Protopic

What is Protopic?

Protopic is a type of medicine called an immunosuppressant, and it’s part of a class of medicines called calcineurin inhibitors. It’s an ointment used for various types of eczema, including discoid eczema, and it works by reducing the inflammation that causes red, swollen, dry, and itchy skin.

Protopic is officially approved for treating atopic dermatitis, but clinicians also use it to treat other skin conditions like discoid eczema, even though this use is called ‘off-label’. Off-label means it’s used for a condition it hasn’t been officially licensed for. Don’t worry though, there’s a wealth of research supporting Protopic’s use in this way. Still, if you’re considering it for discoid eczema, it’s best to have a chat with a clinician to ensure it’s the right choice for you.

It’s generally used as an alternative for you if you can’t use corticosteroids (which tend to be the first line of treatment). But where corticosteroid creams are generally only recommended for flare-ups to avoid skin thinning, Protopic can be used for long-term management and prevention if you tend to have more than four flare-ups per year. ^[1]

How does Protopic work?

Although more research is needed to fully understand how tacrolimus works to improve dermatitis conditions, there are some notable observations. The active ingredient tacrolimus monohydrate is thought to attach to a protein called immunophilin FKBP12, which inhibits the activation and proliferation of T-cells (a type of white blood cell involved in immune responses). This stops certain chemical signals and overactivity from happening, and prevents the production of certain proteins that cause inflammation in the skin.

In animal studies, the use of tacrolimus ointment helped reduce inflammation in skin conditions that were similar to atopic dermatitis in humans. It also didn’t make the skin thinner or cause any damage to the animals. It was also found to not affect collagen production in humans. ^[2]

What doses of Protopic are available?

There are two strengths of Protopic available: 0.03% and 0.1%. One gram of 0.1% Protopic ointment contains 1.0mg of tacrolimus monohydrate. The lower strength of Protopic (0.03%) is usually reserved for children under the age of 16, but your clinician may prescribe you this dose first depending on the severity of your condition.

How to use Protopic

Make sure to follow your clinician’s instructions on how to use Protopic to get the best from it.

For flare-ups, use Protopic twice a day (morning and evening) until your symptoms clear.

For regular maintenance, use it twice a week — leaving two to three days between applications. Your condition will be reviewed every twelve months.

• Make sure your skin is completely dry before applying Protopic.
• Apply it in a thin layer to the affected areas.
• Wash your hands after applying Protopic, unless you’ve used it on your hands.

How long does Protopic take to work?

The time it takes for your eczema to improve can depend on how severe it is. In some cases, it may take up to two weeks to notice the difference. If you don’t see any improvement after two weeks, it might be worth a chat with your clinician to explore other options.

What happens if I make a mistake using Protopic?

If you accidentally ingest the ointment, seek medical help immediately.

If you forget to apply Protopic, use it as soon as you remember. And then continue your routine as normal.