Enstilar

Enstilar is used for the treatment of psoriasis vulgaris.

Can I buy Enstilar online?

The Online Clinic can prescribe Enstilar online for psoriasis following an online assessment by one of our GPs. Please complete an online consultation form to begin.

What is Enstilar?

Enstilar is an antipsoriatic medicine. It contains two active ingredients – calcipotriol (50 micrograms) and betamethasone (0.5 mg). Calcipotriol is a synthetic vitamin D3 product and betamethasone dipropionate is a strong synthetic corticosteroid.

Psoriasis is an inflammatory skin condition that causes skin cells known as keratinocytes to multiply excessively and, because they are produced too rapidly, the production of abnormal keratinocytes. This leads to the characteristic raised, dry, red areas of skin (plaques) with silver scales that can be itchy and painful.

In people with psoriasis, application of vitamin D inhibits keratinocytes from multiplying and promotes their differentiation into keratinocytes, thus normalising keratinocyte production; corticosteroids inhibit the body’s immune (defence) system, thus reducing inflammation. Calcipotriol combined with betamethasone produces a medicine with greater anti-proliferative and anti-inflammatory effects than if either of the two ingredients were acting alone.

How to use Enstilar

Enstilar is a foam that is applied by spraying directly and only on to the site of skin with psoriasis. The can is shaken before spraying at a distance of 3 cm or more from the skin. The can must not held horizontally when spraying. Spraying for two seconds (delivering approximately 0.5 g) should cover an area approximately equivalent to an adult’s hand. The foam is then massaged gently into the skin. Unless treating the hands, then wash your hands to prevent getting the foam on other regions of the body. Leave the treated area uncovered, and avoid bathing immediately after application.

Do not apply the foam to the face or genitals due to their sensitivity to steroids, or to mucous membranes, under skin folds (e.g., armpits, under breasts, and groin), or damaged skin because more of the medicine will be absorbed. Additionally, you should avoid too much sunbathing and exposure to light treatment such as sunbeds, because your skin is photosensitive.

Your doctor will tell you how much, how often and how long to use it. Usually, this is once a day for 4 weeks. The total daily calcipotriol dose must not exceed 15 g, and it should not be used on more than 30% of the body. Do not discontinue the treatment without consulting your doctor, especially after using it over a long time period.

Who can use Enstilar?

All people over the age of 18 years can use Enstilar.

Do not use Enstilar if you have an allergic reaction to calcipotriol or betamethasone or any of this medicine’s ingredients (the ingredient butylhydroxytoluene can cause skin reactions or irritation at the application site); have erythrodermic or pustular psoriasis; or abnormal blood calcium levels. You also should not use this medicine if you have a skin infection caused by a virus, fungus, bacterium, or parasite; tuberculosis; dermatitis around the mouth; acne; rosacea; ichthyosis (dry, fish-like scaly skin); or skin that is thin or with stretch marks ulcers or wounds. Your doctor must be told if you have diabetes or guttate psoriasis.

Notify your doctor about all your other medicines, including those taken currently, recently, and in the future. Especially mention any products containing steroids.

Take your doctor’s advice about whether to use Enstilar if you are pregnant, may be pregnant, planning pregnancy, or breast-feeding. If breastfeeding while using Enstilar, avoid applying the foam to the breasts.

Enstilar side effects

Stop treatment and contact your doctor immediately if you become hypersensitive to Enstilar, with symptoms such as skin rash, swelling of the skin, face, mouth/throat, or breathing problems. Also contact the doctor if you get a skin infection (treatment may need to be stopped), you get blurred vision or visual disturbances (this is rare), or fluctuating blood calcium levels. Due to the betamethasone, if do not use Enstilar as directed (i.e., you use it for a long time, on large area, under dressings, or under skin folds), you may experience symptoms of excess calcium (e.g., constipation, frequently passing urine, weak muscles, and confusion), poor adrenal gland functioning, sight problems (e.g., poor night vision and light sensitivity), infections, blood sugar level fluctuations, and pustular psoriasis – again, seek medical help if you notice any of these symptoms.

Uncommonly, you may experience a psoriasis ‘flare up’ (once treatment has stopped), skin irritation (with redness, itching, burning/stinging), folliculitis (red, painful or swollen at the hair base), and skin colour loss. Other effects include skin thinning or light sensitive, stretch marks, noticeable blood vessels under skin, hair growth, redness surrounding the mouth (perioral dermatitis), and worsening psoriasis.