Typical dosage for Enstilar (calcipotriene / betamethasone)
Enstilar foam contains calcipotriene 0.005% and betamethasone 0.064%.
Adults and children 12 years and older: Apply to the affected area(s) once a day until psoriasis symptoms are under control, for up to 4 weeks. Don't use more than 60 grams every 4 days.
How much does Enstilar (calcipotriene / betamethasone) cost?
$1,317.56
What are alternatives to Enstilar (calcipotriene / betamethasone)?
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