Tacrolimus (topical)

  • Tacrolimus ointment is for external use only and should be applied thinly to the affected area(s) of skin.
  • If you have a skin infection do not apply topical tacrolimus to these areas of skin.
  • Treatment should be continued until the eczema has cleared. An improvement is usually seen within one week, but if there has not been an improvement after two weeks you should see your doctor again.
  • If you drink alcohol whilst using tacrolimus ointment, your skin or face may become flushed or red, and feel hot.
Type of medicine Topical immunosuppressant
Used for Moderate to severe eczema in adults or children over 2 years of age
Also called Protopic®
Available as Ointment

Tacrolimus helps reduce inflammatory reactions. When it is applied topically (onto the skin), it reduces the symptoms of eczema such as inflammation, redness and itching. Tacrolimus ointment is used for moderate to severe eczema in people who have not been able to use other treatments such as steroid creams or ointments.

Before using topical tacrolimus make sure your doctor or pharmacist knows:

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you have swollen lymph glands or a weakened immune system.
  • If you have liver problems.
  • If you have skin cancer.
  • If you have an inherited skin barrier disease such as Netherton's syndrome.
  • If you have generalised erythroderma (inflammation, reddening and scaling of your entire skin).
  • If you have ever had an allergic reaction to tacrolimus or any other medicine, especially the antibiotics erythromycin, clarithromycin, azithromycin and telithromycin.
  • If you are taking any other medicines, including those available to buy without a prescription, herbal and complementary medicines.
  • Before starting this treatment, read the manufacturer's printed information leaflet from inside the pack.
  • Apply this ointment exactly as your doctor has told you.
  • Tacrolimus should be applied thinly to the affected area(s) of skin. Do not apply it to any area that could be infected.
  • Wash your hands after using tacrolimus ointment unless your hands are also being treated.
  • If you forget to apply the ointment, apply it as soon as you remember and then continue as before.
  • Try avoid getting the ointment near your eyes or the inside of your nose or mouth. If the ointment does get on these areas, wipe it off straight away.
  • Do not cover any treated areas with bandages or plasters.
  • You may use moisturising creams and lotions whilst you are being treated with tacrolimus, but do not apply them for two hours after you have applied tacrolimus ointment.
  • You should expect to see some improvement within one week. If however your symptoms have not improved after two weeks, you should see your doctor again.
  • You should continue using this ointment until your eczema has cleared. Depending on your skin's improvement, your doctor may ask you to reduce how often you apply the ointment or may give you a lower strength of ointment.
  • While you are using tacrolimus and for a few weeks after you stop treatment, do not have any immunisations. This is because tacrolimus lowers your body's resistance to infection and there is a chance that you may get an infection from the vaccine.
  • You should protect yourself from strong sunlight while you are using tacrolimus ointment. Do not use sun beds.
  • Whilst you are using tacrolimus ointment, drinking alcohol may cause your skin or face to become flushed or red, and feel hot.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Very common side-effects - these affect more than 1 in 10 people who use this medicine What can I do if I experience this
Skin irritation, a burning sensation, itching These symptoms are usually mild to moderate and generally disappear within one week
Common side-effects - these affect less than 1 in 10 people who use this medicine What can I do if I experience this
Redness, feeling of warmth, pain, increased skin sensitivity to heat and cold, tingling, rash, inflamed or infected hair follicles and cold sores Speak to your doctor or pharmacist if any of these continue or become troublesome

If you experience any other symptoms which you think may be due to this ointment, speak with your doctor or pharmacist.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

  • If you suspect that someone has swallowed some of this preparation, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
  • This preparation is for you. Never give it to other people even if their condition appears to be the same as yours.
  • If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking.
  • Never keep out of date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
  • If you have any questions about this medicine ask your pharmacist.

Further reading & references

  • British National Formulary; 62nd Edition (Sep 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
  • Manufacturer's PIL, Protopic® 0.1% Ointment; Manufacturer's PIL, Protopic® 0.1% Ointment, Astellas Pharma Ltd, electronic Medicines Compendium. Dated April 2009.
  • Manufacturer's PIL, Protopic® 0.03% ointment; Manufacturer's PIL, Protopic® 0.03% ointment, Astellas Pharma Ltd, electronic Medicines Compendium. Dated April 2009.
Original Author: Helen Allen Current Version:
Last Checked: 07/06/2011 Document ID: 8653  Version: 3 © EMIS

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

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