[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Other dermatological medicines](https://durgical.com/en/pharmacology/classes/other-dermatological-medicines/) › Pimecrolimus # Pimecrolimus ## Other dermatological medicines? Other dermatological medicines A calcineurin-inhibitor cream for atopic dermatitis when other treatments fail or cannot be used; unlike corticosteroids, it does not thin the skin. Updated Nov 1, 2026 ## Quick facts **Group** [Other dermatological medicines](https://durgical.com/en/pharmacology/classes/other-dermatological-medicines/) **Target** Calcineurin, through FKBP12 **Used for** Atopic dermatitis **Key effects** Burning · Headache · Eye irritation **Monitor** Response of the eczema · Signs of skin infection **ATC** D11AH02 No doses: the clinician sets them by the current guideline. On this page - The basics Mechanism of action - Indications - Adverse effects - Pharmacokinetics - Memory aid - Safety Contraindications - Key interactions - What is monitored - Administration and safety - Pregnancy and breastfeeding - Nursing care - Study Test yourself - Connections Connections ## Mechanism of action ✂**Calcineurin, through FKBP12**Pimecrolimus ⓘ The figure shows tacrolimus bound to human FKBP12; pimecrolimus is a close relative that acts through the same immunophilin. Calcineurin is not in this crystal. **Target in 3D:** Calcineurin, through FKBP12. PDB structure 1FKF (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/1FKF) · Drag to rotate · pinch to zoom Pimecrolimus acts like tacrolimus: inside skin T cells it binds the immunophilin FKBP12, and the complex blocks the phosphatase calcineurin. The transcription factor NFAT then stays inactive, so T cells release less IL-2 and other inflammatory cytokines and the eczema settles. Very little reaches the blood. - Cream reaches T cells in inflamed skin - Drug binds FKBP12 and the complex blocks calcineurin - NFAT stays off; less IL-2 and cytokines - Itch and eczema settle without skin thinning ## Indications - Atopic dermatitis (second line, short-term or intermittent use) [Atopic dermatitis →](https://durgical.com/en/conditions/atopic-dermatitis/) ## Adverse effects ### Common - Burning, warmth, stinging or redness where applied - Headache, cough, runny nose - Eye irritation - Facial flushing after alcohol ### Serious (rare, important) - Skin infections, including herpes simplex (cold sores, eczema herpeticum) and chickenpox - Severe allergic reactions - Rare reports of skin cancer and lymphoma (a causal link is not established) ## Contraindications - Hypersensitivity to pimecrolimus - Children younger than 2 years - Netherton syndrome or widespread red, peeling skin (needs review first) ## Key interactions **Alcohol** May cause flushing, redness or warmth of the skin. **Sun lamps, tanning beds and ultraviolet light therapy** Avoided on treated skin. ## What is monitored - Response of the eczema; treatment stops when the skin clears - Signs of skin infection or herpes at the treated sites - Review if there is no improvement or the eczema returns ## Administration and safety - A thin layer is applied only to affected skin while symptoms are present, and stopped when they clear. - Treated skin is not covered with bandages, dressings or wraps. - Kept away from the eyes and mouth. - Moisturisers go on after the cream has absorbed; swimming or bathing right after application is avoided. ## Pregnancy and breastfeeding Data are limited; pregnancy and breastfeeding are discussed with the treating team before use. ## Nursing care - Check the skin for crusting, oozing, blisters or cold sores before starting. - Teach sun protection and avoidance of tanning beds and ultraviolet treatment. - Explain that mild burning is common at first; persistent burning is reported. - Teach to report fever, swollen neck glands, blisters or signs of skin infection. ## Pharmacokinetics **Absorption** Applied to the skin; systemic absorption is low to negligible ## Memory aid PIMEcrolimus: Protect from sun, Itchy eczema only, Mild burning at first, Eyes and mouth avoided. ## Test yourself Think of the answer, then tap the question to see it. ## Which enzyme does pimecrolimus block, and through which protein? Calcineurin, after binding the immunophilin FKBP12 (like tacrolimus). ## What is the main advantage of pimecrolimus over topical corticosteroids on the face and skin folds? It does not cause skin atrophy. ## Below what age is pimecrolimus not used? Children younger than 2 years. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/pimecrolimus/) [More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology) ## Connections ## Related drugs 3 - [Tacrolimus](https://durgical.com/en/pharmacology/tacrolimus/) - [Crisaborole](https://durgical.com/en/pharmacology/crisaborole/) - [Abrocitinib](https://durgical.com/en/pharmacology/abrocitinib/) ## Related conditions 1 - [Atopic dermatitis](https://durgical.com/en/conditions/atopic-dermatitis/) [← Back to the class: Other dermatological medicines](https://durgical.com/en/pharmacology/classes/other-dermatological-medicines/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Pimecrolimus Topical: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a603027.html) (MedlinePlus (U.S. National Library of Medicine), 2016); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=D11AH02) (WHO Collaborating Centre for Drug Statistics Methodology, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/pimecrolimus/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/pimecrolimus/