What Is Elidel (Pimecrolimus)?

Reviewed by: HU Medical Review Board | Last reviewed: March 2023 | Last updated: March 2023

Pimecrolimus is a topical treatment option that may be recommended for people with plaque psoriasis. The medicine is sold in the United States under the brand name Elidel®.

Take a look at this topical treatment

Pimecrolimus comes in a cream and contains a similar type of active ingredient as another drug called tacrolimus, which comes in an ointment. Both pimecrolimus and tacrolimus are mainly used to treat the symptoms of another type of skin condition called eczema (also known as atopic dermatitis)1.

The US Food and Drug Administration (FDA) has only approved pimecrolimus for treating eczema in patients at least 2 years old. But in some cases, healthcare providers will recommend that patients with psoriasis try treatment with pimecrolimus.

This usually happens if a patient has tried treatment with other types of topical medications that have been approved for treating psoriasis, but these other medicines have not worked well enough or caused side effects that the patient could not tolerate2.

In patients with psoriasis, pimecrolimus tends to be the most effective in treating symptoms that are located in areas where the skin is particularly thin and/or sensitive, such as around the eyes, face, genitals, and skin folds.

These are areas that can be more susceptible to side effects such as irritation when treated with stronger topical medicines like corticosteroids5.

How does this treatment work?

Pimecrolimus is a type of drug called a calcineurin inhibitor. Psoriasis is an autoimmune condition that causes special cells called T-cells to activate and trigger inflammation that is not needed.

This inflammation causes too many new skin cells to be produced, which causes skin cells to build up and form plaques.

Pimecrolimus works by preventing the T-cells from activating, which reduces inflammation, skin redness, and itching. It may also help to reduce plaques1.

Studies are currently being carried out so that researchers can learn more about the effects that different forms of pimecrolimus may have on treating plaque psoriasis symptoms2. Because it is not approved by the FDA for treating psoriasis, there are no official recommendations about dosing and application.

If you are prescribed pimecrolimus for plaque psoriasis, then your healthcare provider will provide you with guidance about how to use it5.

What are the possible side effects?

There are no specific precautions for the use of topical calcineurin inhibitors such as pimecrolimus for treating psoriasis. This is not an exhaustive list of side effects. However, it should be noted that all of the information, such as the most common side effects, has been gathered from their use in treating atopic dermatitis.

Among people with atopic dermatitis, the most common side effect of treatment with pimecrolimus is a burning sensation or warm feeling where the medicine is applied.

This is experienced by 2%-26% of patients, but it will usually go away after a few days of treatment2. If it lasts longer than that, you should let your healthcare provider know.

Other common side effects of treatment with pimecrolimus include:

  • headache (experienced by between 7%-25% of patients)
  • fever (experienced by between 1%-13% of patients)
  • sore throat (experienced by between 8%-27% of patients)
  • cough (experienced by between 2%-16% of patients)
  • upper respiratory tract infection (experienced by between 4%-19% of patients)

Pimecrolimus has a boxed warning, the strictest warning from the FDA. It has this warning because people who take it may have a slightly higher risk of certain types of cancers, such as skin tumors and lymphoma. To be safe, this drug is not recommended for long-term use.

These are not all the possible side effects of pimecrolimus. Talk to your doctor about what to expect when taking pimecrolimus. You also should call your doctor if you have any changes that concern you when taking pimecrolimus.

Your healthcare provider may recommend that you avoid phototherapy and sun exposure when possible during treatment with pimecrolimus3.

Scientists do not know whether pimecrolimus can be passed along in breastmilk. Talk to your doctor if you are thinking about breastfeeding.

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