In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For Dovonex, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to Dovonex or to other ingredients of the preparation, which you may find listed on the label. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Dovonex has not been studied in pregnant women. However, studies in animals have shown that Dovonex taken in high doses by mouth causes problems in the mother and the fetus, including birth defects. Before using Dovonex, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding - It is not known whether Dovonex passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are using Dovonex and who wish to breast-feed should discuss this with their doctor.

Children - Dovonex has been tested in a limited number of children 2 to 14 years of age with psoriasis on less than 30% of the body. When used for 8 weeks or less, the medicine has not been shown to cause different side effects or problems than it does in adults. However, more studies are needed.

Older adults - Skin-related side effects caused by Dovonex may be more severe when they occur in patients over 65 years of age.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking or using any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other medical problems - The presence of other medical problems may affect the use of Dovonex. Make sure you tell your doctor if you have any other medical problems, especially:

Highly irritated areas of psoriasis on the scalp-Dovonex topical solution may increase the skin irritation because of the alcohol in the product
Hypercalcemia (high blood levels of calcium) or
Hypercalciuria (high urine levels of calcium) or
Hypervitaminosis D (high blood levels of vitamin D)-You should not use Dovonex. It may increase the chance of kidney stone formation
Kidney stones (or history of) - Dovonex may make this condition worse

Proper Use of Dovonex

Dovonex is for external use only. Do not use Dovonex orally and do not apply it in your vagina. Use Dovonex only as directed. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

To help clear up your skin problem completely, it is very important that you keep using Dovonex for the full time of treatment. Do not miss any doses.

Unless otherwise directed by your doctor, do not use more than 100 grams of Dovonex ointment or cream in 1 week (that is, one 100-gram tube or three 30-gram tubes or six 15-gram tubes in 1 week). Do not use more than 60 milliliters of the topical solution for the scalp in 1 week.

Do not use Dovonex on your face, near the eyes, inside your nose or mouth, or on unaffected areas of the skin. If you accidentally get some on these areas, wash it off with water right away.

Use Dovonex sparingly in the folds of your skin because it is more likely to cause irritation there.

Wash your hands after using Dovonex to avoid accidentally getting the medicine on your face or on unaffected areas of the skin. Do not use Dovonex for treating skin problems other than the one for which it was prescribed by your doctor.

For cream and ointment dosage forms:

Apply enough medicine to cover the areas of your skin affected by psoriasis and rub in gently and well. The treated areas should not be covered (for instance, with a bandage or plastic wrap) after the medicine is applied.
If you are being treated with Dovonex ointment in combination with ultraviolet light (found in sunlight and some special lamps), do not apply the morning dose of Dovonex before being treated with the ultraviolet light. It can be applied afterwards.

For solution dosage form:

Before applying the medicine to your scalp, comb your dry hair to remove any flakes, then part your hair so that you can see the scalp lesions. Apply the solution to the lesions and rub it in gently but completely. Do not apply the medicine if the lesions are very irritated because the alcohol in the product may make the irritation worse. Try not to get any medicine on your forehead.

Dosing

Follow your doctor's orders or the directions on the label. The following information includes only the average dose of Dovonex. If your dose is different, do not change it unless your doctor tells you to do so. The length of time you use the medicine depends on the severity of your psoriasis.

For topical dosage form (cream):
For psoriasis:
Adults - Apply to the affected area(s) of the skin two times a day, in the morning and evening. Treatment may be continued for six to eight weeks or as determined by your doctor.
Children - Use and dose must be determined by your doctor.
For topical dosage form (ointment):
For psoriasis:
Adults - Apply to the affected area(s) of the skin one or two times a day, in the morning and evening. Treatment may be continued for six to eight weeks or as determined by your doctor.
Children - Use and dose must be determined by your doctor.
For topical dosage form (solution):
For psoriasis:
Adults - Apply to the affected area(s) of the scalp two times a day, in the morning and evening. Treatment may be continued for six to eight weeks or as determined by your doctor.
Children - Use and dose must be determined by your doctor.

Missed dose

If you miss a dose of Dovonex, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

To store Dovonex:

Keep out of the reach of children.
Store away from heat and direct light.
Keep the medicine from freezing. Do not refrigerate.
Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.
Keep the topical solution away from open flame.

Precautions While Using Dovonex

Dovonex may cause irritation of the affected area(s) of your skin for a short time after you have applied it. Sometimes it may also cause irritation of the surrounding normal skin. If this happens, try not to scratch the area.

If the irritation continues, if you develop rash on your face, or if the medicine causes any other problems for you, stop using the medicine and check with your doctor.

You may have to see your doctor regularly while using Dovonex so that your doctor can check for any side effects, especially an increase in the level of calcium in your blood or urine, because this may lead to kidney stone formation.

Dovonex may cause your skin to be more sensitive to sunlight than it is normally. Exposure to sunlight, even for brief periods of time, may cause a skin rash, itching, redness, or other discoloration of the skin, or a severe sunburn. When you begin taking Dovonex:

Stay out of direct sunlight, especially between the hours of 10:00 a.m. and 3:00 p.m., if possible Wear protective clothing, including a hat. Also, wear sunglasses. Apply a sun block product that has a skin protection factor (SPF) number, especially if you have a fair complexion. If you have any questions about this, check with your health care professional Do not use a sunlamp or tanning bed or booth. If you have a severe reaction from the sun, check with your doctor.

Your doctor may tell you when you should expect to notice an improvement in your condition (usually within 2 to 8 weeks). If your condition has not improved by then or if it becomes worse, check with your doctor.

Side Effects of Dovonex

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

More common Redness and swelling of skin with itching; skin rash; worsening of psoriasis, including spreading to the face and scalp

Rare - for ointment dosage form only Abdominal or stomach pain, constipation, depression, loss of appetite, loss of weight, muscle weakness, nausea, thirst, tiring easily, and vomiting; burning, itching, and pain in hairy areas; pus in the hair follicles; thinning, weakness, or wasting away of skin

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

More common
Burning, dryness, irritation, peeling, or redness of skin

Less common or rare-for cream and ointment dosage forms only Darkening of treated areas of skin