Protopic Side Effects
Please note - some side effects for Protopic may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).
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For the consumer For the professional
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Side Effects of Protopic - for the consumer
Protopic Ointment
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Protopic Ointment:
Seek medical attention right away if any of these SEVERE side effects occur when using Protopic Ointment:Acne; burning, stinging, soreness, itching, or redness of skin; flu-like symptoms; headache; upset stomach.
TopSevere allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); back pain; increased sensitivity to pain or touch; indigestion; nasal congestion; muscle pain; painful menstrual periods; sensitivity to pain; skin infection; swollen glands; swollen or infected hair follicles; weakness.
For the professional
Protopic
No phototoxicity and no photoallergenicity were detected in clinical studies with 12 and 216 normal volunteers, respectively. One out of 198 normal volunteers showed evidence of sensitization in a contact sensitization study.
In three 12 week randomized vehicle-controlled studies and four safety studies, 655 and 9,163 patients respectively, were treated with Protopic Ointment. The duration of follow-up for adult and pediatric patients in the safety studies is tabulated below.
| Time on Study | Adult | Pediatrics | Total |
| < 1 year | 4682 | 4481 | 9163 |
| ≥ 1 year | 1185 | 1349 | 2534 |
| ≥ 2 years | 200 | 275 | 475 |
| ≥ 3 years | 118 | 182 | 300 |
The following table depicts the adjusted incidence of adverse events pooled across the 3 identically designed 12-week controlled studies for patients in vehicle, Protopic Ointment 0.03%, and Protopic Ointment 0.1% treatment groups. The table also depicts the unadjusted incidence of adverse events in four safety studies, regardless of relationship to study drug.
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12-Week, Randomized, Double-Blind, Phase 3 Studies 12-Week Adjusted Incidence Rate (%) |
Open-Label Studies (up to 3 years) 0.1% and 0.03% Tacrolimus Ointment Incidence Rate (%) |
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Adult |
Pediatric |
Adult | Pediatric | Total | ||||
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Vehicle (n=212) % |
0.03% Tacrolimus Ointment (n=210) % |
0.1% Tacrolimus Ointment (n=209) % |
Vehicle (n=116) % |
0.03% Tacrolimus Ointment (n=118) % |
(n=4682)% | (n=4481)% |
(n=9163) % |
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| Skin Burning* | 26 | 46 | 58 | 29 | 43 | 28 | 20 | 24 |
| Pruritus* | 37 | 46 | 46 | 27 | 41 | 25 | 19 | 22 |
| Flu-like symptoms* | 19 | 23 | 31 | 25 | 28 | 22 | 34 | 28 |
| Allergic Reaction | 8 | 12 | 6 | 8 | 4 | 9 | 13 | 11 |
| Skin Erythema | 20 | 25 | 28 | 13 | 12 | 12 | 7 | 9 |
| Headache* | 11 | 20 | 19 | 8 | 5 | 13 | 9 | 11 |
| Skin Infection | 11 | 12 | 5 | 14 | 10 | 9 | 16 | 12 |
| Fever | 4 | 4 | 1 | 13 | 21 | 2 | 14 | 8 |
| Infection | 1 | 1 | 2 | 9 | 7 | 6 | 10 | 8 |
| Cough Increased | 2 | 1 | 1 | 14 | 18 | 3 | 10 | 6 |
| Asthma | 4 | 6 | 4 | 6 | 6 | 4 | 13 | 8 |
| Herpes Simplex | 4 | 4 | 4 | 2 | 0 | 4 | 3 | 3 |
| Eczema Herpeticum | 0 | 1 | 1 | 0 | 2 | 0 | 0 | 0 |
| Pharyngitis | 3 | 3 | 4 | 11 | 6 | 4 | 12 | 8 |
| Accidental Injury | 4 | 3 | 6 | 3 | 6 | 6 | 8 | 7 |
| Pustular Rash | 2 | 3 | 4 | 3 | 2 | 2 | 7 | 5 |
| Folliculitis* | 1 | 6 | 4 | 0 | 2 | 4 | 2 | 3 |
| Rhinitis | 4 | 3 | 2 | 2 | 6 | 2 | 4 | 3 |
| Otitis Media | 4 | 0 | 1 | 6 | 12 | 2 | 11 | 6 |
| Sinusitis* | 1 | 4 | 2 | 8 | 3 | 6 | 7 | 6 |
| Diarrhea | 3 | 3 | 4 | 2 | 5 | 2 | 4 | 3 |
| Urticaria | 3 | 3 | 6 | 1 | 1 | 3 | 4 | 4 |
| Lack of Drug Effect | 1 | 1 | 0 | 1 | 1 | 6 | 6 | 6 |
| Bronchitis | 0 | 2 | 2 | 3 | 3 | 4 | 4 | 4 |
| Vomiting | 0 | 1 | 1 | 7 | 6 | 1 | 4 | 3 |
| Maculopapular Rash | 2 | 2 | 2 | 3 | 0 | 2 | 1 | 1 |
| Rash* | 1 | 5 | 2 | 4 | 2 | 2 | 3 | 3 |
| Abdominal Pain | 3 | 1 | 1 | 2 | 3 | 1 | 3 | 2 |
| Fungal Dermatitis | 0 | 2 | 1 | 3 | 0 | 2 | 4 | 3 |
| Gastroenteritis | 1 | 2 | 2 | 3 | 0 | 2 | 4 | 3 |
| Alcohol Intolerance* | 0 | 3 | 7 | 0 | 0 | 4 | 0 | 2 |
| Acne* | 2 | 4 | 7 | 1 | 0 | 3 | 2 | 3 |
| Sunburn | 1 | 2 | 1 | 0 | 0 | 2 | 1 | 1 |
| Skin Disorder | 2 | 2 | 1 | 1 | 4 | 2 | 2 | 2 |
| Conjunctivitis | 0 | 2 | 2 | 2 | 1 | 3 | 3 | 3 |
| Pain | 1 | 2 | 1 | 0 | 1 | 2 | 1 | 2 |
| Vesiculobullous Rash* | 3 | 3 | 2 | 0 | 4 | 2 | 1 | 1 |
| Lymphadenopathy | 2 | 2 | 1 | 0 | 3 | 1 | 2 | 1 |
| Nausea | 4 | 3 | 2 | 0 | 1 | 2 | 1 | 2 |
| Skin Tingling* | 2 | 3 | 8 | 1 | 2 | 2 | 1 | 1 |
| Face Edema | 2 | 2 | 1 | 2 | 1 | 1 | 1 | 1 |
| Dyspepsia* | 1 | 1 | 4 | 0 | 0 | 2 | 2 | 2 |
| Dry Skin | 7 | 3 | 3 | 0 | 1 | 1 | 1 | 1 |
| Hyperesthesia* | 1 | 3 | 7 | 0 | 0 | 2 | 0 | 1 |
| Skin Neoplasm Benign† | 1 | 1 | 1 | 0 | 0 | 1 | 2 | 2 |
| Back Pain* | 0 | 2 | 2 | 1 | 1 | 3 | 0 | 2 |
| Peripheral Edema | 2 | 4 | 3 | 0 | 0 | 2 | 0 | 1 |
| Varicella Zoster/Herpes Zoster*‡ | 0 | 1 | 0 | 0 | 5 | 1 | 2 | 2 |
| Contact Dermatitis | 1 | 3 | 3 | 3 | 4 | 2 | 2 | 2 |
| Asthenia | 1 | 2 | 3 | 0 | 0 | 1 | 0 | 1 |
| Pneumonia | 0 | 1 | 1 | 2 | 0 | 1 | 3 | 2 |
| Eczema | 2 | 2 | 2 | 0 | 0 | 1 | 0 | 1 |
| Insomnia | 3 | 4 | 3 | 1 | 1 | 2 | 0 | 1 |
| Exfoliative Dermatitis | 3 | 3 | 1 | 0 | 0 | 0 | 1 | 0 |
| Dysmenorrhea | 2 | 4 | 4 | 0 | 0 | 2 | 1 | 1 |
| Periodontal Abscess | 1 | 0 | 1 | 0 | 0 | 1 | 1 | 1 |
| Myalgia* | 0 | 3 | 2 | 0 | 0 | 2 | 1 | 1 |
| Cyst* | 0 | 1 | 3 | 0 | 0 | 1 | 0 | 1 |
| Cellulitis | 1 | 1 | 1 | 0 | 0 | 1 | 1 | 1 |
| Exacerbation of Untreated Area | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 1 |
| Procedural Complication | 1 | 0 | 0 | 1 | 0 | 1 | 1 | 1 |
| Hypertension | 0 | 0 | 1 | 0 | 0 | 2 | 0 | 1 |
| Tooth Disorder | 0 | 1 | 1 | 1 | 0 | 2 | 1 | 1 |
| Arthralgia | 1 | 1 | 3 | 2 | 0 | 2 | 1 | 2 |
| Depression | 1 | 2 | 1 | 0 | 0 | 1 | 0 | 1 |
| Paresthesia | 1 | 3 | 3 | 0 | 0 | 2 | 1 | 2 |
| Alopecia | 0 | 1 | 1 | 0 | 0 | 1 | 1 | 1 |
| Urinary Tract Infection | 0 | 0 | 1 | 0 | 0 | 2 | 1 | 2 |
| Ear Pain | 1 | 0 | 1 | 0 | 1 | 0 | 1 | 1 |
Other adverse events which occurred at an incidence between 0.2% and less than 1% in clinical studies in the above table include: abnormal vision, abscess, anaphylactoid reaction, anemia, anorexia, anxiety, arthritis, arthrosis, bilirubinemia, blepharitis, bone disorder, breast neoplasm benign, bursitis, cataract NOS, chest pain, chills, colitis, conjunctival edema, constipation, cramps, cutaneous moniliasis, cystitis, dehydration, dizziness, dry eyes, dry mouth/nose, dyspnea, ear disorder, ecchymosis, edema, epistaxis, eye pain, furunculosis, gastritis, gastrointestinal disorder, hernia, hypercholesterolemia, hypertonia, hypothyroidism, joint disorder, laryngitis, leukoderma, lung disorder, malaise, migraine, moniliasis, mouth ulceration, nail disorder, neck pain, neoplasm benign, oral moniliasis, otitis externa, photosensitivity reaction, rectal disorder, seborrhea, skin carcinoma, skin discoloration, skin hypertrophy, skin ulcer, stomatitis, tendon disorder, thinking abnormal, tooth caries, sweating, syncope, tachycardia, taste perversion, unintended pregnancy, vaginal moniliasis, vaginitis, valvular heart disease, vasodilatation, and vertigo.
Post-Marketing Events
The following adverse reactions have been identified during postapproval use of Protopic Ointment. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
CNS
Seizures
Neoplasms
Lymphomas, basal cell carcinoma, squamous cell carcinoma, malignant melanoma
Infections
Bullous impetigo, osteomyelitis, septicemia
Renal
Acute renal failure in patients with or without Netherton’s syndrome, renal impairment
Skin
Rosacea
Overdosage
Protopic Ointment is not for oral use. Oral ingestion of Protopic Ointment may lead to adverse effects associated with systemic administration of tacrolimus. If oral ingestion occurs, medical advice should be sought.
TopMore resources:
Protopic Topical - Includes detailed dosage instructions.
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