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Pimecrolimus
Pimecrolimus is a topical immunomodulator used to treat mild to moderate atopic dermatitis (eczema) in patients aged 2 years and older. It works by reducing inflammation and suppressing the immune response that causes eczema flare-ups. Pimecrolimus is often prescribed as an alternative to topical corticosteroids for managing eczema without the risks of skin thinning or long-term side effects associated with steroids.
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Frequently Asked Questions
How long does it take for Pimecrolimus to start working?
Improvements in symptoms may be seen within one week, but it may take up to several weeks for significant relief from eczema flare-ups.
Can I use Pimecrolimus long-term?
Pimecrolimus is intended for short-term or intermittent use during eczema flare-ups. It is not recommended for long-term continuous use due to the potential risks, such as lymphoma or skin cancer.
Can Pimecrolimus be used on the face?
Yes, pimecrolimus can be safely used on the face, including sensitive areas like the eyelids. However, avoid applying it near the eyes, nose, or mouth.
What should I do if I miss a dose?
Apply the missed dose as soon as you remember, but if it is almost time for your next dose, skip the missed dose. Do not apply extra cream to make up for a missed dose.
Can children use Pimecrolimus?
Yes, pimecrolimus is approved for children aged 2 years and older. It is often prescribed as an alternative to steroids for long-term eczema management in pediatric patients.
Comprehensive Drug Guide
How Does Pimecrolimus Work?
Pimecrolimus works by inhibiting calcineurin, an enzyme that activates T-cells in the immune system. By suppressing T-cell activity, it reduces the production of inflammatory cytokines, which helps control eczema symptoms such as redness, itching, and swelling. Unlike topical steroids, it does not cause skin thinning.
Common Dosages
- Topical cream: 1%
Typical Dosing
- Apply a thin layer of pimecrolimus cream to the affected area twice daily.
- Use the cream only during active flare-ups and stop when the symptoms have resolved. It is not meant for continuous, long-term use.
Typical Dosing
FDA Approved Indications
Mild to moderate atopic dermatitis (eczema) in patients aged 2 years and older who do not respond adequately to, or are intolerant of, topical corticosteroids.
Who Shouldn't Take Pimecrolimus?
- Known hypersensitivity to pimecrolimus or any of the ingredients in the formulation.
- Active viral skin infections, such as herpes simplex or varicella (chickenpox).
- Immunocompromised patients unless advised by a healthcare provider.
Advice From The Pharmacist
- Pimecrolimus is for topical use only; do not ingest or apply it to the eyes, nose, or mouth.
- Wash hands thoroughly after applying the cream unless the hands are the treatment site.
- Avoid sunlight or UV exposure (e.g., tanning beds) on treated areas, as pimecrolimus can make the skin more sensitive to the sun.
- If your skin condition does not improve after 6 weeks of use, consult your healthcare provider.
Side Effects of Pimecrolimus
Common Side Effects
- Burning or warm sensation at the application site
- Itching
- Redness
- Headache
Uncommon/Severe Side Effects
- Increased risk of skin infections
- Lymphoma or skin cancer with prolonged use (although this is still being studied)
- Severe allergic reactions (rash, swelling, difficulty breathing)
Risks and Warnings of Pimecrolimus
- Infection Risk: Pimecrolimus may increase the risk of skin infections, particularly if applied to areas of skin that are open or damaged. Do not use on infected areas of skin.
- Lymphoma and Skin Cancer Risk: There have been reports of rare cases of lymphoma and skin cancer in patients using pimecrolimus. Although a direct link is not proven, it is recommended to use the cream for short-term treatment only.
- Sun Sensitivity: Pimecrolimus-treated skin may be more sensitive to sunlight, increasing the risk of sunburn. Use sunscreen and wear protective clothing when outdoors.
Interactions with Pimecrolimus
Common Drug Interactions
- Topical corticosteroids: When used together, there may be an increased risk of skin irritation.
Phototherapy: Using pimecrolimus with light therapy may increase sensitivity to UV light and should be avoided unless directed by a healthcare provider.
Alternatives to Pimecrolimus
- Tacrolimus (Protopic®): Another topical calcineurin inhibitor used for atopic dermatitis.
- Hydrocortisone: A mild topical corticosteroid for eczema and other inflammatory skin conditions.
- Clobetasol propionate: A potent topical corticosteroid for more severe cases of eczema.
- Crisaborole (Eucrisa®): A non-steroidal topical treatment for mild to moderate atopic dermatitis.
