In the article, we consider the instructions for the cream "Pimecrolimus".
Atopic dermatitis is a non-infectious chronic skin lesion of an inflammatory nature that occurs with periods of remissions and exacerbations. This disease manifests itself by excessive dryness, irritation of the skin and severe itching. The disease causes psychological and physical discomfort, lowers the quality of life, and visually presents cosmetic imperfections. In order to reduce the severity of symptoms of pathology, specialists often prescribe Pimecrolimus cream.
Chemical properties of the drug, composition and form of release
The active substance of this drug is a derivative of macrolactam ascomycin. The medication is a crystalline white powder that dissolves in methanol and ethanol, but does not dissolve in water.
The drug in the form of a 1% cream is available in tubes of 15 grams.
pharmachologic effect
Many people wonder if Pimecrolimus is a hormone cream. No. This is a dermatotropic, immunosuppressive, anti-inflammatory drug that actively acts on the cytosolic receptors of macrophilin-12 in T-lymphocytes and inhibits the production of calcineurin - calcium-independent phosphatase. Due to this effect, T-lymphocytes are not activated, transcription and production of cytokines in T-helper cells does not occur.
In addition, the medication inhibits the production of specific inflammatory mediators of interleukin-10, interleukin-4, interferon, tumor necrosis factor, colony-stimulating granulocyte-macrophage factor, interleukin-5 and interleukin-2. Cream "Pimecrolimus" does not directly affect carotenocytes, fibroplasts and endothelial cells.
During the study of the pharmacokinetics of this pharmacological compound in the treatment of adult patients suffering from atopic dermatitis, during the defeat of at least 13-60% of the skin surface, very low concentrations of the active substance were observed for one year, it did not accumulate in tissues and organs.
As the instruction for Pimecrolimus cream indicates, after a single use of the medication, its o-demethylated metabolites were found that circulated throughout the body. At the same time, approximately 80% of the radioactivity was found in feces in the form of metabolites and about 1% in unchanged form. It also turned out that this drug is metabolized by CYP3A enzymes. Biological transformation does not occur in the skin. After 6 months of treatment, signs of atopic dermatitis were practically absent or completely disappeared in 35% of patients, 57% showed almost complete elimination of itching and improvement in general condition.
During independent studies in children suffering from atopic dermatitis of varying severity, normalization of the condition was observed already on the 15th day of therapeutic measures.
Indications for appointment
Cream "Pimecrolimus" is indicated for use in the following cases:
- for short-term therapy of mild or moderate atopic dermatitis in patients after 2 years, with optimal functioning of the immune system;
- with atopic dermatitis in patients who are immune to traditional methods of treatment.
Are there any contraindications?
List of contraindications
The drug "Pimecrolimus" is contraindicated for use in the following situations:
- hypersensitivity to the active substance;
- age less than 3 months;
- acute, viral, fungal or bacterial infections to avoid complications.
Caution should be given to women during pregnancy, during lactation (it is not recommended to apply the drug to the area of the mammary glands).
Side effects
During the application of the cream, 1% cases of the development of phototoxicity, contact sensitization, photoallergy, or inflammatory reactions were not recorded. Most often, with therapy with this medication, itching, burning, redness were observed at the site of application of the medicine, as well as folliculitis and other skin infections, a feeling of warmth.
Suppuration, inflammation and worsening of the condition of the skin, dermatitis, skin rashes, herpetic eczema, paresthesias, peeling and dryness of the skin, papillomas, edema and boils occurred somewhat less frequently.
Prolonged use reactions
With prolonged use during the year and with combined use with GCS, adverse reactions such as urticaria, superinfection and other local allergic phenomena, rhinitis, impetigo often occurred.
It is extremely rare during the treatment with this substance that intolerance to drinks containing ethyl alcohol developed.
If side effects occur, it is recommended to stop using the pharmacological agent and consult a specialist.
Instructions for use
The drug "Pimecrolimus" is used exclusively externally. According to information from the official instructions, this medication is recommended to be applied to the affected skin with a thin layer 2 times a day. It is necessary to slowly, gently rub the cream into the skin until it is completely absorbed. The medication is allowed to be used on the scalp, face, neck, diaper rash. The duration of treatment, as a rule, is a long period - until the symptoms of atopic dermatitis completely disappear. If there are symptoms of a recurring disease, then therapy must be started again.
If within 2 months of using the medication no improvement in the patient's condition has occurred, then you should seek the advice of a doctor and change the treatment regimen and tactics.
The safety of using the cream under an occlusive dressing has not been studied, so it is not recommended to apply the medicine under the dressings.
Drug interaction
Pimecrolimus cream is carefully combined with fluconazole, intraconazole, erythromycin, cimetidine, ketoconazole and other CYP3A enzyme inhibitors.
As a result of a very low degree of systemic absorption, the active substance probably does not enter into drug interaction with other pharmacological drugs that can penetrate into the general bloodstream.
Special recommendations
As indicated by the instructions for use with Pimecrolimus cream, avoid contact with eyes and mucous membranes. Also, during therapy, it is recommended to avoid exposure to the skin of UV radiation and direct sunlight.
It should be remembered that medical treatment increases the likelihood of developing shingles, chickenpox, Kaposi's herpetiform eczema and herpetic eruptions.
Use with caution this medication in children under the age of 2 years.
It is impossible to apply cream on the skin affected by a viral infection of an acute nature, it must first be eliminated.
Some interaction of the active substance of the drug with alcohol was noted, as a result of which the simultaneous intake of alcoholic beverages during the use of the medication is not recommended.
Use during pregnancy and lactation
The use of the drug during pregnancy is possible only in case of emergency, after the recommendation of a doctor. The use of cream during lactation should be discontinued.
Analogues of the drug
The following medicines are analogues of Pimecrolimus cream:
- "Elidel" is a cream-shaped medication that has the ability to selectively inhibit the synthesis and release from tissues of elements that are the main mediators of inflammation reactions - T-lymphocytes and mast cell mediators. A cream is made on the basis of the active component - pimecrolimus. With regular use, this medication effectively reduces inflammation, relieves itching and severity of tissue damage, without provoking an increase in sensitivity, irritation and skin atrophy. Indications for the use of Elidel cream are short-term treatment or long-term therapy of the manifestations and symptoms of atopic dermatitis in adults, adolescents and children from three months. What other analogues does Pimecrolimus have?
- Antipsor is a cream that is made on the basis of extracts of various medicinal plants and medical solidol. The last element has an independent therapeutic effect (keratoplastic, epithelizing, wound healing). The fat base of the drug prevents the evaporation of moisture from the surface of the affected skin, which leads to a significant improvement in the absorption processes of the active components of the plants. Under the influence of the Antipsor preparation, the damaged areas are quickly restored, pain is reduced and the rate of natural resorption of exudate is increased. This is confirmed by the instructions for the analogue of Pimecrolimus.
- "Acrustal" - a tool that is intended to treat dermatitis and psoriasis. It has anti-inflammatory and keratolic effects, normalizes the processes of skin cell metabolism, and stimulates the restoration of skin integuments. The uniqueness of this cream is ensured by patented technologies for the extraction of plant materials, which preserves the biological substances of medicinal plants. Extracts and oils soothe and nourish irritated skin, eliminate itching and inflammation. This cream has a pleasant smell. In its composition it does not contain synthetic additives and antibiotics. Fat solidol in the composition of the drug is made from vegetable oils. Due to the consistency, the cream can be used on the scalp with psoriasis. This medicine is not addictive.
- Protopic is a cream based on the active element of tacrolimus monohydrate. At the molecular level, intracellular cumulation and the effects of this drug are due to the processes of binding to the cytosolic protein. Tacrolimus competitively and specifically inhibits calcineurin, provides calcium-dependent blocking of transmission channels of T-cell signals and prevents the transcription of discrete lymphokine genes. This substance is a highly active immunosuppressant. This medication is intended for the treatment of atopic dermatitis (severe and moderate) in case of insufficient response to traditional treatment methods or the presence of contraindications to them.
Reviews
There are a lot of positive reviews about Pimecrolimus cream on medical sites and forums. Patients who used it, note the high effectiveness of this drug, including in comparison with its analogues. This cream does not have a specific unpleasant odor, which allows it to be used in childhood. Patients note that the cream does not act immediately. The negative manifestations of atopic dermatitis disappear only after some time of application - after about 2 weeks. At the same time, there were practically no side effects during treatment, with the exception of rare cases of allergic phenomena. Such reactions were most often observed in childhood. Patients also say that they prefer to use this medicine as a replacement for hormonal drugs for atopic dermatitis, which have a number of contraindications and side effects.
We reviewed the detailed instructions for Pimecrolimus.