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Topical calcineurin inhibitor (non-steroid)

Tacrolimus: uses, side effects & precautions

Also known as Protopic.

This information is for general guidance only and does not constitute medical advice. Always consult a qualified healthcare professional for personal medical concerns. In an emergency, call your local emergency number.

What it is used for

  • Moderate to severe eczema (atopic dermatitis)
  • Eczema on sensitive areas such as the face and skin folds
  • Eczema where steroid creams are unsuitable for long-term use

How it works

Tacrolimus calms the overactive immune response in the skin that causes eczema, reducing redness, swelling and itching without being a steroid.

How it is taken

Comes as an ointment, usually prescribed by a clinician, in strengths for adults and children. Apply a thin layer to the affected skin exactly as your clinician directs. A mild warm or burning sensation is common in the first days. Use sun protection on treated skin and avoid strong sunlight and sunbeds.

No doses here on purpose. The right strength and schedule depend on you — only a doctor or pharmacist should set them. Always follow your prescription and the label.

Common side effects

  • Burning, warmth or stinging of the skin, especially when starting
  • Itching or redness at the site
  • Increased sensitivity to hot and cold, and skin flushing with alcohol in some people

Serious effects — get help

  • Signs of a skin infection developing (increasing pain, swelling, pus, fever)
  • Signs of an allergic reaction such as facial swelling, widespread rash or difficulty breathing

If a reaction is severe — for example trouble breathing, swelling of the face or throat, or collapse — go to the nearest emergency room now or call your local emergency number. Do not wait for an online consultation.

Interactions to watch

  • Alcohol can cause facial flushing and warmth while using it
  • Avoid strong sunlight, sunlamps and other intensive light treatments on treated skin

Who should take care

  • Use sun protection and limit sun exposure on treated areas
  • Do not apply to infected skin; treat infection first as advised
  • Tell your clinician if you are pregnant or breastfeeding
  • Apply only thin layers to affected areas and review use regularly with your clinician

Frequently asked questions

Is tacrolimus a steroid?
No. It is a non-steroid medicine, which is why it is useful for sensitive areas like the face where long-term steroids are best avoided.
Why does my skin burn when I apply it?
A warm or burning sensation in the first few days is common and usually settles as treatment continues. Tell your clinician if it is severe or persists.
Do I need sun protection with it?
Yes. Protect treated skin from strong sunlight and avoid sunbeds while using it.
Can I use it on infected eczema?
No. Skin infection should be treated first. See your clinician if your eczema looks infected before applying it.
Is Tacrolimus safe to take?
For most people it is safe when taken exactly as a doctor or pharmacist advises and as printed on the label. Tell your clinician about your other medicines and health conditions, and seek urgent care for any serious reaction.

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