pimecrolimus
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.
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.
Drug facts
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.
Less Common 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
Pimecrolimus (Elidel) 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
The following Pimecrolimus (Elidel) 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
congestion (ear or nasal)
cough producing mucus
difficulty with breathing or shortness of breath
dryness or soreness of the throat
ear drainage
general feeling of discomfort or illness
headache
hoarseness
joint pain
loss of appetite
loss of voice
muscle aches and pains
redness
shivering
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
Less common
Blistering, crusting, irritation, itching, or reddening of the skin
blurred vision or other change in vision
fast heartbeat
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
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
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:
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
painful cold sores or blisters on the lips, nose, eyes, or genitals
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.
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Pros and cons of Pimecrolimus (Elidel)
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
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 for Pimecrolimus (Elidel)
- 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.
Common questions about Pimecrolimus
No, Pimecrolimus 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.
It's generally recommended to not use Pimecrolimus 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 and hydrocortisone. Ask your dermatologist if you have questions about whether you can use both of these medications together.
Pimecrolimus 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 to start working for you.
Pimecrolimus isn't FDA approved to treat rosacea. But a study showed people with rosacea who applied Pimecrolimus 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.
Pimecrolimus 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.
Both Pimecrolimus and tacrolimus (Protopic) are topical calcineurin inhibitors that are used to treat eczema. But Pimecrolimus is used for more mild cases whereas tacrolimus (Protopic) is used for more severe cases. Another difference is that Pimecrolimus is a cream, whereas tacrolimus (Protopic) is an ointment. Speak with your dermatologist if you have questions about comparing these medications.
Yes, Pimecrolimus 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.
It's generally recommended to not use Pimecrolimus 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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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.
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 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).
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).
Pimecrolimus (Elidel) dosage
Tube of cream| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 30g of 1% | 1 tube | $46.87 | $46.87 |
| 60g of 1% | 1 tube | $85.73 | $85.73 |
| 100g of 1% | 1 tube | $137.55 | $137.55 |
Typical dosage 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 between Pimecrolimus (Elidel) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
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.
How much does Pimecrolimus (Elidel) cost?
What are alternatives to Pimecrolimus (Elidel)?
