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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Calcipotriol cream discontinued

The manufacturer of calcipotriol cream (Dovonex®) has advised that this product has been discontinued for economic reasons.

The Psoriasis Association note that there are no safety or quality concerns. Current supplies of the cream can continue to be dispensed and used.

Calcipotriol ointment remains available, both as a generic product and as Dovonex. This may be a suitable alternative after consideration of patient acceptability of a greasier product.

Action: Clinicians should be aware of this product discontinuation and make arrangements to switch patients to suitable alternatives.

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110 Comments to “Calcipotriol cream discontinued”

  1. Hi from New Zealand

    We have been advised now in 2016 that Daivonex is being discontinued!

    Absolutely gutted for all of the same reasons in these comments.

    Cheers

    Comment by Andrew NZ — May 2, 2016 #
    Reply

    1. @Andrew NZ,

      According to DermNet Nz it seems that the cream is discontinued and only ointment remains available with effect from July 2016. So, it seems like the same is happening in New Zealand now as happened here in the UK in 2011.

      Comment by Matthew Robinson — May 2, 2016 #
      Reply

  2. I just want to quickly add my story to this long list. I am 31 years old and have had severe psoriasis since the age of 13. I've tried all standard treatments (too many to list) as well as having been admitted to hospital on 3 occasions. I finally settled on Dovonex Cream after having previously dismissed Dovonex Ointment as ineffective and Dovobet as unsuitable for long term use due to recurring flare ups. Dovonex Cream was a life saver for me. Since it's discontinuation, I was placed on Dovonex ointment which resulted in repeated flare ups and no relief despite twice per day application (vs once per day with cream). I was then put back on Dovobet gel which is another of the supposedly suitable replacement therapies. Within 1 month of use I had a severe case of erythrodermic psoriasis and was rushed to A&E after passing out and falling in the shower. Whilst in hospital I was put on Humira which has been effective at treating the psoriasis but has resulted in a number of infections and very regular colds. I also worry about my long term health as a result of being on Humira due to it's immunosuppressive effects. I continue to be surprised and disappointed by the removal of Dovonex Cream from the market and feel that the Department of Health did not judge the situation acurately when this was approved for discontinuation.

    Comment by Thomas — November 1, 2015 #
    Reply

    1. @Thomas

      I sympathise with you predicament and I am sorry to hear you still have not found a suitable replaced for Dovonex cream in the last 4 years. To clarify though, the Department of Health played no part in this decision; the choice to stop making the product was made by the manufacturer for commercial reasons. They cannot be compelled to continue making the product by the NHS or the Department of Health.

      Comment by Matthew Robinson — November 1, 2015 #
      Reply

      1. Hi Matthew,

        Thanks for your reply. Is it not the case that an appropriate alternative must be available before a medicine can be withdrawn by the pharmaceutical company? For the Department of Health or NHS to play no part at all it must be the case that any medicine can be withdrawn with no analysis having been done on the impact of the withdrawal.

        I'd really appreciate you explaining this if possible.

        Comment by Thomas — November 7, 2015 #
        Reply

        1. @Thomas

          I don't work for the Department of Health, MHRA or a pharmaceutical company so I am not entirely certain of any arrangements for products being discontinued.

          However, I would say that, as I am aware, there are no consultations that I have ever been aware of about a product being taken off the market. Applications are made to place a product on the market or to extend its areas for use. Consultations are made when the regulations over product are being consider for change - such as relaxed or tighter regulation of sales. Safety analyses are sometimes conducted to restrict prescribing or remove items from the market. But in my time as a pharmacist I have never seen any consultation or analysis over a product being removed from the market for any other reason.

          Comment by Matthew Robinson — November 7, 2015 #
          Reply

    2. I just came across this thread when looking to see if Dovenex cream was available; I too found it the least antagonising topical treatment for psoriasis. I have been on biologics for 8 years now so have only needed topicals when I am transitioning between different ones so was late to find out about the discontinuation. I also wanted to comment on Humira and reassure Thomas that if Humira does not suit him another one might be more suitable as like lots of Psoriasis treatment, they do not work the same for everyone. Of course, which ever you take, it is extremely important to look after your general health when on immune suppressing treatments (get a flu jab, eat lots of fruit and vegetables, stay away from sick people and take special care of your oral health), but even though I too had lots of colds on Humira, I am now on Stelara, it is easy to forget how awful life is, and how the inflammation (that leads to psoriasis) is damaging your body inside and out. Biologics are much more targeted than systemic immune suppressing treatments like Methotrexate.

      Comment by Dani Kennedy — March 8, 2016 #
      Reply

      1. My son has been given methotrexate, it's severe on the immune system. Why Dovonex cream remains not manufactured is a mystery, it works even on the face. Surely it could be reinstated to save these strong drugs being given as only last attempt to help when there is something discontinued which clears psoriasis.

        Comment by Jeanette Walker — April 20, 2020 #
        Reply

    3. I think the cream is better than dovonex ointment. I have used both and the cream is much better.

      Comment by Jemima MacVicar — October 31, 2017 #
      Reply

    4. Hi Thomas,
      This is three years after you wrote but my suggestion is still valid.
      My psoriasis started when I was 35 and under severe stress. I started taking a 1000mg Royal Jelly capsule then and have done so since. After 3 months, my symptoms, admittedly on the milder side, disappeared and have not re-occurred. I found that, having come off the capsule for a period of time due to other reasons, they re-surfaced, so there is a three month lag in effectiveness.
      Royal Jelly is an allergen with some people so be careful but I suggest you try it to see if it relieves your symptoms.

      Comment by John Court — September 26, 2018 #
      Reply

  3. I was prescribed Calcipotriol ointment and was given a tube of Dovonex made by Leo in Bucks. Is this the same stuff people have trouble getting?

    Comment by Scott — June 25, 2014 #
    Reply

    1. @Scott,

      The issue is with the cream, the ointment is still widely available. Ointment is greasier and tends not to rub into the skin and disappear like a cream would.

      Comment by Matthew Robinson — June 26, 2014 #
      Reply

  4. Just been to Spain again on holiday & we drove down so weren't limited to space & weight. A good pharmacist got us 15 tubes of Daivonex (Dovonex) cream, cost about £450.
    Fortunately we can afford it, but most can't. We are entitled to free prescriptions, so this is an unecessary cost because Leo have withdrawn the product from the UK market. I suspect this is because the NHS will not pay for it!!!!
    While we were away we also found out it can be obtained in France, but only on prescription.
    What a crazy world to withdraw a really good product due to ecconmic reasons when so much money is wasted / lost by the NHS.

    Comment by mike digby — October 22, 2013 #
    Reply

    1. @Mike,

      I'm glad to hear you are at least getting supplies.

      The way the NHS drug reimbursement system works would mean that prescriptions for this cream would be paid for from NHS budgets provided it was licensed and available. In order to be refused for payment, medicines must be added to a list of products 'not to be ordered' more commonly called the black list. Neither calcipotriol or Dovonex are in that list so in theory at least would be paid. In practice this doesn't happen as the product cannot be sourced in the UK.

      So, just to be clear, the economic decision was made by the manufacturer and not the NHS.

      Comment by Matthew Robinson — October 23, 2013 #
      Reply

      1. So why have Leo withdrawn it? Is it greed? I can't see that Spain with their ecconomic crisis are prepared to pay more than the UK.
        I think that Lloyds pharmacy have a product that might be available which is similar & sourced from abroad. (Under their own brand name) My thoughts are that if this is 'C CREAM' under a different name, then Leo's license may have expired & someone else is making it.
        I haven't actually managed to pursue this lead, as I have been on holiday but if I can confirm this & it is true, UP YOURS Leo & great relief for thousands of UK suffers.

        Comment by mike digby — October 25, 2013 #
        Reply

    2. Hi
      Just back from Tenerife where you can buy it over the
      counter at any chemist it's called Daivonex there
      for about 30 euros 100g.

      Comment by Quin — December 2, 2013 #
      Reply

    3. I have had psoriasis for over 20 years and have used Dovonex and Dovobet. Here is a link to explain the difference between the two.

      http://psoriasisclub.org/showthread.php?tid=75

      I found personally that the Dovobet worked for me but unfortunately this is the one that contains the topical steroid, which has thinned my skin.
      I have also had PUVA treatment, through the hospital, which also worked, but unfortunately carries a small risk of skin cancer.

      This link will take you directly to the Leo Pharma page and lists the products they make.

      http://www.leo-pharma.co.uk/Home/Products-and-services/Our-products.aspx

      Also here is a link to the discontinued products by the Royal Pharmaceutical Society, where it states that Dovobet is still available in the 120g tube (6th October 2012).

      http://www.pjonline.com/discontinued_products

      I hope this is of help to people

      Comment by Jujul — January 24, 2014 #
      Reply

  5. I have just been to the doctors for get some more of the DOVONEX OINTMENT, however they were reluctant to do so, the nurse I spoke to rattled on about how each 30g tube cost the NHS £23 and I go through one a week. Eventually I got referred to a doctor who agreed the treatment as it has been successful for me in the past. I understand this is an expensive treatment, however if they didn't prescribe this and they do discontinue it, then they will be shelling out a lot more money to handle depression that would arise and most probably frequent hospital visits for tar treatments, which surely would all amount to much more than £23 a week.

    I have found my most successful technique for fast treatment is to:
    1. Moisturise with ZEROBASE emollient cream, as much as possible all day and night, e.g 8/10 times a day. (MOST IMPORTANT FOR ME)
    2. 1 x Morning and 1 x night application of DOVONEX OINTMENT
    3. Weekly visit to a tanning bed (without this, effectiveness is about halved.)

    This really will keep it at bay and clears up absolutely all flaking for me, sometimes though redness remains, however it's so unpredictable that sometimes I wonder what other factors affect P. Diet? Stress? Hormones? I'm sure its all linked, but we have no clear explanation!

    Comment by CeceLouise — April 26, 2013 #
    Reply

    1. @CeceLouise,

      I'm not sure where the nurse got the quoted price from but the Drug Tariff which is the agreed payment price to the dispensing pharmacy, April 2013 edition lists Calcipotriol Ointment 30g at £5.78 per tube based on the price for Dovonex. If you are using a tube per week then this would be approximately £23 per month.

      If this approach keeps your psoriasis under good control though I would described that as cost-effective and therefore an appropriate use of NHS resources.

      Comment by Matthew Robinson — April 26, 2013 #
      Reply

  6. I was convinced that it was the doctor wanting to make a saving until I did research into the withdrawal of the cream. My hands are very bad and I teach Computing - the cream was ideal as it sank into the skin quickly. The ointment is useless, absolutely useless for use on the hands as it just sits on the skin in a slimy mess. I am looking for an alternative but none appears to exist. Shame on the company.

    Comment by Stephen Bird — February 10, 2013 #
    Reply

    1. I'm in the same boat as everyone else on here. I've emailed the company three times only to be told the same thing: "IT'S BEEN DISCONTINUED". I had to tell my doctor this over a year ago as she wasnt aware of it, but she did manage to get me two tubes from somewhere else both now used up. I have really bad scalp psoriasis and I'm slowly being driven mad by 24 hour itching. I can't use ointments on my scalp because it clogs in my hair and its really hard to shampoo out. I am now on Methotrexate which I didn't really want to take as it has many side affects. For me it's the last resort and I have to say that after 4 months has not worked. I'll give it another two months and hope for the best. I also now use Doublebase which does shampoo off easier better than using ointments. My thoughts are with you all.

      Comment by Linda — February 16, 2013 #
      Reply

      1. Hi Linda,

        I suffer from scalp psoriasis too but Diprosalic scalp application works really well. Sorts it out in two days usually. Worth a go

        Comment by Gav — February 28, 2013 #
        Reply

        1. Highly recommend Diprosalic Scalp Appliation, I've been using it for 22 years and anytime I have a flare up it clears it within a week. Be warned the first couple of times you use it, it can sting as you have open cuts if you scratch. And use it directly after washing you hair, it is absorbed into your scalp with the water and does not make your hair look awful. It dries normally. At least that is my experience of it. I swear by it.

          Kelly

          Comment by Kelly — March 6, 2013 #
          Reply

        2. Highly recommend Diprosalic Scalp Appliation, I've been using it for 22 years and anytime I have a flare up it clears it within a week. Be warned the first couple of times you use it, it can sting as you have open cuts if you scratch. And use it directly after washing you hair, it is absorbed into your scalp with the water and does not make your hair look awful. It dries normally. At least that is my experience of it. I swear by it.

          Comment by Kelly — March 6, 2013 #
          Reply

      2. Hi, I have psoriasis on the scalp. Dead Sea shampoo from Holland and Barrett is good. Shampoo hair, leave on for 3 mins rinse off. If I change shampoo it comes back.

        Comment by Lizzy — June 13, 2013 #
        Reply

    2. Hi. My consultant said that after applying moisturiser, I should rub Dovonex ointment into the skin "with vigour", as this warms the skin and open the pores allowing the medicine to sink in more effectively. I always thought that it should be left to sink in. Anyway, I tried what the specialist recommended and rubbed it in thoroughly. This worked pretty well, leaving only a small amount of residue, so I was able to dress and not be stuck to my clothing!

      Comment by Tim — November 9, 2015 #
      Reply

  7. Hi All,

    I too am upset like you all. I have suffered with this for 21 years and although Dovonex cream didn't cure the problem it kept them at bay with no new ones appearing for years. Since last April my psoriasis have gotten really bad. My big plaques on my elbows and knees have quadrupled in size and now I have psoriasis on my hands, feet and face and ears for the first time ever! I am seriously fed up and it is getting me depressed. I no longer wear skirts, short sleeve tops and I itch all the time, with giant red, flaky legions. My skin looks like a join the dot childrens picture, basically not good. I spoke to my Doctor who is willing to get me a private prescription and appt costing £40, and boots are charging £17.22 for 60g tubes. It's expensive but now as I am ashamed of my body, I find it worthwhile. I hope some of you find this useful and can afford to do this occasionally. I suspect I will only do this once a month due to the cost, but this has to be better than them getting progressively worse as no other treatment works.

    Comment by Kelly — February 4, 2013 #
    Reply

    1. I am in the same position as you. With the Dovonex cream my psoriasis was red but not scaly and some areas had cleared completely. My scales are now coming back. The Dovonex ointment is horrible. It does work a bit and works better when mixed with a moistureiser so it absorbs into the skin. I wish I could find someone who makes a similar cream.

      Comment by Ally Stewart — March 20, 2013 #
      Reply

  8. I too am absolutely gutted that the cream has been discontinued. I don't understand how they can withdraw a product that is so effective for so many people. It's the only thing that worked on my skin, and now my psoriasis has come back in full force. The ointment is disgusting, and as I have the psoriasis all over my legs it is impossible to put the greasy ointment on in the morning and then get dressed. It's all sticky and slimy, like covering yourself in vaseline then putting clothes on, and it doesn't work as well either. I will be ringing the company after reading these comments and just hope that if enough of us do then they may change their minds. I'd like the people who made the decision to cover themselves in the ointment then go about their day, see how they get on.

    Comment by liz meadows — January 19, 2013 #
    Reply

  9. The Dovonex cream was ideal as it moisturised my skin, was absorbed easily and left no horrible greasy residue. I can't believe it's been withdrawn leaving the unctuous ointment (which I will be glad of no doubt but still..) Do these companies not do any form of customer research? The ointment might be cheaper to produce, but I bet not as many customers procure it as they would the cream. It's really quite upsetting to realise that treatment for our condition is only enabled so others can make money out of our misery. I don't know why I'm surprised but I had an optimistic if naive hope that drug companies actually cared!! More fool me.

    Comment by John Smith — January 3, 2013 #
    Reply

  10. My psoriasis started when I was 16 (inherited from my grandfather)at the age of 48 I had a heart attack, the medication that I was prescribed exacerbates the psoriasis and like you all I used to find that the cream was ideal for my purposes I now use Dovonex ointment in conjunction with E45 moisturiser and find that the ointment is more readily absorbed and does not leave so much of a grease feel. Not the ideal solution that I like but it does seem to do the trick, let us hope that our cries are heard and the pharmaceutical companies come up with a better treatment that allows us to function as near "normal" as possible.

    Comment by peter — November 30, 2012 #
    Reply

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