Topical Calcineurin Inhibitors

There are two topical prescription eczema drugs that do not contain steroids. These are called topical calcineurin inhibitors or TCIs. Both are effective in treating the itch and rash of eczema. Neither causes certain side effects, such as thinning of the skin (atophy), or stretch marks (striae), spider veins or discoloration of the skins.


eliedlElidel® (Pimecrolimus)

Elidel® is a steroid-free cream for patients aged 2 years and older who have mild-to-moderate eczema.


protopicProtopic® (Tacrolimus)

It is a steroid-free ointment for patients aged 2 years and older who have moderate-to-severe eczema. Protopic® is available in 2 strengths, 0.03% and 0.1%. Both strengths are approved for use in adults; only 0.03% for children aged 2 to 15 years.


The Food and Drug Administration (FDA) has approved updated labeling on January 19, 2006 for two topical eczema drugs, Elidel Cream (pimecrolimus) and Protopic Ointment (tacrolimus). The new labeling includes a boxed warning about a possible risk of cancer and a Medication Guide (FDA-approved patient labeling). The Medication Guide is to be distributed with each prescription to help ensure that patients using these prescription medicines are aware of this concern. The new labeling also clarifies that these drugs are recommended for use as second-line treatments. This means that other prescription topical medicines should be tried first. Use of these drugs in children under 2 years of age is not recommended.

More information on the FDA black box warning can be found here.