Comprehensive medication guide to Pimecrolimus including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$60 copay with commercial insurance; typically Tier 2–3 on most plans; prior authorization and step therapy requiring prior corticosteroid failure may apply. Approximately 69% of Medicare Part D plans cover pimecrolimus.
Estimated Cash Pricing
$200–$410 retail for a 30g tube of generic pimecrolimus 1% cream; as low as $70–$80 with GoodRx or SingleCare coupons. Brand-name Elidel is generally more expensive.
Medfinder Findability Score
78/100
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Pimecrolimus is a prescription topical cream used to treat mild to moderate atopic dermatitis (eczema). It belongs to the drug class known as topical calcineurin inhibitors (TCIs) — a non-steroidal class of anti-inflammatory medications that work by suppressing the local immune response in skin.
Brand name: Elidel (manufactured for Bausch Health). Generic pimecrolimus 1% cream is also available from multiple manufacturers including Teva. The FDA approved pimecrolimus on December 13, 2001, making it one of the first non-steroidal topical eczema treatments on the US market.
Pimecrolimus is approved as second-line therapy in non-immunocompromised adults and children 2 years and older who have failed topical corticosteroids or for whom steroids are not advisable. It comes only as a 1% cream in 30g, 60g, and 100g tubes, applied twice daily.
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Pimecrolimus works by blocking a key enzyme called calcineurin inside T-cells (white blood cells that drive the inflammatory response in eczema). When applied to the skin, pimecrolimus binds to a protein called FKBP1A (macrophilin-12), forming a complex that inhibits calcineurin activity.
Without calcineurin, T-cells cannot activate a nuclear factor called NFAT, which is required to "turn on" the genes that produce inflammatory cytokines (including IL-2, IL-4, IL-5, and interferon-gamma). By blocking this cascade, pimecrolimus reduces skin inflammation, redness, and itch — without affecting structural skin cells like fibroblasts.
This selectivity is what makes pimecrolimus unique compared to topical steroids: it does not cause skin atrophy (thinning), making it suitable for long-term use on sensitive areas like the face, eyelids, and skin folds. Pimecrolimus also inhibits mast cells, contributing to its strong anti-itch effect.
1% — cream (30g tube)
Apply thin layer to affected skin twice daily for up to 6 weeks
1% — cream (60g tube)
Apply thin layer to affected skin twice daily for up to 6 weeks
1% — cream (100g tube)
Apply thin layer to affected skin twice daily for up to 6 weeks
As of 2026, pimecrolimus is not on the FDA's official drug shortage list. However, patients regularly report difficulty finding it at individual pharmacies. Because it is a second-line specialty topical with relatively lower prescription volumes, many pharmacies stock it in limited quantities — and some carry only the brand Elidel or only the generic, but not both.
Finding pimecrolimus often requires calling multiple pharmacies. medfinder simplifies this process: you provide your medication, tube size, and location, and medfinder calls pharmacies near you to check stock — then texts you the results.
Pimecrolimus is not a controlled substance, so any licensed prescriber with prescribing authority can write a prescription. In practice, it is most commonly prescribed by specialists and primary care providers familiar with atopic dermatitis management:
Dermatologists — most common prescribers, specialists in eczema and skin conditions
Allergists and Immunologists — frequently manage eczema, especially with concurrent allergic conditions
Pediatricians — prescribe for pediatric eczema patients aged 2 and older
Primary Care Physicians (PCPs) — family medicine and internal medicine physicians
Nurse Practitioners (NPs) and Physician Assistants (PAs) in dermatology or primary care settings
Telehealth prescribing is available — platforms such as Teladoc, MDLive, and dermatology-specific services can evaluate and prescribe pimecrolimus remotely. This is especially useful for patients in areas with long dermatology wait times or limited specialist access.
No. Pimecrolimus is not a controlled substance and has no DEA schedule classification. There are no special restrictions on how it can be prescribed or refilled — any licensed prescriber (MD, DO, NP, PA) can write a prescription, and it can be called in, faxed, or e-prescribed like any non-controlled medication.
The primary prescription restrictions come from insurance requirements (prior authorization, step therapy) rather than federal controlled substance regulations. There is no limit on quantity dispensed, no prohibition on early refills, and no requirement for a paper prescription.
Most side effects occur at the application site and typically improve with continued use:
Burning, stinging, or itching at the application site (most common; usually decreases over first 1–2 weeks)
Skin redness (erythema) at the treated area
Increased susceptibility to viral skin infections (herpes simplex, varicella-zoster)
Alcohol flush reaction (warmth, redness, tingling when consuming alcohol during treatment)
Sun sensitivity — avoid sun lamps, tanning beds, and excessive UV exposure
Serious side effects (seek medical attention):
Severe allergic reaction (hives, facial swelling, difficulty breathing) — stop use and seek emergency care
Eczema herpeticum (widespread herpes simplex infection over eczema-affected skin — blisters, fever, flu-like symptoms)
No improvement after 6 weeks of twice-daily use — contact your doctor
FDA Black Box Warning: Pimecrolimus carries a black box warning regarding a theoretical risk of lymphoma and skin cancer (added 2006). A 2023 Lancet meta-analysis found no increased cancer risk with topical calcineurin inhibitor use.
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Tacrolimus (Protopic)
Topical calcineurin inhibitor; same drug class as pimecrolimus; available in 0.03% (ages 2+) and 0.1% (adults); ointment form; generic is often less expensive ($30–$80 with coupons)
Crisaborole (Eucrisa)
PDE4 inhibitor topical ointment; FDA-approved for mild to moderate eczema in patients 3 months+; no black box warning; significantly more expensive without insurance
Hydrocortisone cream (1–2.5%)
Low-potency topical corticosteroid; widely available OTC and by prescription; appropriate first-line for mild eczema; not ideal for long-term facial use due to atrophy risk
Ruxolitinib (Opzelura)
Topical JAK inhibitor; 1.5% cream; FDA-approved for mild to moderate eczema in ages 12+; clinical evidence suggests higher efficacy; expensive and carries JAK inhibitor class boxed warning
Prefer Pimecrolimus? We can find it.
Ketoconazole / Itraconazole (antifungals)
moderateCYP3A4 inhibitors that may increase pimecrolimus blood levels; use with caution, especially when applied to large skin surface areas
Erythromycin / Clarithromycin (antibiotics)
moderateCYP3A4 inhibitors; may increase pimecrolimus levels; use with caution and inform your prescriber
Alcohol
minorMay cause flushing reaction — warmth, redness, or tingling of treated skin when consuming alcohol during treatment
Immunosuppressants (cyclosporine, methotrexate, biologics)
majorAdditive immunosuppression; pimecrolimus is contraindicated in immunocompromised patients; avoid concurrent use
UV light / Phototherapy
majorDo not combine with UV light therapy (phototherapy, PUVA, narrowband UVB) or tanning beds; increased theoretical cancer risk and skin sensitivity
Pimecrolimus (Elidel) remains one of the most important non-steroidal options for managing mild to moderate atopic dermatitis, particularly for sensitive skin areas like the face and eyelids where long-term steroid use is not appropriate. While it carries an FDA black box warning, subsequent research through 2023 has not confirmed the theoretical cancer risk that prompted the warning.
For patients who have trouble finding pimecrolimus in stock at their local pharmacy, medfinder can help — it calls pharmacies near you to find which ones have your medication in stock and texts you the results. Cost savings are also available through GoodRx and SingleCare coupons, which can reduce the price to as low as $70–$80 for a 30g tube of generic pimecrolimus.
If pimecrolimus is unavailable or unaffordable, discuss alternatives with your dermatologist or prescribing physician — tacrolimus ointment (Protopic), crisaborole (Eucrisa), and low-potency topical corticosteroids are all reasonable options depending on your specific situation.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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