Protopic Disease Interactions

The use of calcineurin inhibitors as pimecrolimus and tacrolimus topical should be avoided in immunocompromised adults and children, including patients on systemic immunosuppressive medications. Although causal relationship has not been established, there is a concern about a potential risk of infections, lymphomas and skin malignancies when using topical calcineurin inhibitors for a prolonged time.

Rare postmarketing cases of acute renal failure have been reported in patients treated with topical tacrolimus. Systemic absorption is most likely to occur in patients with epidermal barrier defects, and when topical tacrolimus is applied to large body surface areas. Caution should be exercised in patients with history of renal impairment or predisposed to renal impairment.

The use of calcineurin inhibitors such as pimecrolimus and tacrolimus topical should be avoided on malignant or premalignant skin conditions. Some of these conditions might present as dermatitis. Calcineurin inhibitors should also be avoided in any skin conditions where there is the potential for increased systemic absorption of the medication as when there is a skin barrier defect.