Planex Plus Ointment

Indications

Planex Plus is a topical ointment designed for the effective treatment of plaque-type psoriasis vulgaris that is responsive to topical therapies. The Planex Plus topical suspension is specifically formulated for managing plaque psoriasis on both the scalp and body.

Note: Always use this medication under the guidance of a registered healthcare professional.

Pharmacology

Betamethasone Dipropionate is a highly potent corticosteroid that acts topically, providing immediate, significant, and lasting anti-inflammatory, antipruritic, vasoconstrictive, and immunosuppressive effects. While it alleviates symptoms, it does not cure the underlying condition. Its effectiveness can be significantly enhanced in occlusive environments, increasing the penetration of the stratum corneum by approximately tenfold.

Calcipotriol, a non-steroidal antipsoriatic derived from vitamin D, mimics the effects of vitamin D by competing for the 1,25(OH)₂D₃ receptor. It is equally potent as the natural active form of vitamin D in regulating cell proliferation and differentiation but is less impactful on calcium metabolism. Calcipotriol encourages the differentiation of keratinocytes while suppressing their proliferation without cytotoxic effects, thereby reversing the atypical keratinocyte changes associated with psoriasis. The therapeutic aim is to restore normal epidermal growth.

Dosage & Administration

Topical Ointment: This ointment is for topical application only. The phototoxic effects in psoriasis patients have not been studied. It is advisable to shield treated areas from direct sunlight and UV light when possible.

• Adults: Apply the ointment to the affected area once daily. The total daily dosage should not exceed 15 grams, and the weekly limit is 100 grams. Treat no more than 30% of the body surface area. Usage should be intermittent over a year, under strict medical supervision, with recommended treatment durations of up to four weeks, alternating with one month of Calcipotriol monotherapy as needed.
• Children: The use of this ointment is not recommended for individuals under 18 years.

Topical Suspension: Apply the necessary amount of suspension spray to affected areas once daily, gently massaging it in with your fingertips. Treatment may last for up to 8 weeks, but can be stopped earlier if symptoms resolve. The maximum weekly dosage should not exceed 100 grams. Shake well before use. This topical suspension is not intended for oral, ophthalmic, or intravaginal application.

Note: Always use this medication under the guidance of a registered healthcare professional.

Interaction

There may be additive adverse effects when combined with other steroid treatments.

Contraindications

The use of preparations containing Betamethasone and Calcipotriol is contraindicated in patients with a known hypersensitivity to any of its components, those with disorders related to calcium metabolism, or individuals with severe renal insufficiency or hepatic disorders.

Side Effects

Common adverse reactions include folliculitis and a burning sensation of the skin.

Pregnancy & Lactation

Currently, there are no adequate and well-controlled studies in pregnant women. The ointment or suspension should only be used during pregnancy if the benefits outweigh the potential risks to the fetus. Systemically administered corticosteroids can be transferred into human milk, potentially affecting growth and interfering with endogenous corticosteroid production. It remains unclear if topically administered calcipotriene or corticosteroids can reach sufficient levels in breast milk to cause effects. Caution is advised when administering Calcipotriol and Betamethasone ointment or suspension to nursing mothers.

Precautions & Warnings

Reports of hypercalcemia and hypercalciuria have been noted; if either occurs, discontinue use until calcium metabolism normalizes. Topical corticosteroids may lead to reversible suppression of the hypothalamic-pituitary-adrenal (HPA) axis, Cushing’s syndrome, or unmasking of latent diabetes. The risk of adrenal suppression increases with treatment duration. Systemic absorption may necessitate evaluation for HPA axis suppression, and adjustments should be made if this develops. Using potent corticosteroids on large areas, for extended periods, or under occlusion may heighten systemic absorption risks. Local side effects can include skin atrophy, striae, irritation, acneiform eruptions, hypopigmentation, and allergic contact dermatitis, particularly with occlusive use or stronger corticosteroids. The use of this ointment is not recommended on the face, axillae, groin, or in areas where skin atrophy is present. Children may be more susceptible to systemic side effects from topical corticosteroids.

Therapeutic Class

Betamethasone & Combined Preparations

Storage Conditions

Store in a cool, dry place (below 25ºC) and protect from light. Do not refrigerate. Keep out of reach of children.