Pimecrolimus 1% Topical

Indications

Pimecrolimus 1% Topical is used for: Atopic dermatitis, Eczema

Adult Dose

Topical/Cutaneous Atopic dermatitis Adult: As 1% cream: Apply a thin layer onto the affected areas bid. Stop treatment if there is no improvement after 6 wk or if there is worsening of eczema. Hepatic impairment: Dosage reduction is necessary.

Child Dose

Topical/Cutaneous Atopic dermatitis Child: >2 yr: Apply a thin layer of 1% cream onto the affected areas bid. Stop treatment if there is no improvement after 6 wk or if there is worsening of eczema. Hepatic impairment: Dosage reduction is necessary.

Renal Dose

Renal impairment: Dosage reduction is necessary.

Administration

Contra Indications

Hypersensitivity; children <2 yr; immunocompromised patients. Patients with Netherton's syndrome.

Precautions

Avoid use in areas affected by active, cutaneous viral infections. Avoid contact with the eyes and mucous membranes. Immunosuppression may increase risk of lymphoma and other malignancies. Limit exposure to sunlight or other UV light. Mild to moderate sensation of warmth and/or burning may occur at the treatment site within 1-5 days of initiation. Safety of usage beyond 1 yr is not established. Renal or hepatic impairment. Monitor renal, hepatic, cardiac and visual functions, BP, serum glucose and electrolytes regularly. Pregnancy, lactation. Lactation: not known whether distributed in breast milk; may cause unwanted effects in nursing babies

Pregnancy-Lactation

Pregnancy Category: C Lactation: not known whether distributed in breast milk; may cause unwanted effects in nursing babies

Interactions

Inhibitors of cytochrome P450 3A4 isoenzyme in patients with widespread and/or erythrodermic disease. Potentially Fatal: Increased risk of infections when used with live vaccines.

Adverse Effects

Side effects of Pimecrolimus 1% Topical : >10% Burning sensation (2-26%), Headache (7-25%), Fever (1-13%), Nasopharyngitis (8-27%), Cough (2-16%), Bronchitis (<11%), Upper respiratory tract infection (4-19%) <1% Basal cell carcinoma of skin, Malignant melanoma, Squamous cell carcinoma, Malignant lymphoma, Septic arthritis, Skin discoloration, Eczema, Flushing, Ocular irritation Frequency Not Defined Skin infection, Rash, Application site pain, Paraesthesia, Desquamation, Dryness

Mechanism of Action

Pimecrolimus is a macrolactam and is a derivative of ascomycin. It is an immunosuppressant which inhibits the activation of T-cells and prevents the release of inflammatory mediators from mast cells. It is used for the short term or intermittent long term treatment for mild to moderate atopic eczema.