Institute for rational pharmacotherapy Protopic ointment (tacrolimus)Protopic ointment (tacrolimus) is a new treatment for atopic dermatitis which has an effect similar to that of Class I and II steroids. Local irritation, especially in the form of burning and itching, is seen in about half of the patients treated. The active ingredient, tacrolimus, possesses systemic immunosuppressive potential, so Protopic should only be used for patients who do not respond satisfactorily to other relevant therapies. The cost of one gram of Protopic ointment is roughly ten times that of the same amount of steriod ointment. Protopic has not yet been designated a general reimbursement product, but individual reimbursement for the therapy may be granted. Protopic may only be prescribed by specialists in certain fields.Protopic does not cause skin atrophy, which is its advantage over steroids. In addition, Protopic can be used in sensitive areas such as the face and neck. On the other hand, the above-mentioned studies demonstrated a significantly higher incidence of local irritation in the form of a burning sensation, itching and redness (initially in about 50% of the adults and 20% of the children). However, this irritation resolved in most patients after 5-8 days of treatment (in roughly 20% of the adults and 5% of the children). There was no difference in adverse reactions to the two different strengths of Protopic. However, the extent to which a possible systemic absorption of tacrolimus affects the immune system, especially in children, has not yet been sufficiently studied. As a result, only Protopic 0.03% may be prescribed for children.
