5-Fluorouracil and Calcipotriol

Patient Information: 5-Fluorouracil and Calcipotriol Compound for Actinic Keratoses Management

Understanding Actinic Keratoses (AK):

Actinic keratoses are rough, scaly patches on the skin caused by long-term sun exposure. They are often considered precancerous lesions and can develop into skin cancer if left untreated. Actinic keratoses commonly appear on sun-exposed areas such as the face, ears, scalp, neck, forearms, and backs of hands. While actinic keratoses are typically harmless, it’s essential to treat them to prevent potential progression to skin cancer.

Introduction to Treatment with 5-Fluorouracil and Calcipotriol Compound:

5-fluorouracil (5-FU) is a medication that inhibits the growth of abnormal skin cells, including those found in actinic keratoses. Calcipotriol is a synthetic form of vitamin D that helps regulate cell growth and differentiation. When combined, 5-FU and calcipotriol work synergistically to target and eliminate abnormal skin cells while promoting healthy cell turnover. The combination therapy allows the treatment to be completed in a shorter time frame than the usual treatment with 5-fluorouracil alone. The two creams can be purchased separately or compounded together at select compounding pharmacies.

Where to get the medication:

This medication can be compounded by a compounding pharmacy. Or you will be provided two seperate scripts and Efudix and Calcipitriol and you can mix them together half and half.

For the compounded option – The following pharmacies will deliver the medication to your address.

CustomMed Pharmacy – Randwick – 9326 6515 or email your script to info@custommed.com.au

Compounded – Alexandria – (02) 9693 2313 or email your script to orders@compoundedmedication.com.au

Administration and Application:

  1. Preparation: Wash your face with warm water. Avoid soap, only gentle soap free cleansers. Pat dry the skin. Wait until the skin is completely dry before applying.
  2. Application: Use the compounded cream to Mix 50% Efudix (5-FU) and 50% Calcipitriol and apply a thin layer to the skin. Use a clean finger, or cotton bud.
    • Actinic keratoses on face, chest and scalp – twice daily for 4 days
    • Actinic keratoses on the lip – twice daily for 2 days
    • Actinic keratoses on the hands, forearms or legs – twice daily for 6 days
  3. Do NOT apply a dressing over the top.
  4. Wash hands after application
  5. Skin Reactions: You may experience redness, burning, itching, and peeling of the skin during treatment. These are common side effects and usually indicate that the medication is working. However, if you experience severe discomfort or blistering, contact your dermatologist immediately.

Precautions and Considerations:

  1. Sun Protection: While undergoing treatment, it’s crucial to protect your skin from further sun damage by wearing protective clothing, hats, and sunscreen with a high SPF.
  2. Avoiding Eye Contact: Be careful to avoid getting the medication near your eyes, mouth, or mucous membranes. If accidental contact occurs, rinse thoroughly with water.
  3. Pregnancy and Breastfeeding: Inform your dermatologist if you are pregnant, planning to become pregnant, or breastfeeding, as the safety of this medication during pregnancy and breastfeeding is not well established.
  4. Timing: Apply the cream in the morning and 1-2 hours before going to bed.

Managing side effects and after care:

  1. Cool compresses: Use cool compresses for inflamed and irritated skin.
  2. Paracetamol: Use paracetamol 1g, 4 times a day if uncomfortable
  3. Gentle skin care: Use soap free wash only, and a plain emollient such as Dermeeze ointment, Aquaphor ointment, Vaseline.
  4. Normal Saline Soaks: 1/2 tsp salt in 1 cup of boiled water, allow it to cool down and keep in the fridge. Soap a cotton pad in the saline and rest on the skin for 5-10mins a day.
  5. Follow-Up Visits: Your dermatologist will schedule regular follow-up visits to monitor your progress and assess the response to treatment. If the skin is very inflamed, painful, ulcerating or crusted, please contact me for a review.
  6. Continued Sun Protection: Even after completing treatment, it’s important to continue practicing sun protection measures to prevent the recurrence of actinic keratoses and reduce the risk of skin cancer.

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