Pimecrolimus

About Pimecrolimus

Pimecrolimus is a topical calcineurin inhibitor: it stops immune cells in the skin from releasing the signals that drive eczema, without being a steroid. The label makes it a second-line treatment for short-term, intermittent use in adults and children whose immune systems are not weakened. A thin layer goes on affected skin twice a day and is stopped once the eczema clears; if there is no improvement after six weeks, the label calls for the diagnosis to be reviewed.

Burning, warmth or stinging where it is applied is common; MedlinePlus advises calling the prescriber if it lasts more than a week. The boxed warning notes rare reports of skin cancer and lymphoma in people using this class of medicine, although a causal link has not been shown, so continuous long-term use is avoided and it is not used in children under two. Skin infections should be cleared first, and it may raise the risk of chickenpox, shingles, cold sores and eczema herpeticum. Swollen lymph nodes should be checked. It is not used in Netherton syndrome.

Tacrolimus ointment is the other medicine in this class; it is labeled for moderate to severe eczema and carries the same boxed warning.

Taking Pimecrolimus

How to take it

Apply a thin layer to the affected skin twice a day and rub it in gently and completely, then wash your hands unless they are being treated. Keep it away from the eyes and mouth, do not cover treated skin with bandages or wraps, and do not bathe, shower or swim straight after applying it. Stop when the eczema clears.

If you miss a dose

Apply it as soon as you remember, unless it is almost time for the next application; then skip the missed one and carry on as usual. Do not apply extra to make up.

Storage

At room temperature in the closed tube, away from heat and moisture. Do not freeze. Keep out of reach of children.

Interactions to know about

Alcohol can make the face flush, redden or feel hot during treatment. Protect treated skin from sunlight, and avoid sun lamps, tanning beds and ultraviolet therapy. In widespread eczema, the label advises caution with medicines that slow its breakdown, such as erythromycin, itraconazole, ketoconazole, fluconazole, calcium channel blockers and cimetidine.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Pimecrolimus differs from pharmacy to pharmacy

Generic pimecrolimus comes from only a few manufacturers, and its cost rises with the size of the tube, so the tube size written on the prescription drives the quote. Bigger is not cheaper here: in federal acquisition-cost data, the 100 g tube costs pharmacies slightly more per gram than the smaller sizes. A pharmacy that does not keep the size you need may have to order it, and quotes for the same tube differ between pharmacies by margin.

Ways to pay less for Pimecrolimus without insurance

• Ask the prescriber to allow generic substitution.
• Ask the pharmacy to quote more than one tube size; the largest is not always the best value per gram.
• If cost rules it out, ask the prescriber whether another eczema treatment would suit you.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Pimecrolimus

1. 1.How much should I apply, and where should I not use it?
2. 2.How soon should it help, and when should we review it?
3. 3.Can I use it with my moisturizer or other eczema treatments, and in what order?
4. 4.What should I do if the burning does not settle?
5. 5.Which signs of skin infection mean I should stop and call?

Related medications