Introduction
Tacrol is used to treat eczema (atopic dermatitis). It works by suppressing the activity of certain immune cells that cause inflammation (redness and swelling) of the skin. This relieves itching and improves rashes in atopic dermatitis.
Tacrol is used for external use. It should be used 2-4 times a day on the affected area or use it as suggested by the doctor. It should be applied slowly and evenly to the skin until it is rubbed in. You should not use it too often and you should not cover the treated area with a bandage or plaster. You must inform your doctor if there's no improvement even after two weeks of treatment or if the skin gets worse.
It is a safe medicine with few side effects, but you may get an application site reaction like burning, irritation, itching and redness. This medicine is not normally recommended during pregnancy or while breastfeeding unless it is clearly needed.
Side effects of Tacrol
Common
- Application site reactions (burning, irritation, itching and redness)
How to use Tacrol
This medicine is for external use only. Use it in the dose and duration as advised by your doctor. Check the label for directions before use. Clean and dry the affected area and gently massage the ointment.
How Tacrol works
Tacrol is an immunosuppressant. It works by suppressing the activity of certain immune cells that cause inflammation (redness and swelling) of the skin. This relieves itching and improves rashes in atopic dermatitis.
What if you forget to take Tacrol?
If you miss a dose of Tacrol, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Indication
Atopic dermatitis, Allergic contact dermatitis, Severe eczema, Psoriasis, Alopecia areata, Pyoderma gangrenosum, Cutaneous lupus erythematosus, Dermatomyositis, Seborrheic dermatitis, Rosacea, Lichen Planus, Pemphigus Vulgaris, Vitiligo, Graft-Versus-Host Disease, Ichthyosis.
Administration
Apply a thin layer of Tacrolim ointment onto the affected skin areas and rub in gently and completely. Treatment should be continued for one week after clearing of signs and symptoms of atopic dermatitis. Tacrolim ointment should not be used with occlusive dressings.
Adult Dose
Topical/Cutaneous
Atopic dermatitis
Adult: Apply thinly 0.03% or 0.1% ointment to affected area bid. Rub in gently and completely. For short-term and intermittent use only. If no improvement after 6 wk, re-confirm diagnosis.
Child Dose
Topical/Cutaneous
Atopic dermatitis
<2 years old: Not recommended
Child: 2-15 yr: Apply thinly 0.03% oint to affected area bid. Rub in gently and completely. For short-term and intermittent use only.
>15 years: Apply 0.03% or 0.1% ointment as thin layer to affected area q12hr;
Contraindication
Tacrolimus ointment is contraindicated in patients with a history of hypersensitivity to Tacrolimus or any other component of the preparation.
Mode of Action
Tacrolimus inhibits T-lymphocyte activation, although the exact mechanism of action unclear. Tacrolimus bind to cytosolic receptors known as immunophilins (i.e., cyclophilin and FK binding protein-12 [FKBP-12], respectively), forming complexes that inhibit the production of cytokines via the calcineurin pathway. Inhibition of calcineurin activity inhibits early activation of T-cells (ie.immunosuppresion results).
Precaution
Monitoring of blood trough serum concentrations to prevent organ rejection and to reduce drug-related toxicity. Topical: Used with caution on the face or neck, large areas of the body (not >50% of the total BSA), or areas of broken skin. Infections at the treatment site should be cleared prior to therapy. Delay use in patients with unknown cause of lymphadenopathy or acute infectious mononucleosis till resolution. Use in patients with Netherton's syndrome is not recommended. Pregnancy.
Lactation: Not known whether tacrolimus is distributed in milk following topical administration to skin
Side Effect
>10%
Burning sensation (43-58%), Pruritus (41-46%), Flu-like symptoms (23-31%), Skin erythema (12-28%), Headache (5-20%)
Interaction
Increased nephrotoxicity with ciclosporin, aminoglycosides, amphotericin B, cisplatin, NSAIDs, vancomycin, co-trimoxazole, aciclovir, ganciclovir. Increased risk of hyperkalemia with potassium-sparing diuretics. Increased plasma concentrations and toxicity with azole antifungals, calcium-channel blockers, cimetidine, danazol, HIV-protease inhibitors, macrolide antibacterials and metoclopramide. Antacids, rifampin, rifabutin, casofungin, phenytoin, phenobarbital and carbamazepine decrease tacrolimus plasma concentrations. Concurrent admin of sirolimus and tacrolimus decrease levels of both.