Tacrolimus Ointment: What It's For, How to Use & Side Effects

Tacrolimus ointment is an ointment indicated for the treatment of atopic dermatitis. It contains tacrolimus monohydrate, a substance that can alter the skin's natural immune response to relieve symptoms of atopic dermatitis, like inflammation, redness and itching of the skin.

This ointment can be purchased in pharmacies or drugstores with a prescription. It is available in different doses, 0.03% or 0.1%, in tubes of 10 or 30 grams.

Tacrolimus ointment should be used as prescribed by a  dermatologist who can indicate the dose to be used, as well as the treatment time.

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What it's used for

Tacrolimus ointment is indicated for the treatment of moderate to severe atopic dermatitis. It contains tacrolimus monohydrate, an immunosuppressive substance, which acts by reducing the action of the immune system. It helps to alleviate the symptoms of atopic dermatitis, like redness or itchy skin.

Generally, this medication is indicated in cases where other treatments for atopic dermatitis have not been effective in controlling symptoms or when the person is intolerant to other treatments. 

Tacrolimus ointment may also indicated as a maintenance treatment to prevent flare-ups and to prolong remission periods in people who have a high frequency of worsening of the disease.

Tacrolimus ointment 0.03% is indicated for use in children between 2 and 15 years of age and adults, while tacrolimus ointment 0.1% is indicated for use in adolescents over 16 years of age and adults. 

How to use

Tacrolimus ointment should be applied on the skin at the times established by the doctor. Before using, wash your hands and affected skin with water and neutral soap and pat dey before applying the ointment. Then, apply a thin layer of the ointment to the affected area and gently massage it into the skin to facilitate its absorption. 

It is important not to cover the treated area of skin with any bandages unless instructed to do so by your doctor, as covering the skin may increase absorption of the ointment and cause side effects.

The normally recommended dose of tacrolimus ointment varies according to age and the concentration of tacrolimus in the ointment, and includes:

  • Children aged 2 to 15 years: the normally recommended initial dose is 1 application of tacrolimus ointment 0.03% on the skin, twice a day, once in the morning and once in the evening, for 3 weeks. After this period, the pediatrician can change the dose to 1 application, once a day;
  • Adolescents over 16 years of age and adults: the normally recommended initial dose is 1 application of tacrolimus ointment 0.1% on the skin, twice a day, once in the morning and once in the evening, until the dermatitis completely disappears. This dose can be changed by the doctor according to the response to treatment. The doctor may recommend reducing the frequency of tacrolimus ointment 0.1% applications or change to tacrolimus ointment 0.03%.

The doctor may also consider the application of tacrolimus ointment 0.03% (for adults and children between 2 and 15 years old), or tacrolimus ointment 0.1% (for teenagers over 16 years old and adults) just twice a week, if symptoms are resolving.

It is important to wash your hands after using tacrolimus ointment, except in cases where the ointment is used to treat the skin of the hands. 

Furthermore, the use of tacrolimus ointment should be avoided in areas such as the eyes, mouth, nostrils, genitals and anus.

While using tacrolimus ointment, you should avoid sun exposure, artificial tanning or phototherapy, as it can make your skin more sensitive. You are advised to use a sunscreen as recommended by your doctor.

Possible side effects

The most common side effects that may appear during treatment with tacrolimus ointment are itching and burning at the site of application. These generally disappear after a week of using this medication.

In addition, although they are less common, symptoms like redness, pain, irritation, increased sensitivity to temperature changes, skin inflammation, skin infection, folliculitis, herpes simplex, impetigo or altered sensitivity may also occur.

Tacrolimus ointment can cause alcohol intolerance, which can be noted through symptoms such as heat, flushing or redness of the skin or face. Therefore, consuming alcoholic beverages should be avoided during treatment with this ointment.

Contraindications for use

Tacrolimus ointment should not be used by children under 2 years of age, pregnant or breastfeeding women, or by people with infected skin wounds, skin cancer, or a weakened immune system. 

Furthermore, this ointment should not be used by people who are allergic to tacrolimus or macrolide antibiotics, such as azithromycin, clarithromycin or erythromycin, for example.

During treatment, you should avoid receiving any live vaccines, such as measles, mumps, rubella or oral poliomyelitis, and you must wait at least 28 days after vaccination to start treatment with tacrolimus ointment . For inactivated vaccines, such as tetanus, diphtheria, whooping cough or flu, you should wait at least 14 days after vaccination to start treatment with tacrolimus ointment.