How does this medication work? What will it do for me?

Pimecrolimus cream is used to treat skin conditions such as atopic dermatitis or eczema for people 2 years of age and older with normal immune systems. It is used in mild to moderate cases, on a short-term or intermittent long-term basis. It is used when standard treatments have not worked or if there is a reason they cannot be used.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each g of cream contains pimecrolimus 10 mg (1%). Nonmedicinal ingredients: benzyl alcohol, cetyl alcohol, citric acid, mono- and di-glycerides, oleyl alcohol, propylene glycol, sodium cetostearyl sulfate, sodium hydroxide, stearyl alcohol, triglycerides, and water.

How should I use this medication?

Pimecrolimus cream is applied as a thin layer to the affected skin area(s) twice daily (about 12 hours apart). This medication can be applied to all affected areas of your skin, including your face and neck. Pimecrolimus should not be used continuously for a prolonged period of time. Stop using the cream after the symptoms of dermatitis have cleared, unless your doctor advises you otherwise.

Avoid contact with eyes. If your hands are not being treated, be sure to wash your hands with soap and water after applying this medication.

Do not cover the treatment area with bandages, dressings, or wraps that do not breathe. Do not bathe, shower, or swim right after applying this medication, as this could wash off the medication. Before you apply this medication after taking a bath or shower, be sure your skin is completely dry. Do not use pimecrolimus cream in your nose, eyes or mouth.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

This medication usually begins to provide relief from the symptoms of eczema within one week of use. If you do not notice an improvement in symptoms within the first 3 weeks of use, or if your eczema seems to be getting worse, you should stop using this medication and contact your doctor.

This medication is for external use only. Do not take it by mouth.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose of this medication, apply it as soon as possible and continue with your regular schedule. If it is almost time for the next application, skip the missed dose and continue with your regular schedule. Do not apply a double amount to make up for a missed dose. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of reach of children. Discard any cream that remains in the tube more than 12 months after opening the tube.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use pimecrolimus cream if you:

  • are allergic to pimecrolimus or any ingredients of the medication
  • are under 2 years of age
  • have reduced immune function (e.g., people with AIDS, transplant recipients taking anti-rejection medications)
  • have a skin infection in the area that needs to be treated

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • blemishes on the skin
  • burning feeling or a sensation of warmth at the site of application (usually mild to moderate and temporary, or if severe and persists for more than 1 week)
  • itching or redness of skin (mild)

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

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

  • flu-like symptoms (e.g., runny stuffy nose, chest congestion, cough, fever)
  • headache (with long term continual use)
  • herpes skin infections (cold sores, chickenpox, shingles)
  • nose and throat infection
  • skin discoloration
  • skin rashes or hives
  • skin warts

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Eyes: This medication should not be used in the eye. If it comes in contact with your eye(s), flush with plenty of water and call your doctor.

Immune system: This medication should not be used by people who have problems with their immune system. If you have an immune condition or are taking medication to reduce the activity of your immune system, discuss with your doctor whether to continue using pimecrolimus cream, how this mediation may affect your medical condition and whether any special monitoring is needed.

Medical conditions: Do not use this medication if you have Netherton's syndrome (a rare, inherited skin disorder).

Skin infections: Do not apply this medication to skin that is infected (e.g., chickenpox, cold sores, shingles, bacterial). If you develop skin infections while using this medication, contact your doctor immediately.

Sunlight: Avoid natural or artificial exposure to sunlight while using this medication. Use appropriate sun protection:

  • avoid tanning beds and sunlamps
  • stay out of direct sunlight between 10 am and 3 pm when possible
  • wear protective clothing, sunglasses, and a hat
  • use sunscreen cream and lip balm with sun protection factor (SPF) of at least 15

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while using this medication, contact your doctor immediately.

Breast-feeding: It is not known if pimecrolimus passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: Pimecrolimus cream is not recommended for children under 2 years of age, as there is a higher risk of side effects for this age group. The effects of this medication on the developing immune system are unknown.

What other drugs could interact with this medication?

When applied to a large area of the body, there may be an interaction between pimecrolimus and any of the following:

  • alcohol
  • anticancer medications (e.g., cyclophosphamide, cytarabine, etoposide, vincristine)
  • anti-HIV medications (e.g., delavirdine, indinavir, lopinavir, ritonavir, saquinavir)
  • aprepitant
  • "azole" antifungals (e.g., fluconazole, itraconazole, ketoconazole)
  • bicalutamide
  • boceprevir
  • conivaptan
  • dasatinib
  • diltiazem
  • grapefruit juice
  • imatinib
  • immunosuppressant medications (e.g., cyclosporine, mycophenolate, sirolimus, tacrolimus)

  • macrolide antibiotics (e.g., clarithromycin, erythromycin)
  • medications applied to the skin (e.g., tretinoin)
  • monoclonal antibodies (e.g., infliximab, rituximab)
  • nefazodone
  • oral corticosteroid medications (e.g., dexamethasone, hydrocortisone, prednisone)
  • topical corticosteroid medications (e.g., beclomethasone, hydrocortisone, mometasone)
  • verapamil

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.