Protopic Ointment (Tacrolimus): Uses, Dosage & Side Effects in Pakistan

Protopic Ointment (Tacrolimus) — Uses, Dosage, Side Effects & Price in Pakistan

1. Quick Info (Mukhtasir Maloomat)

2. What is Protopic Ointment? (Protopic kya hai)

Protopic (Tacrolimus) is a prescription topical ointment used for moderate to severe cases of atopic dermatitis (eczema). It belongs to the Topical Immunomodulator (Calcineurin Inhibitor) class and is used in place of steroids when steroids are inappropriate or ineffective.

It inhibits calcineurin — preventing T-lymphocytes from activating — which reduces cytokine production and decreases skin inflammation. Unlike steroids, tacrolimus does not cause skin atrophy.

3. Uses (Fayde / Kis kaam aati hai)

• Atopic Dermatitis (Eczema) — moderate to severe cases not responding to topical steroids
• Facial and periorbital eczema where topical steroids are inappropriate
• Second-line treatment for chronic eczema in skin folds, neck, and face

4. Who Should Take (Kis ko leni chahiye)

• Patients with moderate to severe atopic dermatitis who have not responded to topical corticosteroids
• Patients with eczema on the face, neck, periorbital area, or skin folds where long-term steroid use is not safe
• Adults using 0.03% or 0.1% strength; children aged 2–15 using only 0.03% strength

5. When NOT to Take (Kab nahi leni chahiye)

• Children under 2 years of age — contraindicated
• If you have an active skin infection (bacterial, viral, or fungal) on the area to be treated — treat infection first
• If you are immunocompromised (HIV/AIDS, organ transplant patients on systemic immunosuppression)
• If you are allergic to tacrolimus, macrolides, or any ingredient in Protopic ointment
• Do not apply to malignant or pre-malignant skin conditions

6. Dosage (Kitni leni hai)

• Adults (0.1%): Apply a thin layer to affected area twice daily as directed by doctor
• Children 2–15 years (0.03%): Apply a thin layer twice daily as directed by doctor

• Twice daily application until symptoms clear; then reduce frequency as doctor advises
• Use only when needed — not for uninterrupted long-term use

• Do not exceed the recommended limit; use minimum effective amount for the shortest time

• If you miss an application, apply as soon as you remember. If the next application is close, skip the missed one. Never apply a double dose.

7. How to Take (Kaise leni hai)

• Clean and thoroughly dry the affected area before application

• Apply a thin layer and gently rub in — a thick layer is not needed

• Wash hands thoroughly after application

• Keep away from the eyes, nose, and inside of the mouth

8. Best Time (Kab leni chahiye)

• Morning and evening — as advised by your doctor

• Can be applied before or after moisturiser or sunscreen — confirm timing with your doctor

9. Empty Stomach or After Food (Khali pait ya khane ke baad)

This is a topical ointment — it has no relation to food. It is only applied to the skin.

10. Warnings (Ihtiyat)

• Children under 2 years — absolutely contraindicated
• Immunocompromised patients
• Active skin infections on treatment area
• Known allergy to tacrolimus or macrolides

• Use minimum amount for the shortest time needed to control symptoms
• Long-term safety data regarding lymphoma/skin cancer risk is not fully established — avoid unnecessary prolonged use
• Avoid sun exposure on treated areas; use sunscreen

11. Precautions (Ahm ehtiyaat)

• Store below 25°C; do not freeze
• Keep away from direct sunlight
• Keep out of the reach of children

• If herpes (cold sore) or varicella (chickenpox) develops on the treated area, stop immediately and see a doctor
• Complete antibiotic treatment first for bacterial infections

12. Side Effects (Nuksanat)

• Burning and stinging at application site (usually first few days), pruritus (itching), skin redness/warmth

• Skin infections (bacterial, viral herpes, varicella, fungal) — see a doctor immediately
• Theoretical lymphoma/skin cancer risk (FDA black box — extremely rare in clinical practice)
• Systemic absorption — rare, mainly with damaged skin or large body surface area

13. Drug Interactions (Dawaon ke sath reaction)

• Alcohol may cause facial flushing on tacrolimus-treated areas
• CYP3A4 inhibitors (erythromycin, clarithromycin, itraconazole, fluconazole) — may increase systemic tacrolimus if absorbed
• Avoid concomitant use with other topical immunosuppressants

Systemic interactions are rare with topical use — but exercise caution on damaged or large skin areas.

14. When to See Doctor (Kab doctor ke paas jayein)

• Signs of skin infection on treated area — oozing, crusting, increasing redness, warmth, fever
• Herpes or varicella (chickenpox) outbreak on treated skin
• No improvement after 6 weeks of correct use
• Worsening of skin condition despite treatment
• Any unusual skin changes or new lumps on treated areas

15. Alternatives (Sasti Dusri Dawaein)

16. Price in Pakistan (Price kitni hai)

17. FAQs (Aksar poochay jane walay sawalat)

Q: Tacrolimus ointment kis kaam aata hai?

A: Tacrolimus ointment (Protopic) is used for moderate to severe cases of atopic dermatitis (eczema), particularly when topical steroids do not work or are not appropriate — such as eczema on the face, neck, or skin folds.

Q: Tacrolimus ke side effects kya hain?

A: The most common side effects are burning, stinging, and itching at the application site — these usually resolve within a few days. There is also a risk of skin infections. The FDA has issued a black box warning — so use the minimum amount for the minimum time.

Q: Tacrolimus steroids se behtar kyun hai?

A: The biggest advantage of Tacrolimus is that unlike steroids it does not cause skin atrophy (skin thinning). This makes it safe on sensitive areas such as the face, around the eyes, neck, and skin folds — where long-term steroids can be harmful.

Q: Tacrolimus price in Pakistan kya hai?

A: A verified price listing for Protopic was not found. Confirm the updated price at a local pharmacy or licensed online platform (dawaai.pk, sehat.com.pk). It is an Rx medicine — a prescription is required.

Q: Tacrolimus ointment bachon ke liye safe hai?

A: Absolutely not for children under 2 years of age. For children aged 2–15 years, only the 0.03% strength can be used on a doctor's prescription.

18. Medical Review (Medical jaiza)

Compiled by the PakVita Editorial Team · AI-assisted drafting with editorial review · Sourced from DRAP, WHO, BNF · Last updated: 2026-06-17

19. Disclaimer (Zaroori tanbeeh)

The information on this page is for awareness only. It is not medical advice. Always consult your doctor or pharmacist before taking any medicine. PakVita is not responsible for any harm.