Tacrolimus ointment (Protopic)

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Tacrolimus ointment is for external use only and should be applied thinly to affected area(s) of skin.

Do not apply the ointment to any areas of skin which could be infected.

Expect to see an improvement within one week of using the ointment and then continue to use it for a few more weeks until the eczema has cleared.

Do not drink alcohol - it can make your skin (particularly on your face) become flushed or red, and feel hot.

Type of medicineA topical immunomodulator
Used forModerate-to-severe eczema in adults or children over 2 years of age
Also calledProtopic®
Available asOintment

Tacrolimus ointment helps reduce inflammatory skin reactions. It is prescribed for people with moderate-to-severe eczema, usually as an alternative to other treatments such as steroid creams or ointments. It is applied topically (on to the skin) to reduce symptoms such as inflammation, redness and itching. Tacrolimus ointment is available in two strengths: 0.03% and 0.1%. Only the lower, 0.03% strength, is suitable for use by children. It will be prescribed initially by a skin specialist doctor.

Tacrolimus is also available as a medicine which is taken by mouth, but this is prescribed for a completely different medical condition. There is a separate information leaflet available about this called Tacrolimus to prevent organ rejection.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start using tacrolimus ointment it is important that your doctor knows:

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you have any other skin conditions.
  • If you have swollen lymph glands or a weakened immune system.
  • If you have problems with the way your liver works.
  • If you have ever had an allergic reaction to a medicine, especially if it was to a macrolide antibiotic (such as erythromycin, clarithromycin, azithromycin or telithromycin).
  • If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about the ointment and will provide you with a full list of the side-effects which you may experience from using it.
  • Apply a thin layer of ointment to the commonly affected areas of your skin twice daily (it is usually recommended that you apply it morning and evening). It can be applied to most areas of skin on your body, but do not apply it to areas such as your lips, the inside of your nose, or near to your eyes. Do not apply it to any area of skin that could be infected. Remember to wash your hands well after using the ointment unless you are treating your hands.
  • If you forget to apply the ointment, apply it as soon as you remember and then continue as before.
  • Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
  • Continue to use the ointment until your eczema has cleared. You should expect to see some improvement to your skin within one week of using the ointment, and it should be free from flares within a few more weeks. During this time, your doctor may ask you to reduce how often you apply the ointment or may reduce the strength of the ointment you are using.
  • Tacrolimus ointment is intended to be used for a short period of time (up to six weeks). It should not be used every day over a long period of time. Some people who frequently have flares may be prescribed the ointment to use on two days of each week to prevent further flares from developing. When it is used like this to prevent flares, there should be at least 2-3 days between applications.
  • You may continue to use moisturising creams and lotions whilst you are being treated with tacrolimus, but you should wait for at least two hours after you have applied tacrolimus ointment before applying them.
  • It is important that you don't cover any area of skin treated with tacrolimus with any dressings or bandages. This is because more of the medicine may be absorbed by your skin than is intended.
  • Do not drink alcohol because it can cause your skin and face to become flushed or red, and feel hot.
  • Your doctor will discuss with you the possibility of a slightly increased risk of cancer (particularly skin cancer) associated with medicines like tacrolimus. To help reduce this risk, do not use sunbeds and avoid strong sunlight. On bright days, even if it is cloudy, use a sun cream with a high sun protection factor (an SPF of at least 15).
  • If there is no improvement in your skin after using tacrolimus ointment for two weeks, you should see your doctor again for further advice.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with tacrolimus ointment. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Very common tacrolimus ointment side-effects (these affect more than 1 in 10 people)What can I do if I experience this?
A burning sensation, itchingThese symptoms generally disappear within one week
Common tacrolimus ointment side-effects (these affect less than 1 in 10 people)What can I do if I experience this?
Redness, a feeling of warmth, pain, increased skin sensitivity to heat and cold, tingling, rash, local skin infectionsIf any continue or become troublesome, speak with your doctor

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

  • 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 are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are using.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

The ointment is for use on the skin only. If you suspect that someone has swallowed some of it, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

Do not 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

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.

Original Author:
Helen Allen
Current Version:
Peer Reviewer:
Dr Helen Huins
Document ID:
8653 (v4)
Last Checked:
Next Review:
The Information Standard - certified member

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