Elidel

Elidel is a medicine used in dermatology.

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Indications Elidela

It is used to eliminate atopic dermatitis (moderate or mild), when it is impossible to use local corticosteroids. Among such cases:

• hypersensitivity to local corticosteroids;
• lack of the desired result from the use of corticosteroids;
• the need for application to the neck or face, areas where intermittent, long-term use of corticosteroids may be inappropriate.

Release form

Released as a 1% cream, in a 15 g tube.

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Pharmacodynamics

The element pimecrolimus is a derivative of the macrolactam ascomycin, which has anti-inflammatory properties and selectively slows down the processes of formation and then release of cytokines (inflammatory conductors).

A significant portion of pimecrolimus is specifically synthesized with the substance macrophilin-12, and also inhibits calcium-dependent phosphatase - the calcineurin element. As a result, the process of T-lymphocyte activation is inhibited - due to blocking the transcription of previously identified cytokines.

The active component of Elidel combines a strong anti-inflammatory effect, as well as a weak effect on general immune manifestations.

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Pharmacokinetics

When applying cream to the skin surface, the levels of its active substance in the blood are very low, making it impossible to determine the processes of drug metabolism.

In vitro tests of plasma protein synthesis have shown that 99.6% of the substance is synthesized with it. The largest plasma fraction of pimecrolimus is synthesized with various lipoproteins.

No metabolism of the drug is observed within the skin (during in vitro tests).

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Dosing and administration

The duration of the course of therapy is prescribed by the doctor, taking into account the severity and stage of the disease.

The cream can be used in short courses to eliminate the symptoms and manifestations of atopic eczema, and in addition, it can be used periodically over a long period of time as a preventative measure against exacerbation of the pathology.

Therapy should be started immediately after the first symptoms of atopic dermatitis appear. The cream should be applied only to the areas affected by the disease. The medicine is used in short courses, only during periods of exacerbation of the pathology. After the signs of the disorder disappear, it is necessary to stop using Elidel. The course of therapy should be short-term and periodic.

The medicine is applied to the affected areas in a thin layer - 2 times a day.

According to testing data, periodic use of the cream is possible for up to 1 year.

If after 6 weeks of the course there is no improvement or, on the contrary, a deterioration is noted, the treatment should be discontinued. In this case, it is also necessary to conduct a repeated diagnosis of the disease and think over a scheme of subsequent treatment measures.

The cream may be applied to all areas of the skin (including the neck with head and face, and intertriginous zones - in the genital area with inguinal folds), excluding only the mucous membrane areas. It is also prohibited to cover the treatment areas with tight bandages.

It is also recommended to treat the skin with emollients immediately after applying the cream.

The dose sizes and methods of using the cream for children are similar to the recommendations described above.

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Use Elidela during pregnancy

There is insufficient information regarding the use of the drug in pregnant women. Animal tests have not demonstrated any direct or indirect negative effects on fetal development in the womb after external application. However, animal tests of oral administration of the drug have revealed the development of reproductive toxicity.

Since pimecrolimus is absorbed into the body in minimal quantities when applied topically, the likelihood of complications in humans is considered quite low. However, doctors still do not recommend using this cream during pregnancy.

Elidel should be used with caution during breastfeeding. It is prohibited to treat the sternum and mammary glands with the cream to avoid the possibility of accidental penetration of the drug into the baby's mouth.

Contraindications

Contraindications are intolerance to pimecrolimus and other macrolactams, as well as other components of the drug. In addition, it is prohibited to use the cream for children under 2 years of age.

Side effects Elidela

The use of the cream may cause the appearance of certain side effects:

• infectious diseases: molluscum contagiosum;
• immune disorders: manifestations of anaphylaxis (this also includes severe forms of pathology);
• metabolic disorders: lack of tolerance to alcoholic beverages (often rashes, hot flashes, swelling or itching appear immediately after drinking alcohol);
• problems with the skin and subcutaneous layer: infectious processes on the skin (for example, folliculitis), as well as impetigo and furuncles, herpes zoster or simple herpes, herpetic dermatitis (herpetic eczema) and skin papilloma. Allergic reactions may occur, including urticaria and rashes, Quincke's edema and changes in skin tone (hypo- or hyperpigmentation);
• systemic disorders and local manifestations: a burning sensation at the site of application of the cream, as well as various reactions in this area (such as itching, pain, dryness and irritation, as well as erythema, rashes, peeling with paresthesia and swelling).

During post-marketing use of the cream, patients occasionally developed malignant neoplasms (including cutaneous and other types of lymphoma), as well as melanoma. However, it was not possible to establish a connection with the use of Elidel in these cases.

There is information about the occurrence of lymphadenopathy (detected during post-marketing and clinical tests), but it also could not be associated with the use of the cream.

Interactions with other drugs

No systematic evaluation of possible interactions of the cream with other medications has been performed. The substance pimecrolimus is metabolized only by the element CYP 450 3A4. Since Elidel has a low degree of absorption, the probability of its interaction with systemic drugs is quite low.

Existing information confirms that the drug is approved for use in combination with antihistamines, antibiotics, and GCS (nasal, oral or inhalation type).

The possibility of drug interactions with vaccination is also very low (but only theoretically, because such tests have not been conducted). Because of this, people with disseminated or widespread pathologies need to be vaccinated during periods when the cream is not used.

There is no information on the combined use with immunosuppressants used to eliminate atopic eczema (including UVB and UVA radiation, as well as PUVA therapy (psoralen plus UVA radiation), cyclosporine type A and azathioprine).

It is necessary to avoid excessive UV irradiation of the skin (this includes PUVA, as well as UV therapy and the use of solariums) during treatment with the cream.

Rarely, there have been cases of rash, redness, itching, burning or swelling occurring immediately after drinking alcohol in people using the cream.

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Storage conditions

Elidel can be stored in a place inaccessible to children. Temperature – maximum 25°C. The cream cannot be frozen.

Special instructions

Reviews

Elidel is generally rated positively by patients because it demonstrates real effectiveness. Although many are put off by the fact that the cream has quite a few side effects, the main one being the risk of developing oncological pathologies.

At the same time, medical reviews of the drug indicate that the frequency of negative effects of the cream is much lower than that of hormonal drugs.

Another disadvantage of Elidel that patients consider to be its rather high price.

Shelf life

Elidel is allowed to be used for 2 years from the date of release of the cream. However, after opening the tube, the medicine must be used within 1 year.

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