Is pimecrolimus a steroid?
Topical steroids are a first-line treatment for many skin conditions such as eczema. When they cannot be used due to lack of effectiveness or tolerability, your healthcare provider may prescribe pimecrolimus. It is not a steroid. Pimecrolimus is a macrolactam derivative that belongs to a class called topical calcineurin inhibitors (TCIs). By blocking activation of calcineurin, it reduces production of inflammatory cytokines involved in eczema, leading to fewer flare-ups and clearer skin. Pimecrolimus is intended as a short-term treatment and should not be used for more than six weeks at a time.
Pimecrolimus FAQs
Is pimecrolimus FDA approved?
Topical pimecrolimus 1% cream is the generic form of Elidel. It is FDA-approved for atopic dermatitis (eczema) in adults and children aged two years and older. It reduces flare-ups but is recommended only for short-term use, as long-term safety has not been established.
It is used when topical steroids are ineffective or not tolerated, since prolonged steroid use can cause skin atrophy and systemic effects. Pimecrolimus cream is not recommended for patients with Netherton’s syndrome, immunodeficiency, or skin cancers.
What does pimecrolimus do to the skin?
Pimecrolimus cream is applied as a thin layer to affected areas twice daily. It reduces redness, swelling, itching, and rash by dampening the overactive immune response in eczema.
What are the side effects of pimecrolimus?
Common side effects include:
- Application site reactions (redness, burning, discoloration)
- Headache
- Viral infections
- Bronchitis
- Cold symptoms
- Skin infections (cold sores, chickenpox, shingles, folliculitis)
- Swollen lymph nodes
- Upper respiratory tract infections
Rare serious side effects may include:
- Allergic reactions (hives, facial or throat swelling, breathing difficulty)
- Increased risk of skin cancer or lymphoma
- Increased sensitivity to sunburn
These are not all possible adverse effects. Consult your dermatologist for any concerns and report events to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
What drug interactions are there with pimecrolimus?
- Calcium channel blockers
- Erythromycin
- Itraconazole
- Ketoconazole
- Fluconazole
- Cimetidine
- Alcohol
When should you not use pimecrolimus?
Do not use if you have an allergy to pimecrolimus or any cream ingredient, immunodeficiency, cancerous or precancerous skin disease, Netherton’s syndrome, or if you are under two years of age.
What other warnings and precautions are there?
Tell your doctor if you have:
- Cutaneous T‑cell lymphoma
- Skin infections (herpes, chickenpox, shingles)
- Burned or damaged skin
- Ongoing UV or phototherapy
- Pregnancy, plans to become pregnant, or breastfeeding
How long can you use pimecrolimus?
You may apply pimecrolimus cream twice daily for up to six weeks. If symptoms persist, your doctor will reassess and consider alternative treatments such as biologics or topical corticosteroids.
Does pimecrolimus weaken your immune system?
Pimecrolimus is an immunosuppressant. It reduces overactive immune activity in the skin but is used topically when steroids are not suitable.
Can you drink alcohol while using pimecrolimus?
Alcohol may rarely cause flushing or increased skin irritation at application sites. Avoid sun exposure on treated areas to reduce risk of sunburn.
How long does it take for pimecrolimus to work?
Some users notice symptom relief within 8–15 days; it may take up to a month for clearer skin. Contact your doctor if there is no improvement after six weeks.
Should you use pimecrolimus in the morning or night?
Apply twice daily, once in the morning and once in the evening. You may use moisturizers after pimecrolimus but do not cover treated skin with wraps or bandages.
Related Medications
- Protopic Ointment (tacrolimus)
- Lidex Topical Solution (fluocinonide)
- Dupixent (dupilumab)
- Elocon Cream (mometasone furoate)
- Temovate Cream (clobetasol)