The Surrey & North West Sussex APC recognises the off-label use of tacrolimus and pimecrolimus (topical use) for short-term treatment of facial, flexural, or genital psoriasis in patients unresponsive to, or intolerant of other topical therapy as per the NICE clinical guidance (CG153) Psoriasis: assessment and management.

This is considered as BLUE (with no information sheet), with the following taken from the guidance:

• Calcineurin inhibitors should be initiated by healthcare professionals with expertise in treating psoriasis
• The prescriber should follow relevant professional guidance, taking full responsibility for the decision 
• The patient (or their parent or carer) should provide informed consent, which should be documented
• See the General Medical Council's Good practice in prescribing medicines – guidance for doctors for further information.

In addition, it has been decided locally that the transfer of prescribing from the specialist to primary care may be considered following the first prescription from the specialist.