Tacrolimus topical ointment dosage: A detailed guide

This article describes tacrolimus topical* ointment’s dosages, strengths, and how to apply it. You’ll also find information on cost savings and coupon options for tacrolimus.

Tacrolimus topical ointment is a generic version of the brand-name drug Protopic. Tacrolimus also comes as an oral capsule and an injection given into a vein. These forms have different uses that aren’t described in this article. To learn more about these forms, talk with your doctor.

If you want to know more about tacrolimus oral capsules, see this overview article. It covers details about the drug’s uses, side effects, ways to save on cost, and more.

* Topical means the drug is applied to your skin.

Boxed warning: Possible risk of certain cancers with long-term use

Tacrolimus topical ointment has a boxed warning for the risk of certain cancers with long-term use. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

It’s not known whether tacrolimus ointment is safe to use long term. In rare cases, it may increase your risk of certain types of cancer. These include lymphoma and skin cancer.

Tacrolimus topical ointment is not recommended for use in children under 2 years old.

See the end of this article for more information about this warning.

Form and strengths of tacrolimus

Tacrolimus topical ointment comes as follows:

• Form: topical ointment*
• Strengths: 0.03% and 0.1%

* Topical means the drug is applied to your skin.

Dosage of tacrolimus

This article describes the recommended dosages for tacrolimus topical ointment. These are provided by the drugmaker.

If your doctor prescribes this medication, you should follow the dosage they prescribe. Your doctor will determine the dosage that best meets your needs. Do not change your dosage of tacrolimus topical ointment without your doctor’s recommendation.

Usual recommended dosages of tacrolimus in adults

The dosage of tacrolimus ointment depends on how severe your condition is. Usually, doctors start by prescribing a low dosage of tacrolimus topical ointment. Then, they’ll adjust it over time until the right dosage is reached. Ultimately, your doctor will prescribe the smallest dosage of tacrolimus topical ointment that gives the desired outcome.

Dosage for atopic dermatitis

Below is the dosage of tacrolimus topical ointment for atopic dermatitis (a type of eczema) in adults:

• Dose: 0.03% or0.1% strength applied as a thin film to the affected area(s)
• Frequency: twice per day

Dosage of tacrolimus in children

Tacrolimus topical ointment is only approved to treat atopic dermatitis in children ages 2 years and older. It is not recommended for children younger than 2 years.

Below is the dosage of tacrolimus ointment for children ages 2–15 years old:

• Dose: 0.03% strength applied as a thin film to the affected area(s)
• Frequency: twice per day

Children ages 16 years and older can use either the 0.03% or 0.1% strength ointment. For more details, refer to “Usual recommended dosages of tacrolimus in adults” just above.

Dosage adjustments for tacrolimus

Your doctor will prescribe a dosage of tacrolimus topical ointment based on several factors, including:

• your condition and how severe it is
• your age
• other health conditions you may have

Missed dose of tacrolimus

Talk with your doctor or pharmacist right away if you realize you forgot to apply a dose of tacrolimus topical ointment. They may advise you to apply the missed dose. Or they may advise you to skip it and continue with your next dose as scheduled.

For tips on how to plan your doses of tacrolimus topical ointment and avoid missing a dose, read this article. You could also try:

• downloading a reminder app on your phone
• setting an alarm
• putting a note where you’ll see it, such as on your calendar, bathroom mirror, or bedside table

Frequently asked questions

Below are answers to some commonly asked questions about tacrolimus topical ointment and its dosage.

How is my dose of tacrolimus calculated?

Your dose of tacrolimus is prescribed based on your age and how severe your condition is. Your doctor may start treatment with the lowest dosage of tacrolimus ointment. This would be with the 0.03% strength applied twice per day.

For adults and children ages 16 years and older, the dose may be increased to the 0.1% strength. This is usually done if your symptoms don’t ease with the lower dose. During tacrolimus treatment, your doctor will monitor you for certain side effects and to find out how your body responds to treatment.

If you have questions about your dosage of tacrolimus and how it’s prescribed, talk with your doctor.

Is tacrolimus used long term?

No, doctors don’t usually prescribe tacrolimus topical ointment as a long-term treatment. Instead, it’s usually recommended for short-term use. In fact, tacrolimus ointment has a boxed warning about the risk of certain cancers with long-term use. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). See the end of this article for more information.

If you have used tacrolimus topical ointment for 6 weeks with no improvement in your condition, your doctor may reexamine your eczema. They may prescribe a different medication or restart treatment with tacrolimus ointment. They may ask you to wait 2 weeks before restarting your tacrolimus treatment.

If you have questions about how long you should use tacrolimus topical ointment, talk with your doctor.

How tacrolimus is applied

Tacrolimus ointment is applied topically to the affected skin area(s). (Topical means it’s applied directly to the skin.) You’ll apply it twice per day in a thin film.

Apply tacrolimus ointment exactly as prescribed by your doctor. Only apply it to skin areas affected with atopic dermatitis.

Be sure to wash your hands after applying the medication. For more information on how to use tacrolimus ointment, see the medication guide.

If you have trouble applying tacrolimus ointment, talk with your doctor or pharmacist. They can offer recommendations to help with applying the drug.

Tacrolimus coupon

Visit this page to access Optum Perks coupons and get price estimates for tacrolimus when you use the coupons. These coupons can provide significant savings on your prescription costs. 

Note: Optum Perks coupons cannot be used with insurance copays or benefits.

Overdose of tacrolimus

It’s important that you do not apply more tacrolimus topical ointment than your doctor prescribes. Doing so can lead to harmful side effects.

What to do if you apply too much tacrolimus

If you think you’ve applied too much tacrolimus, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have severe symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

What to ask your doctor

This article describes the usual recommended dosages for tacrolimus topical ointment. If your doctor prescribes this medication, they’ll determine the dosage that’s best for you.

Do not change your dosage of tacrolimus topical ointment without your doctor’s recommendation. You should use tacrolimus topical ointment exactly as your doctor prescribes it. Let your doctor know if you have concerns or questions about your treatment plan.

Here’s a list of some possible questions you may want to ask your doctor:

• Would I need a different prescription if you change my dosage of tacrolimus ointment?
• Does my dosage affect my risk of side effects from tacrolimus ointment?
• Will a lower dosage of tacrolimus ointment cost less if I don’t have insurance?

Boxed warning for tacrolimus

Tacrolimus has a boxed warning for the risk of certain cancers with long-term use. A boxed warning is a serious warning from the Food and Drug Administration (FDA).

It’s not known whether tacrolimus ointment is safe to use long term. In rare cases, it may increase the risk of certain types of cancers. These include lymphoma (a cancer of the lymphatic system) and skin cancer. This risk may increase with higher doses and long-term use of the drug.

Your doctor will monitor you while you’re using tacrolimus ointment. This includes checking your skin for any changes. They may also recommend ways to protect your skin from cancer. This includes using sunscreen products with high sun protection factor (SPF). It also includes wearing sun protective clothing when you’re exposed to sun or ultraviolet light.

Tacrolimus topical ointment is not recommended for use in children under 2 years old.

You can talk with your doctor to learn more about this risk.

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.