Pimecrolimus cream medication by Ray Sahelian, M.D.
January 20 2016

 

Pimecrolimus is an pharmaceutical medication used in the treatment of atopic dermatitis (eczema). Pimecrolimus is currently available as a topical cream. Pimecrolimus is sold by Novartis, under the trade name Elidel.

 

Pimecrolimus Caution, side effects

Two topical eczema drugs, Elidel Cream ( pimecrolimus ) and Protopic Ointment ( tacrolimus ) must have a boxed warning about a possible risk of cancer. These drugs are recommended for use as second-line treatments. This means that other prescription topical medicines should be tried first. Use of these drugs in children under 2 years of age is not recommended.

 

Atopic dermatitis
Pediatrics. 2015. Safety and efficacy of pimecrolimus in atopic dermatitis: a 5-year randomized trial. Atopic dermatitis (AD) primarily affects infants and young children. Although topical corticosteroids (TCSs) are often prescribed, noncorticosteroid treatments are needed because compliance with TCSs is poor due to concerns about their side effects. In this longest and largest intervention study ever conducted in infants with mild-to-moderate AD, pimecrolimus 1% cream (PIM) was compared with TCSs. Long-term management of mild-to-moderate AD in infants with PIM or TCSs was safe without any effect on the immune system. PIM was steroid-sparing. The data suggest PIM had similar efficacy to TCS and support the use of PIM as a first-line treatment of mild-to-moderate AD in infants and children.

 

Pimecrolimus for Steroid Induced Erythema in Rosacea

Steroid-induced erythema in rosacea is a therapeutic challenge because of its tendency to rebound. The condition may improve when steroid treatment is discontinued and therapy with pimecrolimus cream 1% twice daily initiated. The calcineurin antagonist pimecrolimus may offer an option in the acute therapy of steroid-aggravated facial dermatoses.

 

Pimecroliums cream for asteatotic eczema
Pimecrolimus cream 1% is effective in asteatotic eczema: results of a randomized, double-blind, vehicle-controlled study in 40 patients. J Eur Acad Dermatol Venereol. 2007. Department of Dermatology, University Clinics Munster, Munster, Germany.
Pimecrolimus cream 1% is a treatment for atopic eczema. The aim was to investigate the efficacy of pimecrolimus cream in asteatotic eczema, a skin disease similar to atopic eczema and its associated dry skin and itching. Results After 4 weeks of treatment showed pimecrolimus was helpful. With pimecrolimus there was better control of pruritus. Conclusion Pimecrolimus cream 1% is effective in patients with asteatotic eczema.

 

Eur J Dermatol. 2013 Dec 1. Recommendations for pimecrolimus 1% cream in the treatment of mild-to-moderate atopic dermatitis: from medical needs to a new treatment algorithm. Pimecrolimus 1% cream is an effective, non-corticosteroid, topical anti-inflammatory treatment for atopic dermatitis (AD). The aim of this article was to review published clinical data that have examined how pimecrolimus can address the medical needs of AD patients. Clinical studies have demonstrated that early treatment with pimecrolimus decreases the progression to disease flares, rapidly improves pruritus and significantly enhances quality of life. Patients find the formulation easy to apply, which may result in improved adherence with the treatment regimen. Pimecrolimus, in contrast to topical corticosteroids (TCSs), does not induce skin atrophy or epidermal barrier dysfunction and is highly effective for the treatment of AD in sensitive skin areas. Furthermore, pimecrolimus reduces the incidence of skin infections compared with TCSs and is not associated with other TCS-related side effects such as striae, telangiectasia and hypothalamic-pituitary-adrenal axis suppression. An additional benefit of pimecrolimus is its substantial steroid sparing effect. On the basis of these data, a new treatment algorithm for patients with mild-to-moderate AD is proposed in which pimecrolimus is recommended as a first line therapy for patients with established mild AD at the first signs and symptoms of disease. Pimecrolimus is also recommended for mild-to-moderate AD after initial treatment with a TCS. After resolution of lesions, maintenance treatment with pimecrolimus may effectively prevent subsequent disease flares. In conclusion, the clinical profile suggests that it may be considered the drug of choice for the treatment of mild-to-moderate AD in children as well as adults and particularly in sensitive skin areas.