pimecrolimus (Elidel)

Pimecrolimus is a chemical that is used to treat atopic dermatitis (eczema). Atopic dermatitis is a skin condition characterized by redness, itching, scaling, and inflammation of the skin. The cause of atopic dermatitis is not known; however, scientists believe that it may be due to activation of the immune system by various environmental or emotional triggers. Scientists do not know exactly how pimecrolimus reduces the manifestations of atopic dermatitis, but pimecrolimus reduces the action of T-cells and mast cells which are part of the immune system and contribute to responses of the immune system. Pimecrolimus prevents the activation of T-cells by blocking the effects of chemicals (cytokines) released by the body that stimulate T-cells. Pimecrolimus also reduces the ability of mast cells to release chemicals that promote inflammation. Pimecrolimus was approved by the FDA in December 2001.

What brand names are available for pimecrolimus?

Elidel

Is pimecrolimus available as a generic drug?

The most common side effects of pimecrolimus are:

• reactions at the site of application,
• burning,
• itching, and
• redness.

Other important side effects include:

• sore throat,
• stuffy nose,
• headache,
• cough,
• respiratory tract and
• viral infections.

Skin cancer and lymphoma have rarely occurred during treatment with pimecrolimus. Therefore, pimecrolimus should not be used for long-term treatment and should only be applied to affected areas.

Patients should completely rub in a thin layer of pimecrolimus to the affected areas twice daily. An improvement in symptoms can be seen within 8-15 days, and patients should contact their physician if there is no response after six weeks of use.

Interactions between pimecrolimus and other drugs have not been studied. Since very little pimecrolimus is absorbed from the skin, drug interactions are not expected. However, since some pimecrolimus is absorbed, caution should be exercised when pimecrolimus is used by individuals also taking drugs (for exmaple, ketoconazole [Nizoral, Extina, Xolegel, Kuric], itraconazole [Sporanox], erythromycin, fluconazole [Diflucan], calcium channel blockers [CCBs], cimetidine [Tagamet]) that inhibit the liver enzymes that eliminate pimecrolimus and could increase the levels of pimecrolimus and promote its toxicity.

There are no adequate studies that evaluate the use of pimecrolimus during pregnancy.

Use of pimecrolimus by nursing mothers has not been evaluated, and it is not known if pimecrolimus is excreted in breast milk. Nursing mothers should decide whether to stop nursing or use alternative treatments.

What preparations of pimecrolimus are available?

Cream, 1%

How should I keep pimecrolimus stored?

Pimecrolimus should be stored at room temperature, 15 C - 30 C (59 F - 86 F).