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Protopic Ointment (Tacrolimus)


Protopic Ointment or Tacrolimus is a topical medication used on the skin to treat atopic dermatitis (eczema). Eczema is a chronic skin disease that causes skin inflammation, resulting in redness, itchiness, cracking, swelling, crusting, weeping and scaling. The inflammation is primarily caused due to activation of the immune system. The reason for activation is not known yet. Protopic Ointment suppresses the inflammation substantially by inhibiting calcineurin, an enzyme vital for the growth of T-cells (cells responsible for activating the immune system). This drug belongs to a class of medicines known as topical calcineurin inhibitors. It was approved for treating atopic dermatitis in Dec. 2000. It is prescribed to adults and children over two years of age who have strong immune system. This medication is normally recommended for a short-time usage. However, if needed, treatment can be repeated, provided that small breaks are taken in between.

Ingredients: Tacrolimus (either 0.03 percent or 0.1 percent) is the active ingredient of this medication. Inactive constituents include paraffin, mineral oil, white petrolatum, propylene carbonate and white wax.

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Dosage: Protopic Ointment is applied to the disease-affected areas of skin two times a day. Generally, it is used to treat a patient when topical corticosteroids does not prove effective, or when they cannot be used. For example, if a person experiences unacceptable side effects associated with topical steroids, it is advisable to treat him/her with Tacrolimus.

Protopic 0.03 percent is approved for children over two years of age.

Protopic 0.1 percent is appropriate for adults aged sixteen years and over.

Pregnancy: Since Protopic Ointment is a topical drug, a very small amount is absorbed from the ointment. No side effects associated with this drug are known. There is no proof of this medication being toxic to the fetus. However, kidney problems and high potassium failures are reported among new-born children whose mothers have been taking oral Tacrolimus during pregnancy. For that reason, Protopic Ointment should only be used under dire circumstances related to eczema, and it should be ensured in advance that the benefits outweigh the possible danger to the fetus.

Nursing mothers: When taken orally or via injection, this prescription medication passes into breast milk. Though is not likely that ointment applied to the infected skin will pass in substantial amounts, breastfeeding should be avoided while receiving treatment with protopic ointment. It is advised to seek further information and medical advice from a physician.

Drug interactions: There are no known studies or research carried out to determine if this drug has significant interactions with other medications. However, it should never be used together with immunosuppressive medicines like ciclosporin and azathioprine.

Light treatments, such as UV light treatment or PUVA should not be received while using this drug. It is necessary to avoid applying moisturizer to the same affected areas of skin for at least 2 hours of applying protopic ointment.

The medicines listed below are likely to increase levels of this medication in the bloodstream if absorbed.

1. Erythromycin

2. Diltiazem

3. Ketoconazole

4. Itraconazole

Therefore, these drugs must be used very cautiously during protopic treatment, especially in patients who have widespread eczema and are using ointment on large skin areas. Moreover, it is also reported that vaccines are less effective in patients using this drug since Tacrolimus suppresses the activity of immune system.


1. The drug is an ointment, i.e. it is for external use only. Therefore, it should never be used for any purpose other than treating eczema.

2. The ointment must be applied thinly to the affected areas. If symptoms prevail even after the usage of drug for two weeks, the patient must consult a physician.

3. Avoid direct contact of Protopic Ointment with the eyes and skin areas that line the body cavities, such as mucous membranes inside mouth and nose. If it accidently comes in contact with such areas, it should be wiped, and the area must be thoroughly rinsed with water.

4. You must wash your hands carefully after applying protopic ointment.

5. Do not cover the affected area with bandages or other similar airtight dressings.

6. Protopic Ointment might cause skin reactions like itching, burning sensation, or feeling of warmth at the place of application. These effects are short lived and mild. Consult your doctor immediately if the reactions are severe and uncontrollable.

6. Avoid using sun beds during treatment. Sunlight exposure must also be minimized by wearing appropriate clothing and using sunscreens.

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