Plaque Psoriasis Drugs

Synthetic vitamin D3, binds to vitamin D receptor and inhibits keratinocyte proliferation and differentiation

applied topically once or twice daily

initial improvements seen within 2 weeks, but may take 6-8 weeks for full effect, no more than 100g per week

calineurin inhibitors, blocks synthesis of inflammatory cytokines

topically applied twice daily

used off label, good for thinner skin, black box warning for developing malignancies

synthetic retinoid, prodrug. It normalizes abnormal keratinocyte differentiation, lowers hyperproliferation, and lowers expression of inflammatory markers.

applied topically once daily

Pregnancy category X, takes 8-12 weeks to see effect

Used in short contact anthralin therapy (SCAT)

topically applied once daily in the evening

Apply small amount to thick lesions, wash off after 20-30 minutes.

phosphodiesterase 4 inhibitor

Topically applied once daily

used in patients 12 years old or older, can cause diahreah, headache, insomnia, use with caution with CYP3A4 inhibitors

aryl hydrocarbon receptor agonist, specific MOA unknown

applied topically once daily

Can cause folliculitis, inflamation of hair follicles, and headache.

competitive inhibition of dihydrofolate reductase, which inhibits proliferation of lymphoid tissue and supresses secretion of inflammatory cytokines.

orally administered once weekly

many systemic side effects and pregnancy category X

phosphodiesterase 4 inhibitor, resulting in anti-inflammatory effect.

Orally taken twice daily

less side effects than methotrexate and less lab testing, but must avoid use of CYP450 inhibitors.

calceneurin inhibitor

orally taken twice daily

many side effects, bad for kidneys and blood pressure, lots of monitoring, and is a CYP3A4 substrate and inhibitor

Oral retinoid (vitamin A derivative)

pregancy category X

oral tyrosine kinase 2 (TYK2) inhibitor