Examples
| pimecrolimus |
Elidel |
| tacrolimus |
Protopic |
Topical medicines are put directly on the skin. Tacrolimus is
an ointment, and pimecrolimus is a cream. Both medicines are applied
only to skin affected by atopic dermatitis.
How It Works
Calcineurin inhibitors block the
inflammation process, which is part of the body's
immune response. This can relieve itching and improve
the rash of
atopic dermatitis. They are a type of
immunosuppressant, a medicine that decreases the effects of your body's
immune system.
Why It Is Used
Topical calcineurin inhibitors may be used
when conventional treatment (such as with
corticosteroids) is not possible or unsuccessful.
Calcineurin inhibitors are used on sensitive skin, such as the face
and eyelids, where corticosteroids are avoided. Calcineurin
inhibitors are used for short-term treatment of
moderate atopic dermatitis. Calcineurin
inhibitors are used in people age 2 and older with a healthy
immune system. Short-term treatment may be
repeated with breaks in between.
How Well It Works
Both pimecrolimus and tacrolimus have been shown to be effective for use in atopic dermatitis. Most patients have much less itching within 3 days of starting treatment, and they feel much better.1
Side Effects
A common side effect of topical calcineurin inhibitors is a
burning and itching that goes away after the first few days of treatment. Less
common side effects include
acne, headache, increased sensitivity of the skin to
hot and cold temperatures, and flu-like symptoms.
Topical calcineurin inhibitors are relatively
new, and long-term side effects are not fully known.
The U.S.
Food and Drug Administration (FDA) recommends caution when prescribing or using
pimecrolimus cream and tacrolimus ointment because of a
potential cancer risk. Rare cases of cancer have been reported in
people using pimecrolimus and tacrolimus. The FDA also stresses
that these medicines only be used as directed and only after trying other
treatment options. Talk to your doctor about whether these products are right
for you or your child.
See Drug Reference for a full list of side effects. (Drug Reference
is not available in all systems.)
What To Think About
There is not adequate information on the use of calcineurin
inhibitors in pregnant or breast-feeding women. Talk to your doctor if you are breast-feeding, pregnant, or planning to become
pregnant.
Calcineurin inhibitors make your skin more sensitive to light.
After using calcineurin inhibitors, avoid sunlight and sunlamps and treatment
with ultraviolet light. If you need to be outside after using calcineurin
inhibitors, wear loose-fitting clothing that protects the treated skin from the
sun.
Unlike topical corticosteroid medicine, topical calcineurin
inhibitors do not thin the skin.
Calcineurin inhibitors are typically used in combination with
preventive measures, such as moisturizing your skin and avoiding skin
irritants.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
References
Citations
-
American Academy of Allergy, Asthma and Immunology (2004). Disease management of atopic dermatitis: An updated practice parameter. Annals of Allergy, Asthma and Immunology, 93: S1–S28. Available online: http://www.aaaai.org/professionals/resources/pdf/atopic_derm2004.pdf.
Credits
|
By
|
Healthwise Staff |
|
Primary Medical Reviewer
|
Adam Husney, MD - Family Medicine |
|
Specialist Medical Reviewer
|
Amy McMichael, MD - Dermatology |
|
Last Revised
|
April 17, 2012 |
American Academy of Allergy, Asthma and Immunology (2004). Disease management of atopic dermatitis: An updated practice parameter. Annals of Allergy, Asthma and Immunology, 93: S1–S28. Available online: http://www.aaaai.org/professionals/resources/pdf/atopic_derm2004.pdf.