Tretinoin

Tacrolimus

Caffeine

Niacinamide

Chamomile Extract (Bisobolol)

Vitamin C (Ascorbic Acid)

DMAE

In a Copper-peptide-infused cream base

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Active Ingredients: 

Tretinoin

Tacrolimus

Caffeine

Niacinamide

Chamomile Extract (Bisobolol)

Vitamin C (Ascorbic Acid)

DMAE

In a Copper-peptide-infused cream base

Overview of Contained Information: 

• Ingredient information
• Interactions
• Side effects
• How to take the medication
• How to store the medication
• Other important information you should know prior to starting the medication

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Instructions: 

This treatment plan may help: improve the skin's appearance, increase healthy cell turnover, reduce hyperpigmentation, reduce the appearance of dark circles, smooth fine lines, plump and tighten the skin, increase hydration and firmness, and improve overall skin texture and tone around the eye area when used regularly and as prescribed. 

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The main mechanism of action is to increase healthy cell turnover, hydrate, firm, brighten, plump, and smooth eye skin. It may take several months to see maximum results from this treatment. 

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Follow all directions on your prescription label and read all medication guides or instruction sheets. 

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Use the medicine exactly as directed. Using more medicine or applying it more often than prescribed will not make it work any faster, and may increase side effects. 

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Do not take by mouth. Topical medicine is for use only on the skin. Avoid getting this medication in your eyes or mouth. 

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Do not use on sunburned skin, or skin affected by eczema. 

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Wash your hands before and after applying the formula. Before applying, clean and dry the skin area to be treated. Applying the formula to wet skin may cause skin irritation. 

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Do not wash the treated area or apply other skin products for at least 20 minutes after applying the formula. This treatment is meant to be left on the skin overnight.

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This formula should be used as part of a complete skin care program that includes moisturizing, avoiding excess sunlight, and using an effective sunscreen. Store at room temperature away from moisture and heat. 

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Keep the container tightly closed when not in use. Store away from children and pets.

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You can use this medicine in conjunction with other topical skin products, but avoid other products that also contain tretinoin, retinol, or other retinoids.

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Do not use with skin products that contain benzoyl peroxide, sulfur, resorcinol, salicylic acid, or other skin-exfoliating acids unless otherwise directed by your doctor. These products can cause severe skin irritation if used with this formula.

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Allergies: 

This medication may cause allergic reactions if you are allergic to a component of the medication or medications similar to the ingredients in this product. If you are allergic to any of the ingredients listed (Ingredients: Tretinoin, Tacrolimus, Caffeine, Niacinamide, Chamomile Extract (Bisobolol), Vitamin C (Ascorbic Acid), DMAE) please stop the medication, reach out to us, and contact your doctor. 

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If you are experiencing any of the following symptoms: hives, difficulty breathing, swelling of your face, lips, tongue, or throat, you may be having an acute allergic reaction and you need to get emergency medical help immediately.

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Conditions: 

We have evaluated your health history and the specific health information you provided us. However, if anything changes and you develop or discover any new condition please contact us and your doctor to make sure this medication is still appropriate for you. 

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Some medications can have interactions with conditions and we will help you evaluate that risk and decide on an appropriate treatment plan.

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Small amounts of Tacrolimus are used in this formula. Tacrolimus may not be appropriate for you to use if you have the following conditions:

• Immune system problems
• Past or current skin cancer
• Cutaneous T-cell lymphoma
• A current viral infection including chickenpox, cold sores, or herpes
• Burned or damaged skin on or near the application site
• Recent or ongoing radiation therapy
• Netherton’s syndrome
• An allergic reaction to Tacrolimus and similar medications, or other ingredients in this cream

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Pregnancy and Breastfeeding: 

Tretinoin and Tacrolimus products are to be avoided during pregnancy due to the risks to the growing fetus. 

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It is not known if Tretinoin goes into breastmilk and what the effects might be on a growing child, so it is not recommended to use Tretinoin products while breastfeeding.

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Tell your doctor if you are pregnant, breastfeeding, or planning to become pregnant in the near future.

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Side Effects: 

You may experience side effects with these medications. 

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Black Boxed Warning

• Long-term Safety of Topical Calcineurin Inhibitors (Tacrolimus) Has Not Been Established.
• Although a causal relationship has not been established, rare cases of malignancy (e.g., skin and lymphoma) have been reported in patients treated with topical calcineurin inhibitors, including Tacrolimus.

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These side effects are common and may go away with time and daily use:

• Itching
• Redness
• Scaling 
• Dryness
• Increased skin sensitivity to hot or cold temperatures
• Mild skin irritation
• Mild itching
• Tingling sensation

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These side effects may be managed with frequent use of an everyday moisturizer and sunscreen. 

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You may also experience:

• Peeling
• Burning
• Stinging
• Skin soreness
• Increased sensitivity to the sun
• Headache
• Muscle pains
• Nausea

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Less common side effects may occur, these should be reported to your doctor right away:

• Cold sores, shingles, chickenpox
• Feeling extreme tiredness
• Skin bleeding or changes (new or changed freckles, moles, color changes, new growths)
• Swollen glands
• Hair follicle or skin infection

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You should also avoid other products known to cause skin irritation on the area of treatment such as: medicated or abrasive soaps, chemical hair removers or waxes, electrolysis, products with alcohol or astringents, and cosmetics with a strong drying effect.

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Medicines and Supplements:

We have evaluated your health history and the specific health information you provided us. However, if anything changes and you start or discover that you are taking any additional medicines or supplements please contact us and your doctor to make sure this medication is still appropriate for you. 

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Some medications can have interactions and we will help you evaluate that risk and decide on an appropriate treatment plan.

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The following medications may interact with the Tacrolimus component in this cream:

• Antifungal medications including fluconazole, keotconazole, itraconazole
• Calcium Channel Blocker medications including diltiazem and nifedipine
• Erythromycin
• Cimetidine
• Certain vaccines

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This may not be a full list of all medicine and supplement interactions. Share all currently used supplements and medications with your care team to ensure this is an appropriate treatment for you.

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Risks: 

We have evaluated the specific health information provided by you to identify if this product is appropriate for you. If you forgot to provide us with any information or incorrectly provided the information we may misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment. 

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If you need to update or clarify any information about your health you can call us and update your profile so that we may reevaluate if this is appropriate for you.

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Treatment Failure: 

This treatment is not 100% effective for every patient. It may not work for every patient or may only work partially to resolve the condition that it is meant to treat. 

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If the treatment is not working, or if you find that you are experiencing new or worsening symptoms, contact us as well as your doctor to identify if you should continue this treatment. 

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If it is an emergency, call 911 or seek immediate medical help. 

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We are providing this treatment for you because the potential benefits outweigh the risks in our estimation based on the medical information provided. 

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You should evaluate this information and any input from your in-person healthcare team, and any other relevant information to decide if this treatment plan is appropriate for you. 

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Share with Your Healthcare Team:

We recommend that you update all of your physicians, pharmacists, and the rest of your healthcare team to let them know about any new medicines or supplements that you are taking or any changes in your health. 

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You can also ask us questions anytime regarding your therapy and we are happy to help you share any information about your health with anyone in your personal healthcare team.

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Additional Resources

The following links provide further information on the potential risks and benefits of this medication:

• Official Tretinoin PDR
• FDA Tretinoin Prescribing Information
• Official Tacrolimus Ointment PDR
• FDA Tacrolimus Ointment Prescribing Information

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