Calcineurin Inhibitor (Topical) Pregnancy: Caution — limited data; topical use on small areas likely safe

Pimecrolimus

Brand names: Elidel

Adult dose

Dose: Apply thinly BD to affected areas

Route: Topical

Frequency: BD

Max: Apply minimum needed area

For mild-moderate atopic eczema (alternative to topical steroids). 1% cream only. Not for infected skin.

Route: Topical

Frequency: BD

Max: Not for children <2 years

Concentration: 1% cream Cream/ml

Licensed ≥2 years. Particularly useful for face and neck (avoids steroid side effects). Not in children <2 years.

Renal

N/A

Hepatic

N/A

NICE NG190: pimecrolimus/tacrolimus topical second-line for moderate-severe eczema or when steroids have failed/inappropriate (face, flexures)
Black box warning (MHRA): historical concern re: lymphoma and skin cancer — no causal link established in trials to date; counsel patients
Apply sun protection — can increase photosensitivity
Useful for steroid-free phases in maintenance therapy

Burning/stinging on application (first few days)
Increased sun sensitivity
Risk of skin infections
Theoretical malignancy risk (MHRA black box warning — observational, not proven in trials)

CYP3A4 inhibitors — theoretical increased systemic pimecrolimus (minimal topical absorption)

Reference: BNFc; BNF; NICE NG190; BAD Eczema Guidelines. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways