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Medicine overview

Indications of Tapisis

Tapisis cream is a non-steroidal topical medicine used for the following skin conditions:

Established / Approved Uses

  • Plaque psoriasis (adults): Topical treatment of plaque psoriasis in adult patients.
  • Atopic dermatitis (adults and children aged 2 years and older): Topical treatment of mild, moderate, or severe atopic dermatitis (eczema).

Tapisis is not approved for use in children below 2 years of age or for plaque psoriasis in the pediatric population, as safety and efficacy have not been established for these uses.

Composition

Each gram of Tapinarof cream contains 10 mg (1% w/w) of Tapinarof as the active ingredient in a topical cream base intended for external application to the skin.

Description

Tapisis is a first-in-class, non-steroidal topical small-molecule that works as an aryl hydrocarbon receptor (AhR) agonist. It is formulated as a 1% cream for once-daily topical application and is used in the management of plaque psoriasis and atopic dermatitis. As a non-steroidal option, Tapisis does not carry the skin-thinning (atrophy) or hypothalamic-pituitary-adrenal (HPA)-axis suppression risks associated with long-term topical corticosteroid use, although it has its own distinct side-effect profile that patients should be counseled about. Tapisis is available in Bangladesh as a 1% cream under several brand names.

Therapeutic Class

Topical Aryl Hydrocarbon Receptor (AhR) Agonist; non-steroidal topical anti-inflammatory agent for dermatologic use.

Pharmacology

Tapinarof is an agonist of the aryl hydrocarbon receptor (AhR), a ligand-activated transcription factor expressed in skin cells. By binding and activating AhR, Tapinarof is thought to help normalize skin barrier function (including upregulation of genes such as filaggrin), reduce production of pro-inflammatory Th17-pathway cytokines (including interleukin-17), and exert antioxidant effects through activation of the NRF2 pathway. The precise mechanism responsible for the clinical benefit of Tapinarof in psoriasis and atopic dermatitis has not been fully established.

Following topical application, systemic absorption of Tapinarof is minimal; plasma concentrations are frequently below the limit of quantification in adults. Tapinarof is highly protein-bound (~99%) and is metabolized via oxidation, glucuronidation, and sulfation. It does not clinically inhibit or induce the major cytochrome P450 (CYP) enzymes at recommended topical doses, and does not prolong the QTc interval.

Dosage & Administration of Tapisis

The dose and frequency of Tapisis cream depend on the indication being treated. Always follow the physician's specific instructions.

IndicationAge groupRecommended dosing
Plaque psoriasisAdultsApply a thin layer of Tapisis cream once daily to the affected skin areas.
Atopic dermatitisAdults and children ≥2 yearsApply a thin layer of Tapisis cream once daily to the affected skin areas.

Treatment should generally be limited to the affected (lesional) skin areas only, and Tapisis should be discontinued once control is achieved unless the physician advises otherwise. Improvement is usually assessed over 8-12 weeks of continuous use; if there is no improvement within this period, the physician should be consulted.

Administration of Tapisis

  • For topical (external) use on the skin only. Tapisis is not for oral, ophthalmic (eye), or intravaginal use.
  • Apply a thin, even layer of Tapisis cream to the affected skin areas once daily.
  • Wash hands with soap and water after application, unless the hands are being treated.
  • Avoid contact with the eyes, lips, mouth, and vaginal mucosa; rinse thoroughly with water if accidental contact occurs.
  • Do not apply Tapisis under occlusive dressings unless specifically directed by a physician.

Interaction of Tapisis

No clinically significant systemic drug-drug interactions have been established for Tapisis cream. Laboratory studies show that Tapisis does not clinically inhibit or induce major cytochrome P450 (CYP) enzymes (including CYP1A2, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, and CYP3A4/5) at the systemic exposure levels achieved with topical use, so meaningful drug interactions are considered unlikely.

As a general precaution, avoid applying other topical products (including other medicated creams, strong irritants, or exfoliants) to the same skin area at the same time as Tapisis, since this may increase local skin irritation. Inform the physician or pharmacist of all other topical or systemic medicines being used.

Contraindications

Tapinarof is contraindicated in patients with known hypersensitivity to Tapinarof or to any other component of the cream formulation.

Side Effects of Tapisis

The side-effect profile of Tapisis differs somewhat by indication.

IndicationCommon side effects (≥1%)
Plaque psoriasisFolliculitis (most common, ~20%), nasopharyngitis, contact dermatitis, headache, pruritus (itching), influenza-like illness.
Atopic dermatitisUpper respiratory tract infection, folliculitis, lower respiratory tract infection, headache, asthma exacerbation, vomiting, ear infection, limb pain, abdominal pain.

Folliculitis (inflammation of hair follicles) is the most frequently reported local skin reaction with Tapisis and is usually mild to moderate and self-limiting, though it occasionally requires stopping treatment. Contact dermatitis, application-site irritation, and, rarely, urticaria (hives) or other hypersensitivity reactions can also occur. If a severe or worsening skin reaction, or signs of an allergic reaction, develop while using Tapisis, treatment should be stopped and a physician consulted promptly.

Pregnancy & Lactation

Pregnancy: There are limited human data on the use of Tapisis in pregnant women. Animal reproduction studies did not show fetal harm at systemic exposures well above those achieved with recommended topical human use. Because human safety data remain limited, Tapisis should be used during pregnancy only if clearly needed and if the potential benefit to the mother justifies the potential risk to the fetus; a physician should be consulted before use.

Lactation: There are no data on the presence of Tapisis in human milk or its effects on the breastfed infant or on milk production. In animal studies, Tapisis was detected in the offspring of treated lactating animals, suggesting transfer into milk is possible. The developmental and health benefits of breastfeeding should be weighed against the mother's clinical need for Tapisis and any potential risk to the infant; a physician should be consulted, and applying the cream directly to the breast/nipple area should be avoided.

Precautions & Warnings

Tapisis is for external (topical) use only and should not be applied to the eyes, lips, mouth, or vaginal mucosa.

  • Folliculitis and local skin reactions: Folliculitis is a commonly reported reaction with Tapisis (see Side Effects); contact dermatitis, irritation, or urticaria can also occur. Discontinue and seek medical advice if a reaction is severe, worsening, or associated with signs of a serious allergic reaction (e.g., swelling, difficulty breathing).
  • Not for use with strong CYP1A2 substrates without medical advice: Although Tapisis has low systemic absorption and clinically insignificant effects on CYP enzymes at recommended doses, patients on medicines with a narrow therapeutic index that depend heavily on CYP1A2 metabolism should mention Tapisis use to their physician as a precaution.
  • Non-steroidal profile: Unlike topical corticosteroids, Tapisis is not associated with skin atrophy (thinning) or hypothalamic-pituitary-adrenal (HPA)-axis suppression, which can make it a suitable option for long-term or sensitive-area use; however, it carries its own distinct risk of folliculitis and local irritation that should be discussed with the physician.
  • Avoid unnecessary sun exposure or use of tanning equipment on treated skin areas.
  • Keep away from open flame; the cream base may be flammable before it dries.

Overdose Effects of Tapisis

Topical overdose of Tapisis is unlikely to cause serious systemic toxicity given its minimal systemic absorption, but excessive or prolonged application beyond the recommended area and frequency may increase the risk of local skin irritation, folliculitis, or contact dermatitis. If Tapisis cream is accidentally ingested, or if signs of a severe skin or allergic reaction occur after use, seek immediate medical attention or contact a poison control center/emergency services rather than attempting home treatment.

Storage Conditions

Store at room temperature (20°C to 25°C; brief excursions between 15°C and 30°C are permitted), away from light, excessive heat, and moisture. Do not freeze. Keep the tube tightly closed and out of reach of children.

Use In Special Populations

Renal and hepatic impairment: Tapisis has not been specifically studied in patients with renal or hepatic impairment; however, because systemic absorption after topical use is minimal, clinically significant accumulation is not expected. Use with the usual precautions and physician guidance.

Elderly (geriatric) patients: Clinical trials of Tapisis included patients aged 65 years and older, and no overall differences in efficacy, safety, or tolerability were observed compared with younger adults; no dose adjustment is required based on age alone.

Pediatric patients: See Pediatric Uses for details specific to children.

Duration Of Treatment

The duration of Tapisis treatment should be individualized by the treating physician based on response and tolerability. In clinical trials, Tapisis was studied for continuous use of up to 12 weeks in plaque psoriasis and up to 8 weeks in atopic dermatitis, with longer-term intermittent use also studied. If the skin condition has not improved after 8-12 weeks of regular use, or if it worsens at any time, the patient should follow up with the physician rather than continuing treatment indefinitely on their own.

Drug Classes

Aryl hydrocarbon receptor (AhR) agonists; non-steroidal topical anti-inflammatory/dermatologic agents used for plaque psoriasis and atopic dermatitis.

Mode Of Action

Tapinarof acts by binding to and activating the aryl hydrocarbon receptor (AhR), a receptor and transcription factor present in skin keratinocytes and immune cells. Activation of AhR by Tapinarof is thought to help restore normal skin barrier gene expression, downregulate pro-inflammatory Th17-related cytokines such as interleukin-17 (IL-17), and activate the NRF2 antioxidant response pathway, together reducing the inflammation and skin barrier dysfunction seen in plaque psoriasis and atopic dermatitis. The full mechanism by which this translates into clinical improvement has not been completely elucidated.

Pediatric Uses

Atopic dermatitis: Tapisis is approved for use in children aged 2 years and older with atopic dermatitis, using the same once-daily application as in adults. In clinical trials, the overall safety profile in this age group was generally similar to adults, though upper respiratory tract infections and ear infections were reported somewhat more frequently in younger children. Safety and efficacy of Tapisis for atopic dermatitis in children below 2 years of age have not been established.

Plaque psoriasis: The safety and efficacy of Tapisis for plaque psoriasis have not been established in pediatric patients (below 18 years), and it should not be used for this indication in children outside of a physician's specific direction.

Frequently Asked Questions

Q: What is Tapisis 20 gm Cream used for?

A: Tapisis 20 gm Cream is a topical cream used to treat plaque psoriasis in adults and atopic dermatitis (eczema) in adults and children aged 2 years and older.

Q: How should I apply Tapisis 20 gm Cream cream?

A: Apply a thin layer of Tapisis 20 gm Cream cream once daily to the affected skin areas, and wash your hands afterward unless you are treating your hands. Avoid contact with your eyes, mouth, and vaginal area.

Q: Is Tapisis 20 gm Cream a steroid cream?

A: No. Tapisis 20 gm Cream is a non-steroidal topical medicine that works through a different mechanism (an aryl hydrocarbon receptor agonist). Unlike topical corticosteroids, it is not associated with skin thinning or hormonal (HPA-axis) suppression, though it can cause its own side effects such as folliculitis.

Q: What are the most common side effects of Tapisis 20 gm Cream?

A: The most common side effect is folliculitis (inflammation around hair follicles), along with contact dermatitis, headache, itching, and cold- or flu-like symptoms. Most reactions are mild to moderate, but you should contact your physician if a reaction is severe or does not improve.

Q: Can Tapisis 20 gm Cream be used during pregnancy or breastfeeding?

A: There is limited human data on Tapisis 20 gm Cream use during pregnancy, and it is not known whether it passes into human breast milk. It should be used during pregnancy or breastfeeding only if clearly needed, after discussing the potential benefits and risks with a physician.

Q: What should I do if I miss a dose or apply too much Tapisis 20 gm Cream?

A: If you miss a dose, apply it as soon as you remember and continue your regular schedule; do not apply extra to make up for a missed dose. Applying more than the recommended amount does not improve results and increases the risk of skin irritation; if you accidentally ingest the cream or experience a severe reaction, seek medical attention or contact a poison control center immediately.

Disclaimer

The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.

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