Before using topical tacrolimus

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.

How to use topical tacrolimus

• 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.

Getting the most from your treatment

• 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.

Can topical tacrolimus cause problems?

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.

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

How to store topical tacrolimus

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

Important information about all medicines

References

• Manufacturer's PIL, Protopic® 0.1% Ointment, Astellas Pharma Ltd, electronic Medicines Compendium. Dated April 2009.
• Manufacturer's PIL, Protopic® 0.03% ointment, Astellas Pharma Ltd, electronic Medicines Compendium. Dated April 2009.
• British National Formulary; 61st Edition (March 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF)