Topical Calcineurin Inhibitors

​Certain side effects of topical calcineurin inhibitor are common and may even disappear during treatment. If any of the following side effects do not go away or are severe, consult your doctor.

The most common side effects at the site of application are warm sensation (sometimes burning), stinging or itching of the skin. This is usually mild to moderate and most common during the first few days of treatment. It usually lessens as your skin heals.

Other side effects include:

• Headache
• Flu-like symptoms such as blocked or runny nose
• Skin infections such as cold sores, chicken pox or shingles

​Inform your healthcare professional if:

• You are allergic to this medication or any of the other ingredients of this medication
• You are pregnant, planning to become pregnant, or breastfeeding
• You suspect that you have an infection on your skin e.g. chickenpox or herpes
• You have a weakened immune system (immunocompromised)
• You are on ultraviolet light therapy, using sun lamps or tanning bed    
• Avoid staying directly under sunlight or ultraviolet light for long durations. Use a broad-spectrum sunscreen product with Sun Protection Factor (SPF) of at least 30 and wear protective clothing when you are exposed to direct sunlight.
• You have a history of skin cancer    
• The association of skin cancer and this medication has not been proven. Safety of long-term use of this medication is unknown. Avoid using this medication continuously for a long time. If needed, treatment may be repeated with breaks in between.

•  1. Wash your skin with cleanser, rinse and pat dry
  
  2. Wash your hands before applying
  
  3. Apply your moisturiser after washing and drying the skin.
  
  4. Apply enough medication on the affected areas according to your doctor's instructions
• For Tacrolimus: Apply the medication 2 hours after applying the moisturiser
• For Pimecrolimus: Apply the medication after applying the moisturiser

           5. Wash your hands after applying the medication

• Avoid applying the medication too near your eyes, mouth and nose (unless specifically instructed) as it may cause irritation
• Flush the area thoroughly with water if the medication accidentally gets into your eyes, mouth, and nose
• Do not cover the treated skin with bandages, dressings or wraps. You can wear normal clothing.
• If you feel that the medication is not working well, do not apply more than instructed. Check with your doctor.    

​If you forgot to apply a dose of this medication, apply it as soon as you remember. Skip the dose if it is almost time for the next dose. Apply your next dose at the usual time. Do not apply two doses to make up for the missed dose.

​Pack this medication into a black trash bag and seal it tightly before throwing into the rubbish chute or bin.

​The symptoms of a drug allergy include one or more of the following:

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.