What may be at the pharmacy
Generic tacrolimus ointment is available, so the tube may show only the generic name rather than Protopic.
US cost and coverage snapshot · checked August 16, 2026
FDA-approved generic versions are available.
Vendor estimate checked August 16, 2026: about $35–$39 with a coupon for one 30 g tube of generic tacrolimus, depending on strength and pharmacy. Retail averages were much higher; compare the exact prescription and location.
Generic coverage is plan-specific, and off-label vitiligo use can still trigger an authorization or quantity limit. A discount coupon is not insurance and usually does not count toward the plan deductible or out-of-pocket maximum.
- US Food and Drug Administration (opens in a new tab): An FDA-approved generic form of Protopic (tacrolimus) ointment exists · primary · high confidence · checked August 16, 2026
- GoodRx (opens in a new tab): Current live pharmacy price comparison · vendor · low confidence · checked August 16, 2026
Patient-community context · anecdotal
What some people described online
The two linked discussions described itching, burning, or warmth. One also described the ointment as greasy or sticky and said discomfort eased. These observations are anecdotal and have no denominator.
These are self-selected posts, not clinical evidence. Diagnoses, products, other treatments, and adherence cannot be verified. There is no denominator. The posts cannot establish efficacy, frequency, typical experience, safety, what caused an experience, or support a treatment recommendation.
These posts are registered as Tier 6 lived experience for question discovery. They are not citations supporting a treatment claim. Relationship status: not established.
- Community discussion · tolerability · September 2023Pseudonymous poster in an online support group · Lived experience - not evidence · published September 8, 2023 · checked August 16, 2026The author is pseudonymous. Their identity, product use, other treatments, adherence, and financial or organizational relationships cannot be verified.
- Community discussion · access and tolerability · May 2025Pseudonymous poster in an online support group · Lived experience - not evidence · published May 30, 2025 · checked August 16, 2026The author is pseudonymous. Their identity, product use, other treatments, adherence, and financial or organizational relationships cannot be verified.
Compare this topical with another option
Why was I offered tacrolimus if it is not approved for vitiligo?
In the United States, tacrolimus ointment is approved for specified atopic dermatitis use, not vitiligo, so using it for vitiligo is off-label. Clinicians may still offer an off-label medicine when they judge the broader evidence relevant. Protopic is a brand name; the current label for the exact product you receive still matters. Think of calcineurin as a switch immune cells flip to attack pigment cells; tacrolimus blocks that switch without thinning your skin the way a steroid can. Evidence Evidence Evidence
Why this matters
- Sources cited, not yet graded
Tacrolimus is a topical calcineurin inhibitor that affects immune signaling in skin. The vitiligo guidelines I read discuss it as one topical option, including when a clinician is considering alternatives to corticosteroids.
Considerations
- Depends on you
Off-label use does not create a regulator-reviewed vitiligo indication, and guideline inclusion does not mean tacrolimus fits you. Your age, body area, immune status, other medicines, and the current product label all matter.
Questions for your clinician
Why do you think this off-label option fits my vitiligo and this body area?
Saving keeps this on your device and needs JavaScript, which is off in this browser.What evidence supports this choice?
Saving keeps this on your device and needs JavaScript, which is off in this browser.What key questions remain unanswered?
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Where does it work best, and where does it not?
In the pooled studies, tacrolimus and Elidel (pimecrolimus) together did far better on the face and neck than anywhere else. About 35% of people reached a marked response there. On the trunk and limbs, about 2% did. On hands and feet, almost no one did. Evidence
Why this matters
- Sources cited, not yet graded
The meta-analysis I read reports these body-area differences from pooled trial data. It does not separate tacrolimus results from pimecrolimus results.
Considerations
- Depends on you
Which pattern applies to your specific patch is not something this pooled average can predict, and it sets no dose or schedule for you.
Questions for your clinician
Does the body area of my patch change what you would expect from this medicine?
Saving keeps this on your device and needs JavaScript, which is off in this browser.Would you recommend something else for a harder area, like my hands or feet?
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Face and neck
About 35% of people reached a marked response.
Trunk and limbs
About 2% of people reached a marked response.
Hands and feet
Almost no one reached a marked response.
From the same pooled meta-analysis cited above. It pools tacrolimus with pimecrolimus and cannot predict your own patch.
How often do you use it, and how long before you know if it is working?
The label directs most patients to apply a thin layer twice a day. No improvement after six weeks is the label’s own signal to check back with your prescriber. In the pooled vitiligo studies, treatment typically ran about three months, ranging from two to seven months. Evidence Evidence
Why this matters
- Sources cited, not yet graded
I checked the tacrolimus label. It states the twice-daily dosing and six-week re-evaluation window for its approved eczema use. The vitiligo meta-analysis separately reports a median three-month treatment duration across its pooled studies.
Considerations
- Depends on you
Neither source sets a vitiligo-specific dosing schedule. Use is off-label, so how long your prescriber has you continue depends on how your own patch responds.
Questions for your clinician
How long do you want me to use this before we check in?
Saving keeps this on your device and needs JavaScript, which is off in this browser.What would make you extend or stop this treatment?
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What are realistic expectations for my patches?
Research on topical calcineurin inhibitors, including Protopic (tacrolimus), reports repigmentation in some people with vitiligo. In the pooled studies, about 18% of people using a calcineurin inhibitor alone reached a marked response, most of a patch’s color back. Adding narrowband UVB nearly tripled that, to about 48%. The studies vary, and personal response, extent of change, and durability remain individual. Evidence Evidence Evidence
Why this matters
- Sources cited, not yet graded
The systematic review I read combined studies with different participants, body sites, treatment contexts, and definitions of success. The guidelines use that broader evidence to support discussing an option - not to claim every patch responds the same way.
Considerations
- Depends on you
Some studies are small or lack strong comparison groups. Do not confuse results from tacrolimus alone with results from a treatment pair. Your body area may also differ from the areas studied.
Questions for your clinician
What change would be realistic to hope for without assuming it will happen?
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What should I know about the boxed warning and skin reactions?
People I have heard from ask about side effects early, and this warning is the part that worries them. The US label for tacrolimus ointment carries the FDA’s strongest safety alert. This is called a “boxed warning.” It notes rare cancer reports but says the medicine has not been proven to cause them. It also warns against continuous long-term use. Burning, stinging, soreness, or itching can occur where you apply it. The label’s own studies reported burning in roughly 46% to 58% of patients and itching in roughly 41% to 46%, most starting in the first few days and easing with continued use. Evidence
Why this matters
- Sources cited, not yet graded
The boxed warning and the Medication Guide belong in your decision. The phrase “steroid-free” must not hide them. Local discomfort can happen. Ask your care team whether a reaction is expected or needs attention.
Considerations
- Depends on you
A boxed warning communicates a serious uncertainty and precaution; it does not calculate your personal likelihood of harm. Your health history, skin findings, infections, lymph-node changes, immune status, and other treatments need professional review.
Questions for your clinician
Can you explain the boxed warning in the context of my health history?
Saving keeps this on your device and needs JavaScript, which is off in this browser.Which changes should make me contact you?
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What if I am also using or considering phototherapy?
Tell both the prescriber and phototherapy team. The tacrolimus label tells patients to minimize or avoid natural and artificial sunlight, including ultraviolet treatment, while vitiligo guidelines discuss selected clinician-supervised combinations. That conflict needs an explicit, coordinated answer; it is not permission to combine them on your own. Evidence Evidence Evidence
Why this matters
- Sources cited, not yet graded
The product label sets approved warnings for tacrolimus, while the guidelines I read assess a broader evidence base that includes off-label practice. A qualified prescriber and phototherapy team need to reconcile both for you and the exact products involved.
Considerations
- Depends on you
The product label and clinical literature answer different questions. Get one coordinated plan from your prescriber and phototherapy team before combining tacrolimus with ultraviolet treatment.
Questions for your clinician
How does the ultraviolet warning affect my plan?
Saving keeps this on your device and needs JavaScript, which is off in this browser.Who is coordinating the tacrolimus and phototherapy instructions?
Saving keeps this on your device and needs JavaScript, which is off in this browser.Who resolves conflicts in my written instructions?
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Three more answers: cost, what other patients say, and what to track
What does it cost?
I could not complete a live retail-price check: GoodRx returned an access-blocked response on 2026-09-08. Here is what I confirmed from the FDA labels. A generic tacrolimus ointment, in both 0.03% and 0.1% strengths, is currently marketed separately from the brand Protopic label. Ask your pharmacy to run both your insurance price and a discount-card price for the exact product and strength you were prescribed, generic or brand. Evidence
Why this matters
- Sources cited, not yet graded
The generic tacrolimus label I read confirms a currently marketed generic product as of the date recorded above.
Considerations
- Depends on you
I did not check a live pharmacy price for this figure. I could not confirm a Protopic-specific manufacturer copay or assistance program on the manufacturer’s current support pages as of 2026-09-08.
Questions for your clinician
Is the generic version appropriate for what you are prescribing me?
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What do other people say about using it?
No reader has sent me a first-hand account of tacrolimus for vitiligo yet. Until someone does, here is what the label and the studies say about living with it. Evidence
Why this matters
- Sources cited, not yet graded
Early burning or itching is common and typically eases with continued use. The medicine is chosen partly because it will not thin the skin the way a steroid can.
Considerations
- Depends on you
No one has told me yet what using this treatment feels like day to day.
Questions for your clinician
What have your other patients told you about using this day to day?
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What is worth tracking while you use it?
Keep a simple, dated record: which product and strength you are using, which patch you are treating, and when you started. Add a same-conditions photo (same light, distance, and angle) each time. Because response varies so much by body area, note the area too. That gives you and your prescriber something concrete to compare at the six-week check-in the label describes, rather than relying on memory. Evidence
Why this matters
- Sources cited, not yet graded
A dated, comparable, area-labeled record is what lets the six-week check-in actually answer whether the medicine is working for that specific patch.
Considerations
- Depends on you
A photo log does not replace a clinical exam and cannot by itself tell you whether a rarer boxed-warning effect has started.
Questions for your clinician
What should I photograph or note between now and my next visit?
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Evidence and update context
This optional layer shows the evidence boundary I reviewed as of 2026-09-19.
- What this evidence supports
- Tacrolimus is a topical calcineurin inhibitor that affects immune signaling in skin. The vitiligo guidelines I read discuss it as one topical option, including when a clinician is considering alternatives to corticosteroids.
- What it does not establish
- Off-label use does not create a regulator-reviewed vitiligo indication, and guideline inclusion does not mean tacrolimus fits you. Your age, body area, immune status, other medicines, and the current product label all matter.
Pending clinical review
This statement has a dated source and is waiting for a clinician's sign-off.
Pending clinical review
This statement has a dated source and is waiting for a clinician's sign-off.
Pending clinical review
This statement has a dated source and is waiting for a clinician's sign-off.
Pending clinical review
This statement has a dated source and is waiting for a clinician's sign-off.
Pending clinical review
This statement has a dated source and is waiting for a clinician's sign-off.
Pending clinical review
This statement has a dated source and is waiting for a clinician's sign-off.
Pending clinical review
This statement has a dated source and is waiting for a clinician's sign-off.
Pending clinical review
This statement has a dated source and is waiting for a clinician's sign-off.
Pending clinical review
This statement has a dated source and is waiting for a clinician's sign-off.
Applicability check
Who was studied?
These fields show what the cited evidence reports about the people and body sites behind outcome or safety claims. “Not reported” means the reviewed source omitted the field; “Pending exact source review” means SteadySkin has not made that determination yet.
One evidence record, 2 statements
In the pooled studies, tacrolimus and Elidel (pimecrolimus) together did far better on the face and neck than anywhere else. About 35% of people reached a marked response there. On the trunk and limbs, about 2% did. On hands and feet, almost no one did.
Research on topical calcineurin inhibitors, including Protopic (tacrolimus), reports repigmentation in some people with vitiligo. In the pooled studies, about 18% of people using a calcineurin inhibitor alone reached a marked response, most of a patch’s color back. Adding narrowband UVB nearly tripled that, to about 48%. The studies vary, and personal response, extent of change, and durability remain individual.
- Age range
- Children and adults were pooled together. One subgroup of 162 children, in 5 studies, was reported apart from the rest. The review states no adult age range.
- Condition subtype
- Not reported
- Severity or extent
- Not reported
- Sample size
- 46 of 56 identified studies, 1,499 people, were used to judge response. Pooled response figures came from smaller subsets: 520 people in 19 studies for a marked response, 560 people in 21 studies for at least a mild response. Protopic (tacrolimus) and Elidel (pimecrolimus) were pooled together, not counted apart.
- Geography and care setting
- Studies came from the United States, Mexico, India, France, Spain, Austria, Turkey, Iran, Italy, Germany, China, Thailand, Canada, Belgium, Pakistan, Brazil and Bangladesh.
- Skin tone or phototype
- Not reported
- Race
- Not reported
- Ethnicity
- Not reported
- Body sites
- Face and neck showed the best pooled response, a marked response in about 35%. Trunk and limbs showed about 2%. Hands and feet showed close to none.
What that means for this page: This is a pooled average across studies that used Protopic (tacrolimus), Elidel (pimecrolimus), or both, with considerable differences in design and protocol. It does not isolate tacrolimus. It is not a prediction for one person, one patch or one body site, and it sets no dose or schedule.
People I have heard from ask about side effects early, and this warning is the part that worries them. The US label for tacrolimus ointment carries the FDA’s strongest safety alert. This is called a “boxed warning.” It notes rare cancer reports but says the medicine has not been proven to cause them. It also warns against continuous long-term use. Burning, stinging, soreness, or itching can occur where you apply it. The label’s own studies reported burning in roughly 46% to 58% of patients and itching in roughly 41% to 46%, most starting in the first few days and easing with continued use.
- Age range
- Not reported
- Condition subtype
- Not reported
- Severity or extent
- Not reported
- Sample size
- Not reported
- Geography and care setting
- The tacrolimus label is current US prescribing information and its Medication Guide. It reports no study population.
- Skin tone or phototype
- Not reported
- Race
- Not reported
- Ethnicity
- Not reported
- Body sites
- Not reported
What that means for this page: The label is regulatory, not a study of a patient group. It reports rare cancer cases and says a causal link is unproven. It does not estimate one person’s risk or say how often local reactions occur.
Tell both the prescriber and phototherapy team. The tacrolimus label tells patients to minimize or avoid natural and artificial sunlight, including ultraviolet treatment, while vitiligo guidelines discuss selected clinician-supervised combinations. That conflict needs an explicit, coordinated answer; it is not permission to combine them on your own.
- Age range
- Not reported
- Condition subtype
- Not reported
- Severity or extent
- Not reported
- Sample size
- Not reported
- Geography and care setting
- One source is the current US tacrolimus label. The other two are the 2021 UK vitiligo guideline and the 2023 worldwide Task Force statement. None reports a study population for this point.
- Skin tone or phototype
- Not reported
- Race
- Not reported
- Ethnicity
- Not reported
- Body sites
- Not reported
What that means for this page: The label sets a US regulatory warning against added ultraviolet exposure. The two guidelines describe selected clinician-supervised combinations from a wider evidence base. None of the three is a study, and none resolves the conflict for one person. That needs a coordinated prescriber and phototherapy plan.
Guidelines and a systematic review support discussing topical calcineurin inhibitors for vitiligo, but heterogeneous studies do not make tacrolimus and Elidel (pimecrolimus) interchangeable or predict one patch’s response.
- Age range
- Pending exact source review
- Condition subtype
- Pending exact source review
- Severity or extent
- Pending exact source review
- Sample size
- Pending exact source review
- Geography and care setting
- Pending exact source review
- Skin tone or phototype
- Pending exact source review
- Race
- Pending exact source review
- Ethnicity
- Pending exact source review
- Body sites
- Pending exact source review
What that means for this page: The pooled review spans different ages, products, body sites, durations, and combinations. Exact study-population extraction remains pending, so this draft cannot support a product-specific or individual response estimate.
The current tacrolimus ointment label describes local reactions, a boxed warning, and ultraviolet precautions in its labeled atopic-dermatitis context; vitiligo use is off-label.
- Age range
- Pending exact source review
- Condition subtype
- Pending exact source review
- Severity or extent
- Pending exact source review
- Sample size
- Pending exact source review
- Geography and care setting
- Pending exact source review
- Skin tone or phototype
- Pending exact source review
- Race
- Pending exact source review
- Ethnicity
- Pending exact source review
- Body sites
- Pending exact source review
What that means for this page: The label is for atopic dermatitis rather than vitiligo, and exact population and body-site extraction remains pending. It supports a safety boundary, not a vitiligo-specific adverse-event rate or personal risk estimate.
Evidence behind this page
Sources
Each evidence badge opens the source and its limits. The full list stays available here.
- GoodRxPatient education · Patient education, tier 5Relevant relationship disclosed
- Published
- SteadySkin last checked
What this source can and cannot tell you
Why the independence label says this: GoodRx is a commercial pharmacy-price and coupon marketplace; displayed prices can vary by prescription, pharmacy, location, and time.
What this source supports
Supports only the dated discounted-cash estimate recorded for a defined generic tacrolimus prescription.
What it does not support
It does not guarantee availability, coverage, coupon eligibility, or a personal price.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
Protopic (tacrolimus) ointment: US prescribing information and Medication Guide (opens in a new tab)
DailyMed, U.S. National Library of MedicineRegulatory · Regulatory / guideline, tier 1Relevant relationship disclosed- Published
- SteadySkin last checked
What this source can and cannot tell you
Why the independence label says this: The National Library of Medicine hosts DailyMed. The product company submits the label to FDA, so it is authoritative for product labeling but not independent efficacy evidence.
What this source supports
It establishes the US atopic-dermatitis indication, boxed warning, local effects, long-term-use precaution, and ultraviolet instructions for this product. Its mechanism-of-action section supports that tacrolimus binds FKBP-12 to block calcineurin phosphatase, preventing the T-cell activation that its boxed warning and local-effect data describe. Its local-adverse-reaction data supports burning in roughly 46-58% and itching in roughly 41-46% of studied patients, most often in the first few days and easing as treatment continues. Its Dosage and Administration section supports applying a thin layer twice daily and re-examining the patient if signs and symptoms do not improve within six weeks.
What it does not support
It does not approve tacrolimus for vitiligo or psoriasis, establish efficacy for either, or resolve off-label guideline discussion of supervised combinations. Its dosing and six-week re-examination window are stated for its approved atopic-dermatitis indication, not as a vitiligo-specific schedule.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- JAMA Dermatology (Lee JH, et al.)Systematic review · Clinical research, tier 2Independent source
- Published
- SteadySkin last checked
What this source can and cannot tell you
What this source supports
Supports pooled group-level repigmentation outcomes for topical calcineurin inhibitors alone and with phototherapy, including variation by body area.
What it does not support
Considerable study heterogeneity limits product-specific and individual inference, and the review does not override current product labels or prove one medicine superior. Supports the exact pooled figures: 55.0% (560 patients, 21 studies) reached at least a mild (>=25%) response, 38.5% (619 patients, 23 studies) reached a moderate (>=50%) response, and 18.1% (520 patients, 19 studies) reached a marked (>=75%) response using a calcineurin inhibitor alone, versus 47.5% marked response when combined with phototherapy. Supports a median treatment duration of 3 months (range 2-7 months) across the pooled studies.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- DailyMed, U.S. National Library of MedicineRegulatory · Regulatory / guideline, tier 1Relevant relationship disclosed
- Published
- SteadySkin last checked
What this source can and cannot tell you
Why the independence label says this: The National Library of Medicine hosts DailyMed. The product company submits the label to FDA, so it is authoritative for product labeling but not independent psoriasis evidence.
What this source supports
Supports that a generic tacrolimus ointment, in both 0.03% and 0.1% strengths, is currently marketed under this label (packager Padagis Israel Pharmaceuticals Ltd, manufacturer LEO Laboratories Ltd), separate from the brand Protopic label cited above.
What it does not support
This label covers the atopic-dermatitis indication only; it does not approve tacrolimus for psoriasis or state a retail price.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- Journal of the European Academy of Dermatology and VenereologyGuideline · Regulatory / guideline, tier 1Relevant relationship disclosed
- Published
- SteadySkin last checked
What this source can and cannot tell you
Why the independence label says this: The journal is the publisher. This label refers to extensive author relationships disclosed for the recommendation, not to the journal itself.
What this source supports
It supports current expert-consensus terminology, clinical assessment, disease-activity evaluation, treatment-goal discussion, and shared decision-making. Its modified assessment check list names where the patches are as a disease feature, and gives genital involvement as its own example. It records white hairs as an item of its own, apart from what the vitiligo has done in the past six months. Its classification table keeps mucosal vitiligo as a subtype, both across more than one site and at one site alone. It supports planning care around what is there to work with, and its example is hair that still has its color. It names stable vitiligo and active vitiligo as two different states that change the care plan. Its shared-decision steps ask what the patient wants from care. At the time it was written, one cream form of a newer drug type had just been approved. Pill forms of that same drug type were still being studied.
What it does not support
It is not independent comparative proof. It cannot diagnose a reader from a description or photograph. It gives no figure for genital involvement, and it does not name lichen sclerosus. It does not set out the Vitiligo European Task Force grading scale. It puts no figure on white hairs and predicts nothing for one person.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.
- British Journal of Dermatology (Eleftheriadou V, et al.)Guideline · Regulatory / guideline, tier 1Independent source
- Published
- SteadySkin last checked
What this source can and cannot tell you
What this source supports
Supports the clinical history and assessment domains, evaluation of associated autoimmune conditions, its recommendation for thyroid function and antithyroid antibody screening, current classification context, treatment-option map, psychosocial assessment, medical photography and the limits of pediatric evidence. Its classification table defines mucosal vitiligo as the oral or genital mucosae. One mucosal site alone is filed as undetermined or unclassified. Its differential diagnosis table lists genital or extragenital lichen sclerosus among the conditions that can be mistaken for vitiligo. That table also lists eczema, psoriasis, lichen planus, pityriasis alba and piebaldism. It calls autoimmunity a contributor to the pathogenesis of vitiligo. It reports an earlier review finding a possible negative impact on intimacy and sexual functioning. It tells clinicians to discuss the psychosocial impact of living with the condition. R28 offers a skin camouflage visit to people who want one. R10 to R14 name potent or very potent topical steroids as the first choice, with a topical calcineurin-inhibitor cream as an option for the face. These are different creams with different proof behind them. R20 names narrowband UVB as the first light option. It says the skin often does better on the face and trunk than on hands and feet. It says there is not enough proof to use any one current pill alone for vitiligo that is not changing. R25 and Table 2 keep cell grafting for vitiligo that is not changing and did not respond to other care. They also say a doctor cannot always tell if the vitiligo has truly stopped changing.
What it does not support
It was designed for UK care and reviewed literature through May 2019; it does not establish a universal testing plan, prescribe an individual plan, or establish current US labeling or coverage. Its differential diagnosis table is a list, not a method a reader can apply to their own skin. It does not say how to tell any two of those conditions apart. It gives no figure for how often vitiligo affects genital skin.
Claim-specific review for this source is still in progress. Only the source-level evidence and limits are shown here.