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Updated: Aug 15, 2026
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Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
Published on: November 8, 2015
Alcohol-induced rash caused by topical tacrolimus
Adina Kay Knight1, Mitchell Boxer, Michael J Chandler
1Department of Clinical Immunology, The Mount Sinai School of Medicine, New York, New York, USA. Adina.Knight@mssm.edu
Summary
Topical tacrolimus can cause alcohol-induced flushing, mimicking a food allergy. Stopping the medication resolves this skin reaction, preventing misdiagnosis of allergic conditions.
Area of Science:
- Dermatology
- Pharmacology
Background:
- Topical tacrolimus is a common treatment for inflammatory skin conditions.
- Alcohol consumption can trigger adverse reactions in patients using topical tacrolimus.
Observation:
- Three patients using topical tacrolimus experienced flushing after alcohol ingestion.
- This reaction mimicked symptoms of a food allergy.
Findings:
- Discontinuation of topical tacrolimus effectively resolved the alcohol-induced flushing.
- The observed reaction is a drug interaction, not a true food allergy or worsening of atopic disease.
Implications:
- Clinicians should consider alcohol interaction in patients on topical tacrolimus presenting with new skin complaints.
- A thorough patient history, including alcohol use, is crucial for accurate diagnosis and management.
- Awareness of this interaction can prevent unnecessary avoidance of foods and misdiagnosis.
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