Pmec Cream

Indications

Pimecrolimus 1% cream is used to treat mild to moderate atopic dermatitis (eczema) in adults and children aged 2 years and over. It is mainly used for short periods or on and off over the long term, especially on delicate skin such as the face, eyelids, neck and skin folds, or when steroid creams are not suitable.

How It Works

Pimecrolimus is a calcineurin inhibitor. It blocks certain immune cells in the skin from releasing substances that cause inflammation, redness and itching. Unlike steroid creams, it does not thin the skin.

Dosage and Administration

Apply a thin layer to the affected skin twice a day and rub in gently and completely, or as prescribed. Use it as soon as signs of eczema appear and stop when they clear. Moisturisers can be used, but apply them after the cream has soaked in. Wash your hands after use unless you are treating the hands. See your doctor if there is no improvement after 6 weeks.

Interactions

Few interactions are expected because little is absorbed through the skin. Avoid using other creams on the same area at the same time unless advised. People with widespread eczema taking medicines that block the CYP3A4 liver enzyme, such as Ketoconazole or Erythromycin, should use it with care. Live vaccines should be discussed with the doctor during treatment. Alcohol may cause facial flushing in some users.

Contraindications

• Allergy to Pimecrolimus, other macrolide immune modulators (such as Tacrolimus) or any ingredient of the cream.
• Children under 2 years.
• People with a weakened immune system.
• Skin that is infected or has a skin cancer or pre-cancerous change.

Side Effects

The most common effect is a warm, burning or stinging feeling where it is applied, usually mild and settling within a few days. Itching, redness, skin infections such as folliculitis or cold sores (herpes), and flushing after alcohol can occur. Long-term safety is still being studied, and a possible link with skin cancer or lymphoma has been raised, though not proven.

Stop using it and get urgent medical help if you have swelling of the face, lips or throat, difficulty breathing, a spreading painful rash with blisters or fever, or swollen glands that do not go away.

Pregnancy and Lactation

There is limited information in pregnancy, so it should be used only if your doctor thinks it is needed. It is not known whether it passes into breast milk; if used while breastfeeding, do not apply it to the breast area.

Precautions and Warnings

• Limit sun exposure and avoid sunbeds; use protective clothing and sunscreen.
• Do not cover the treated skin with tight bandages or occlusive dressings.
• Infected eczema should be treated first.
• Avoid the eyes and inside of the mouth or nose; rinse with water if it gets there.

Overdose

Using too much on the skin is unlikely to cause harm. If swallowed, contact a doctor or poison centre.

Therapeutic Class

Topical calcineurin inhibitor (topical immunomodulator).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Do not freeze.