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pimecrolimus

Generic Elidel
Used for Eczema
Used for Eczema

Pimecrolimus (Elidel) is a topical calcineurin inhibitor cream used to treat mild-to-moderate eczema in adults and children ages 2 years and older. It's typically given short term to people whose immune system is working well and who have tried (or can’t take) other medications for eczema. You apply it to the affected areas of the skin twice a day. It's available both in brand-name and generic versions. Side effects include a higher risk of certain infections as well as a burning sensation at the application site.

Reviewed by:
reviewer
Robert Chad Hakim, PharmD, BCCCP
reviewer
Daisy Chau, PharmD
Last reviewed on October 9, 2024
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostAlternativesLatest newsReferencesPricesMedicare
basics-icon

What is Pimecrolimus (Elidel)?

What is Pimecrolimus (Elidel) used for?

  • Mild-to-moderate eczema in people ages 2 years and older

How Pimecrolimus (Elidel) works

Pimecrolimus (Elidel) is a topical calcineurin inhibitor. It's not completely known how the medication works to treat eczema. But it's thought to block a protein called calcineurin, which helps to activate our immune system. By blocking calcineurin, pimecrolimus (Elidel) helps to reduce inflammation on the skin to treat eczema.

When does Pimecrolimus (Elidel) start working?
Time passed since treatment started:
HOURS
DAYS
WEEKS
MONTHS
Initial effect
Full effect

Drug Facts

Common BrandsElidel
Drug ClassImmunosuppressant
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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$196.72(save 64.42%)
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$70.00
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What are the side effects of Pimecrolimus (Elidel)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Adults
  • Application-site burning (26%)
  • Other application-site reactions (e.g., stinging, dryness) (15%)
  • Flu (10%)
  • Common cold symptoms (8%)
  • Skin infection (7%)
  • Headache (7%)
  • Application-site irritation (6%)
  • Application-site itching (5%)
Children
  • Common cold symptoms (27%)
  • Headache (25%)
  • Cough (16%)
  • Flu (13%)
  • Fever (13%)
  • Bronchitis (11%)
  • Application-site burning (9%)
  • Diarrhea (8%)
  • Sore throat (8%)
  • Viral infection (7%)
  • Stomach flu (7%)
  • Vomiting (7%)
  • Upper stomach pain (6%)
  • Swelling of the tonsils (6%)
Side effects above are from studies where pimecrolimus (Elidel) was taken for 1 year.

Other Side Effects

  • Stuffy nose
  • Ear infection
  • Sore throat
  • Back pain
  • Joint pain
  • Earache
  • Swelling of the sinuses
  • Pneumonia
  • Chickenpox
  • Sinus congestion
  • Wheezing
  • Nosebleeds
  • Nausea
  • Toothache
  • Constipation

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Possible cancer risk: loss of appetite, fatigue, lumps on skin, new moles or spots on skin, swollen lymph nodes, weight loss, nosebleeds
  • Serious infections: fever, difficulty breathing, cough, weakness, chills, redness and peelings of skin, blisters on the skin, cold sores
When do Pimecrolimus (Elidel) possible side effects begin and end?
Time passed since treatment started:
MINUTES
HOURS
DAYS
WEEKS
MONTHS
Mild burning sensation

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Abdominal or stomach pain

body aches or pain

burning, itching, redness, skin rash, swelling, or soreness at the application site

change in hearing

chills

cold or flu-like symptoms

congestion (ear or nasal)

cough producing mucus

diarrhea

difficulty with breathing or shortness of breath

dryness or soreness of the throat

earache or pain in the ear

ear drainage

fever

general feeling of discomfort or illness

headache

hoarseness

itching

joint pain

loss of appetite

loss of voice

muscle aches and pains

nausea

pain

redness

runny nose

shivering

sneezing

sweating

swelling

tenderness

tender, swollen glands in the neck

tightness in the chest

trouble with swallowing

trouble with sleeping

unusual tiredness or weakness

voice changes

vomiting

warmth on the skin

wheezing

Less common

Blistering, crusting, irritation, itching, or reddening of the skin

blurred vision or other change in vision

eye pain

fast heartbeat

hives

itchy, raised, round, smooth, skin-colored bumps found on just one area of the body that are oozing, thick, white fluid

irritation

joint pain, stiffness or swelling

rash

redness of the eye

redness of the skin

sensitivity of the eyes to light

skin rash on the face, scalp, or stomach

swelling of the eyelids, face, lips, hands, or feet

tearing

troubled breathing or swallowing

Incidence not known

Black, tarry stools

change in size, shape, or color of existing mole

cough

dizziness

itching, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

large, hive-like swelling on the face

mole that leaks fluid or bleeds

new mole

small, red skin lesion, growth, or bump usually on the face, ears, neck, hands, or arms

sores that will not heal

weight loss

yellow eyes and skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Burning, itching, and pain in hairy areas

pus at the root of the hair

Less common

Blemishes on the skin

bloody nose

burning or stinging of the skin

difficulty having a bowel movement (stool)

flushing; redness of skin; unusually warm skin at site

heavy bleeding

painful cold sores or blisters on the lips, nose, eyes, or genitals

pimples

redness or swelling in the ear

vaginal pain and cramps

Incidence not known

Burning, stinging, itching, or mild discomfort of the eye (after applying the cream to the eyelids or near the eyes)

feeling of warmth (with alcohol use)

redness of the face, neck, arms, and occasionally, upper chest (with alcohol use)

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Pimecrolimus (Elidel)

thumbs-up

Pros

A recommended option for treating mild or moderate eczema

Can start to work as early as 1 week

Can be given to children as young as 2 years old

thumbs-down

Cons

Not recommended for treating severe eczema

Not the best choice for people with a weakened immune system

Needs to be applied twice daily

pharmacist-tips

Pharmacist tips for Pimecrolimus (Elidel)

pharmacist

  • Before using pimecrolimus (Elidel), let your prescriber know if you have areas of skin cancer or precancerous conditions. This medication shouldn't be applied to these areas of the skin because it can worsen or raise the risk of skin cancer.

    • Pimecrolimus (Elidel) is for use on your skin only. Avoid applying it to your eyes, mouth, genitals, or rectum, as this can cause burning and irritation. If the medication accidentally gets on those areas, wipe off as much as possible and rinse thoroughly with cold water.

      • Apply the smallest amount of pimecrolimus (Elidel) needed to cover the affected area(s) with a thin layer. Wash your hands with soap after applying the cream, unless your hands are being treated.

        • Avoid contact with water, such as bathing, showering, or swimming, right after applying pimecrolimus (Elidel) to prevent washing off the cream.

          • Don't cover medicated area(s) with bandages, dressings, or wraps. This can cause more pimecrolimus (Elidel) to get absorbed into your body, which raises your risk for side effects. But it's okay to wear normal clothing over the affected area(s).

            • Pimecrolimus (Elidel) commonly causes burning, stinging, itching, or skin irritation during the first few days. While these symptoms usually go away, let your prescriber know if they continue or become bothersome.

              • Pimecrolimus (Elidel) can make your skin more sensitive to the sun. Try to minimize direct sunlight while taking this medication to prevent sunburn. Use sunscreen and wear protective clothing to lower your risk of sun damage.

                • Use moisturizers to keep your skin hydrated since it can help relieve your symptoms. Be sure to apply it after pimecrolimus (Elidel).

                  • Stop using pimecrolimus (Elidel) once your eczema symptoms (e.g., itching, rash, redness) go away. If your symptoms don’t improve after 6 weeks, tell your prescriber. They might need to check whether you should continue the medication or not.

                    • Let your care team know if you're pregnant, thinking of becoming pregnant, or are breastfeeding before taking pimecrolimus (Elidel). They'll discuss with you the risks and benefits of using this medication.

                      • Store pimecrolimus (Elidel) at room temperature only. Don't put it in the refrigerator or freezer because this could damage the medication.

                        faqs

                        Frequently asked questions about Pimecrolimus (Elidel)

                        Is pimecrolimus (Elidel) a steroid?
                        No, pimecrolimus (Elidel) isn't a steroid; it's a topical calcineurin inhibitor. While both are recommended treatment options for eczema, they work to reduce inflammation in different ways.
                        Can I use pimecrolimus (Elidel) and hydrocortisone together?
                        It's generally recommended to not use pimecrolimus (Elidel) and topical steroids like hydrocortisone on the same areas at the same time. Doing so can raise the risk of skin-related side effects like burning, irritation, and pain. But your dermatologist might suggest using both medications on different parts of your body, or alternating between pimecrolimus (Elidel) and hydrocortisone. Ask your dermatologist if you have questions about whether you can use both of these medications together.
                        How long does pimecrolimus (Elidel) take to work?
                        Pimecrolimus (Elidel) can start to improve skin symptoms as early as 1 week, with most improvement typically seen after 3 weeks. Keep in mind that everyone responds differently to medications. Talk to your prescriber if you're concerned about how long it's taking for pimecrolimus (Elidel) to start working for you.
                        Can you use pimecrolimus (Elidel) for rosacea?
                        Pimecrolimus (Elidel) isn't FDA approved to treat rosacea. But a study showed people with rosacea who applied pimecrolimus (Elidel) twice daily for a month had less skin redness and bumps. Though the medication might also cause rosacea. Speak with your dermatologist if you have questions about whether this medication can be used to treat rosacea.
                        Is pimecrolimus (Elidel) for hyperpigmentation?
                        Pimecrolimus (Elidel) isn't FDA approved for treating hyperpigmentation, a condition where some areas of the skin become darker than the rest. Talk to your dermatologist if you're looking for treatment of hyperpigmentation.
                        What's the difference between pimecrolimus (Elidel) and tacrolimus (Protopic)?
                        Both pimecrolimus (Elidel) and tacrolimus (Protopic) are topical calcineurin inhibitors that are used to treat eczema. But pimecrolimus (Elidel) is used for more mild cases whereas tacrolimus (Protopic) is used for more severe cases. Another difference is that pimecrolimus (Elidel) is a cream, whereas tacrolimus (Protopic) is an ointment. Speak with your dermatologist if you have questions about comparing these medications.
                        Can pimecrolimus (Elidel) be used on the face and eyelids?
                        Yes, pimecrolimus (Elidel) can be used on the face or eyelids if prescribed that way. Just be sure not to get any of the medication inside your eyes or mouth. Ask your prescriber for guidance on where you should apply the cream.
                        How long can I use pimecrolimus (Elidel) cream?
                        It's generally recommended to not use pimecrolimus (Elidel) for longer than one year due to potential risks of skin infections and cancers. Typically, it's used for up to 6 weeks to treat an eczema flare. But your prescriber might have you continue using it to prevent flares, as long as you're not experiencing serious side effects. Regular follow-ups with your prescriber are important so they can check your progress and adjust your treatment if needed.
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                        What are the risks and warnings for Pimecrolimus (Elidel)?

                        Pimecrolimus (Elidel) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                        risk-warning

                        Long-term use and risk of cancer

                        • Risk factors: Weakened immune system | Taking pimecrolimus (Elidel) for a long time

                          Pimecrolimus (Elidel) might raise your risk of getting certain types of cancers, such as lymphoma or skin cancer, especially if it's used long term. So it's important to use pimecrolimus (Elidel) as directed and not for longer than prescribed. Apply the cream only to treatment areas and away from healthy skin. If eczema symptoms don't get better within 6 weeks, schedule a follow-up visit with your prescriber since they might have to reassess. If you experience symptoms, such as swollen lymph nodes, fatigue, weight loss, loss of appetite, frequent nosebleeds, or lumps on your skin, contact your prescriber right away.

                          risk-warning

                          Risk of skin infection

                          Pimecrolimus (Elidel) can raise your risk of bacterial and viral skin infections. Don't apply pimecrolimus (Elidel) to areas of the skin where there's an active infection. If a skin infection develops while you're using this medication, stop using it and let your prescriber know. The infection will need to be treated before you can use pimecrolimus (Elidel).

                          risk-warning

                          Swollen lymph nodes

                          Let your prescriber know if you notice swollen lymph nodes after starting pimecrolimus (Elidel). This could be a sign of an infection or another serious medical problem. Depending on the cause of your swollen lymph nodes, you might have to stop using pimecrolimus (Elidel).

                          dosage

                          Pimecrolimus (Elidel) dosage forms

                          The average cost for 1 tube of 30g of 1% of Pimecrolimus (Elidel) is $70.00 with a free GoodRx coupon. This is 64.42% off the average retail price of $196.72.
                          tube of cream
                          Tube of cream
                          DosageQuantityPrice as low asPrice per unit
                          30g of 1%1 tube$70.00$70.00
                          60g of 1%1 tube$120.00$120.00
                          100g of 1%1 tube$200.00$200.00

                          Typical dosing for Pimecrolimus (Elidel)

                          Apply a thin layer to the affected area(s) twice a day until symptoms (e.g., itchiness, rash, redness) go away.

                          interactions

                          Interactions between Pimecrolimus (Elidel) and other drugs

                          Pimecrolimus (Elidel) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Pimecrolimus (Elidel). Please note that only the generic name of each medication is listed below.

                          Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                          • Tofacitinib

                          Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                          drug-cost

                          How much does Pimecrolimus (Elidel) cost?

                          To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
                          Elidel (brand)
                          GoodRx lowest price

                          $70.00

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                          Pimecrolimus (Elidel) (generic)
                          GoodRx lowest price

                          $70.00

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                          alternatives

                          What are alternatives to Pimecrolimus (Elidel)?

                          There are a number of medications that your doctor can prescribe in place of Pimecrolimus (Elidel). Compare a few possible alternatives below.
                          Pimecrolimus (Elidel)
                          Used for:

                          • Mild-to-moderate eczema in people ages 2 years and older

                          $70.00 Lowest GoodRx priceView Prices
                          Fluocinonide (Vanos)
                          Used for:

                          • Skin inflammation disorders, including psoriasis, eczema, and seborrheic dermatitis

                          $24.00 Lowest GoodRx priceView Prices
                          Tacrolimus (Protopic)
                          Used for:

                          • Moderate-to-severe eczema in adults and children ages 2 years and older

                          $40.00 Lowest GoodRx priceView Prices

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                          References

                          Best studies we found

                          Bausch Health US, LLC. (2020). Elidel- pimecrolimus cream [package insert]. DailyMed.

                          Drugs and Lactation Database (LactMed®). (2024). Pimecrolimus. National Institute of Child Health and Human Development.

                          Gupta, A. K., et al. (2003). Pimecrolimus: A review. Journal of the European Academy of Dermatology and Venereology.

                          View All References (7)

                          Kim, M. B., et al. (2011). Pimecrolimus 1% cream for the treatment of rosacea. The Journal of Dermatology.

                          Leukemia and Lymphoma Society. (n.d.). Lymphoma.

                          National Eczema Society. (n.d.). Topical calcineurin inhibitors (TCIs).

                          Safarini, O. A., et al. (2023). Calcineurin inhibitors. StatPearls.

                          Sidbury, R., et al. (2023). Guidelines of care for the management of atopic dermatitis in adults with topical therapies. Journal of the American Academy of Dermatology.

                          Weatherhead, S., et al. (2007). Eczema in pregnancy. British Medical Journal.

                          Zhang, H., et al. (2021). Topical calcineurin inhibitors as a double-edged sword in rosacea: A systematic review. Journal of Cosmetic Dermatology.

                          GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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