Topgraf Ointment

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Varför beställa från MedsBase

Våra generiska läkemedel kommer från WHO-GMP-certifierade tillverkare och skickas världsvidt i diskreta, enkla förpackningar — inget läkemedelsnamn på försändelsens utsida. Kortbetalningar hanteras via en reglerad betalningsprocessor (kontoutdrag visar en reglerad kortbetalningsprocessor — aldrig “MedsBase” eller något läkemedelsnamn). Krypto och SEPA-banköverföring accepteras också. Varje beställning backas upp av vår Reshipment Assurance Policy.

Varför beställa från MedsBase

Choosing Topgraf Ointment from MedsBase:

• WHO-GMP certified manufacturer — sourced from a regulated facility, finished pack with batch number and expiry.
• Diskret förpackning — plain envelope, no medication name on the outside.
• Världsvid leverans with Reshipment Assurance — if your parcel does not arrive within 20 business days we re-ship at no cost (subject to policy terms).
• Loyalty points — 1 point per $1 spent (excludes peptides); 100 points = $5 off.

What Topgraf Ointment is and how it works

Topgraf Ointment contains tacrolimus 0.03% or 0.1%. Tacrolimus is a macrolide calcineurin inhibitor — it binds FK-binding protein-12 (FKBP-12); the resulting complex inhibits calcineurin phosphatase, blocking dephosphorylation of NFAT and preventing transcription of T-cell activation cytokines (IL-2, IL-4, IFN-γ). The net effect is targeted suppression of skin inflammation without the skin-thinning, atrophy, or HPA-axis effects of topical corticosteroids. Manufacturer: Glenmark / generics (WHO-GMP certified).

Indikationer

• Moderate-to-severe atopic dermatitis (eczema) — second-line where topical steroids are unsafe or inadequate.
• Eyelid and facial eczema — first-line steroid-sparing option (steroids on eyelids cause cataracts and glaucoma).
• Vitiligo — off-label, often combined with phototherapy, for facial and intertriginous patches.
• Steroid-induced rosacea / perioral dermatitis — steroid-sparing taper.
• Lichen planus — including oral and vulvovaginal forms.
• Lichen sclerosus — second-line after potent steroid induction.

Hur du ansöker

• Wash hands. Apply a thin layer to affected skin only, twice daily.
• Continue until clear, then maintenance: twice-weekly application on previously affected sites for relapse prevention.
• Adults: 0.1%. Children 2–15: 0.03%.
• Avoid occlusive dressings unless directed.
• Use SPF 30+ broad-spectrum daily during therapy — tacrolimus increases UV sensitivity.

Biverkningar

• Very common (first 1–2 weeks): burning, stinging, warmth at the application site — usually settles with continued use.
• Vanligt: mild itching, erythema, headache, alcohol intolerance (facial flushing with even small amounts of alcohol).
• Mindre vanliga: folliculitis, herpes simplex flare-up.
• Sällsynt: photosensitivity, contact allergy.

Kontraindikationer

• Children under 2 years.
• Active bacterial, viral, or fungal skin infection without concurrent treatment.
• Netherton syndrome and other genetic skin-barrier disorders (excessive systemic absorption).
• Immunosuppression (HIV, transplant, chemotherapy).
• Known hypersensitivity to tacrolimus.

Läkemedelsinteraktioner

Topical absorption is low, but avoid concurrent topical erythromycin and other macrolide antibiotics on the same skin (additive effect). Caution with strong CYP3A4 inhibitors (clarithromycin, itraconazole, ritonavir) — although systemic levels are usually trivial, large-area or barrier-impaired application can raise systemic tacrolimus enough to matter.

Förvaring

Store below 25 °C in the original tube. Keep tube tightly closed. Do not refrigerate.

Vanliga frågor

Why does Topgraf Ointment burn when first applied?

Initial burning/stinging at the application site is the most common side effect, occurring in ~50% of users during the first week. It is thought to be due to substance-P release in cutaneous nerve fibres. It typically settles within 7 days of continued use. Cooling the cream in the fridge before application can help.

Is tacrolimus safer than topical steroids for long-term use?

Yes — tacrolimus does not cause skin atrophy, telangiectasia, or HPA-axis suppression even with prolonged use, making it preferable for long-term maintenance and for thin-skinned areas (face, eyelids, flexures). The trade-off is the upfront burning sensation and the FDA black-box on theoretical malignancy risk.

Can I use Topgraf Ointment on my face?

Yes — face, eyelids, and flexures are exactly where topical tacrolimus is most useful, since potent steroids on these areas cause atrophy, rosacea, perioral dermatitis, cataracts, and glaucoma. Tacrolimus is preferred for facial eczema in adults and children.

Why must I use sunscreen with tacrolimus?

Tacrolimus increases UV sensitivity. The FDA recommends daily broad-spectrum SPF 30+ sunscreen during therapy and limiting tanning beds and prolonged sun exposure.

Is the lymphoma warning real?

The rodent studies showed lymphoma at very high systemic doses (~30–50× human topical exposure). Long-term cohort studies in humans (>20 years post-launch) have NOT confirmed an increased lymphoma rate. The black-box is a precautionary FDA classification rather than evidence of meaningful risk in normal use.

Can I drink alcohol while using Topgraf Ointment?

Some users develop facial flushing within 5 minutes of alcohol consumption — this is a recognised side effect and resolves on stopping the drug. It does not indicate liver toxicity.

How long can I use Topgraf Ointment for?

Indefinitely if needed. Maintenance use (twice-weekly) for atopic dermatitis is well-established for relapse prevention. Re-evaluate every 6 months and step down where possible.

Can I use it during pregnancy?

Limited data; tacrolimus crosses the placenta. Topical absorption is minimal so risk is low, but use only if benefit clearly outweighs risk and discuss with your specialist.

What should I use it with — moisturiser before or after?

Moisturise after waiting 15–30 minutes from tacrolimus application. Heavy occlusive moisturisers immediately after the drug can amplify absorption.

Is Topgraf Ointment the same as Protopic?

Yes — Protopic is the original brand of tacrolimus ointment from Astellas. Topgraf Ointment is a generic equivalent containing the same active ingredient at the same strengths.

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