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Pimecrolimus for Dogs and Cats

By Barbara Forney, VMD

Last reviewed: 7/13/2022

Commonly prescribed for: Keratoconjunctivitis sicca, atopic dermatities, perianal fistula

Species: Dogs and Cats

Therapeutic Class: Macrolactam Immunomodulator

Basic Information

Pimecrolimus is an immunomodulatory drug from the same family as tacrolimus. These drugs were originally developed specifically for the treatment of inflammatory skin disease in people. The mechanism of action for both pimecrolimus and tacrolimus is through the inhibition of calcium-dependent pathways that effect the enzymatic action of calcineurin. This, in turn, blocks the proliferation of T lymphocytes and cytotoxic cells.

Pimecrolimus has significant anti-inflammatory and immunmodulatory properties, veterinary use of both pimecrolimus and tacrolimus is primarily for keratoconjunctivitis sicca (KCS) in dogs and cats, and immune-mediated dermatologic diseases.

There is a topical pimecrolimus cream that is approved for human use called Elidel®. It is used for the treatment of atopic dermatitis in humans.

Dogs and Cats

Keratoconjunctivitis sicca due to decreased tear production is primarily an immune-mediated disease of the lacrimal glands. It is seen more commonly in dogs than in cats. Cyclosporine has been the standard drug for the treatment of keratoconjunctivitis sicca treatment, although not all animals respond adequately. Ophthalmic pimecrolimus is considerably more effective than cyclosporine in decreasing clinical signs due to inflammation, and equally as effective in increasing tear production. Animals with immune-mediated KCS will need to be on treatment for the rest of their lives.

Side Effects

  • Pimecrolimus is very well-tolerated in the ophthalmic treatment of KCS. Animals irritated by ophthalmic tacrolimus may tolerate ophthalmic pimecrolimus.
  • Pimecrolimus is generally well-tolerated when used for the localized topical treatment of dermatologic problems. Skin irritation is the most-common side effect cited in the human literature.
  • GI symptoms may be encountered from ingestion of the topical ointment (licking).


Only topical or ophthalmic use of pimecrolimus are currently recommended. Reports in the human literature would indicated that there is very little systemic absorption of topical pimecrolimus.

Drug Interactions

No information regarding drug interaction was found.


No information regarding overdose was found.
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