Tacrolimus (Protopic) Risks, Warnings, and Complications

Precautions Before Starting Tacrolimus (Protopic)

Tell your doctor if you have ever had an allergic reaction to tacrolimus ointment, injection, or capsules, any of the active or inactive ingredients in tacrolimus ointment, or any other drugs. Your pharmacy can give you a list of ingredients.

Give your doctor or pharmacist a list of all the medicines you are taking, including prescription drugs, non-prescription drugs, dietary supplements, and herbal products. This can help avoid possible interactions between tacrolimus and your other medications.

Give your doctor a complete medical history. Tacrolimus may not be safe for people with certain health conditions, such as skin disease, skin infection, Netherton’s syndrome (an inherited skin condition), kidney disease, or a viral infection such as chicken pox, shingles, cold sores, or eczema herpeticum. Also, tell your doctor if you develop a skin infection on top of your eczema rash with symptoms such as blistering, crusting, or oozing skin.

Tell your doctor if you are pregnant, could be pregnant, are planning a pregnancy, or are breast-feeding.

Precautions During Use of Tacrolimus (Protopic)

Keep all your medical and lab appointments during treatment with tacrolimus ointment.

Do not use this medication continuously for the long term. Apply a thin layer twice a day as prescribed. Limit the application of tacrolimus ointment to the affected areas. Use the minimum amount of medicine necessary to control your eczema symptoms. Discontinue use of the medicine as soon as the symptoms resolve. Do not place a wrap, bandage, or dressing on the treated area. You can, however, wear normal clothing over the affected skin. 

Use only the 0.03% strength in children between 2 and 15 years. Do not use the 0.1% strength of tacrolimus ointment in children younger than 16 years. 

Ask your doctor how to protect your skin from sunlight while using tacrolimus. Avoid unnecessary sun exposure and wear loose-fitting clothing when outdoors (even when the medication is not applied to the skin areas affected by eczema). Do not use sun lamps or tanning beds, and avoid ultraviolet light therapy while using Protopic ointment. 

Talk to your doctor about which moisturizers you should use for dry skin caused by eczema. Always apply the moisturizer on top of the tacrolimus ointment. 

Avoid drinking alcohol while using tacrolimus ointment, as this may make you feel hot and cause skin flushing. 

Avoid contact with people who have chickenpox, shingles, or other viral infections. Call your doctor immediately if you develop a viral infection while using tacrolimus ointment. 

Tell all your health care professionals you are using tacrolimus, especially before any surgery, including dental procedures.

Tacrolimus (Protopic) Drug Interactions

Certain other medicines can affect how tacrolimus works. Using tacrolimus and other medicines together can increase the risk of severe adverse reactions. Your doctor may change the doses of your medications, switch you to another medication, and/or monitor you carefully for adverse effects if there are known interactions between tacrolimus and your other medicines.

The following medications can have possible interactions with tacrolimus:

• Antifungal drugs such as itraconazole (Sporanox), fluconazole (Diflucan), and ketoconazole (Nizoral)
• Calcium channel blockers such as verapamil (Covera, Calan, Verelan, Isoptin) and diltiazem (Dilacor, Cardizem, Tiazac)
• H2 blockers like cimetidine (Tagamet)
• Certain antibiotics such as erythromycin (Erythrocin, E.E.S., E-Mycin)
• Other creams, ointments, and lotions

The above list may not include all the possible interactions with tacrolimus. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, dietary supplements, and herbal remedies. Also, tell your healthcare provider if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause a serious reaction when used with prescription and over-the-counter medicines.