Tacrolimus and pimecrolimus should not be used to treat mild atopic eczema. When atopic eczema is moderate or severe, tacrolimus and pimecrolimus should not be used as 'first-line' treatments - that is, they should not be used before other treatments have been tried. But, they may be considered in the circumstances below:
Treatment with either tacrolimus or pimecrolimus should only be started by doctors with a special interest and experience in skin diseases (this can include your GP), and only after the pros and cons of these and other appropriate treatment options have been discussed.
Since the NICE guidance on topical pimecrolimus and tacrolimus was issued, following a safety review the European Medicines Evaluation Agency (EMEA) has recommended greater caution in the way these medicines are used in order to reduce potential risks of skin cancer and lymphoma as far as possible.
Patients who are using tacrolimus and pimecrolimus should not stop or modify their treatment without consulting their prescribing healthcare professional.