Home Drug Guide Pimecrolimus

Drug Guide

Generic Name

Pimecrolimus

Brand Names Elidel

Classification

Therapeutic: Immunosuppressant, Topical

Pharmacological: Calcineurin inhibitor

FDA Approved Indications

  • Atopic dermatitis (moderate to severe) in pediatric patients 2 years and older and adults

Mechanism of Action

Pimecrolimus inhibits calcineurin, thereby decreasing T-cell activation and the release of inflammatory cytokines, leading to reduced inflammation.

Dosage and Administration

Adult: Apply a thin layer to affected areas twice daily.

Pediatric: Apply a thin layer to affected areas twice daily starting at age 2, as prescribed.

Geriatric: No specific dose adjustments; use with caution and monitor.

Renal Impairment: No specific adjustment needed.

Hepatic Impairment: No specific adjustment needed.

Pharmacokinetics

Absorption: Minimal systemic absorption when used topically.

Distribution: Widely distributed in tissues, negligible in plasma.

Metabolism: Metabolized hepatically via CYP3A4 enzymes.

Excretion: Excreted primarily in feces; minimal renal excretion.

Half Life: Approximately 3 hours in systemic circulation.

Contraindications

  • Known hypersensitivity to pimecrolimus or any component.

Precautions

  • Avoid in skin infections or open wounds.
  • Use with caution in children under 2 years.
  • Long-term safety data is limited; monitor for local adverse effects.

Adverse Reactions - Common

  • Application site burning or sensation (Common)
  • Erythema (Common)

Adverse Reactions - Serious

  • Herpes virus infection (HSV, VZV) in treated areas (Less common)
  • Lymphadenopathy, hypersensitivity reactions (Rare)

Drug-Drug Interactions

  • None well-established; avoid concomitant use with other topical immunosuppressants

Drug-Food Interactions

  • None

Drug-Herb Interactions

  • Limited data; use caution with herbal products affecting immune function

Nursing Implications

Assessment: Assess for skin infections or lesions before application.

Diagnoses:

  • Impaired skin integrity

Implementation: Instruct patient to apply a thin layer as prescribed, avoiding occlusion or excessive coverage.

Evaluation: Monitor skin improvement and adverse reactions.

Patient/Family Teaching

  • Apply as directed, avoid occlusive dressings unless instructed.
  • Report signs of infection or severe irritation.
  • Avoid emotional stress to reduce flare-ups.
  • Use caution around eyes, mouth, and genital areas.

Special Considerations

Black Box Warnings:

  • Possible increased risk of lymphoma and skin cancer with prolonged use.

Genetic Factors: Limited data available.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: Local skin irritation, systemic absorption in overdose may cause immunosuppression.

Treatment: Discontinue use, supportive care, and symptomatic treatment.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable; keep in original container, protect from excessive heat or moisture.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.