The transient burning sensation and stinging itch caused by tacrolimus ointment in atopic dermatitis (AD) patients can be distressing, especially in those with severe lesions. Although not fully elucidated, neuropeptide release at the application site may underlie these phenomena. Olopatadine is a second generation antihistamine with efficacy in allergic disorders; it may also decrease neuropeptide release at inflammatory sites. It reduced application site burning and pruritus in some AD patients (Kawashima, M. and Takahashi, T. 17th Congr Eur Acad Dermatol Venereol (EADV) (Sept. 17-21, Paris) 2008, Abst. FP0076).