📋 Indications & Clinical Dosage
*Short-term treatment of moderate to severe atopic eczema (including flares) unresponsive to, or intolerant of conventional therapy:*
Adult: Apply twice daily until lesion clears, initially 0.1% ointment to be applied thinly, reduce frequency to once daily or strength of ointment to 0.03% if condition allows.
*Prevention of flares in patients with moderate to severe atopic eczema:*
Adult: Apply twice weekly, 0.1% ointment to be applied thinly, with an interval of 2-3 days between applications, use short-term treatment regimen during an acute flare.
*Short-term treatment of facial, flexural, or genital psoriasis unresponsive to, or intolerant of other topical therapy:*
Adult: Apply twice daily until symptoms resolve,0.1% ointment to be applied thinly, reduce to once daily or switch to 0.03% ointment if condition allows, max. duration of treatment 4 weeks.
⛔ Contraindications
Application to malignant or potentially malignant skin lesions, application under occlusion, avoid contact with eyes and mucous membranes, congenital epidermal barrier defects, generalized erythroderma, immunodeficiency, infection at treatment site, pregnancy, lactation, hypersensitivity to macrolides
⚠️ Precautions & Warnings
Hepatic failure, avoid exposure to UV light. Treat infections before therapy. Monitor patients who develop lymphadenopathy.
🔄 Drug Interactions
Avoid use of emollients within 2 hours, CYP3A4 inhibitors in widespread or erythrodermic disease, vaccines.
⚠️ Adverse Reactions / Side Effects
Application-site pain, infections and reactions, herpes simplex infection, local irritation, Kaposis varicelliform eruption, acne. Rare: cutaneous lymphoma, other types of lymphomas, rosacea, skin malignancy
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.