Imiquimod topical: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

What is topical imiquimod used for?

Topical imiquimod is used to treat abnormal skin growths such as actinic keratosis (a type of precancerous growth), superficial basal cell carcinoma (a type of skin cancer), and genital warts present outside the body.

Topical imiquimod may also be used for other conditions as determined by your healthcare provider.

How does topical imiquimod work (mechanism of action)?

The exact mechanism of action of topical imiquimod is unknown. Topical imiquimod may change the immune system response to help clear abnormal skin growths.

How is topical imiquimod supplied (dosage forms)?

Topical imiquimod is available as Aldara, Zyclara, and generic imiquimod in the following dosage forms that are applied to the skin.

2.5% topical cream
3.75% topical cream
5% topical cream

How should I store topical imiquimod?

Some topical imiquimod products should be stored at room temperature or in the refrigerator, between 39 F to 77 F (4 C to 25 C). Other topical imiquimod products should only be stored at room temperature, between 68 F to 77 F (20 C to 25 C), and can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting them. Ask your pharmacist if you are unsure about how to store your topical imiquimod product. Avoid freezing.

Side Effects

What are the most common side effects of topical imiquimod?

The most common side effects of topical imiquimod are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

Skin reactions such as pain, itching, burning, redness, dryness, peeling, crusting, swelling, blisters, and ulcers (see below)
Tiredness
Fever
Headache
Flu-like symptoms (see below)
Nausea

There may be other side effects of topical imiquimod that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of topical imiquimod?

While less common, the most serious side effects of topical imiquimod are described below, along with what to do if they happen.

Local Skin Reactions. Topical imiquimod may cause severe skin reactions such as skin drainage (weeping) skin breakdown, sore development, and swelling of the outside of the vagina that can make peeing hard. Stop using topical imiquimod, wash the treatment area with mild soap and water, and call your healthcare provider right away if you experience any symptoms that interfere with your daily activities or do not go away.

Sensitivity to Sunlight. Your skin may be very sensitive to light from the sun and devices that give off similar light, such as sunlamps and tanning beds, while you are using certain drugs, including topical imiquimod. This is called photosensitivity. Use sunscreen and wear a hat and clothes that cover your skin if you need to be in the sunlight. Exposing your skin to this kind of light, even for a short time, can cause your skin to be severely sunburned, blistered, or swollen. Tell your healthcare provider right away if any of these happen.

Severe Allergic Reactions. Topical imiquimod may cause allergic reactions, which can be serious. Stop using topical imiquimod and get help right away if you have any of the following symptoms of a serious allergic reaction.

Breathing problems or wheezing
Racing heart
Fever or general ill feeling
Swollen lymph nodes
Swelling of the face, lips, mouth, tongue, or throat
Trouble swallowing or throat tightness
Itching, skin rash, or pale red bumps on the skin called hives
Nausea or vomiting
Dizziness, feeling lightheaded, or fainting
Stomach cramps
Joint pain

Warnings & Precautions

Who should not use topical imiquimod?

Allergies to Ingredients. People who are allergic to any of the following should not use topical imiquimod.

Imiquimod
Aldara
Zyclara
Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific topical imiquimod products they stock.

What should I know about topical imiquimod before using it?

Do not use topical imiquimod unless it has been prescribed to you by a healthcare provider. Use it as prescribed. Wash your hands before and after using topical imiquimod.

Do not share topical imiquimod with other people, even if they have the same condition as you. It may harm them.

Keep topical imiquimod out of the reach of children.

Topical imiquimod is only to be applied to the skin. Avoid applying it near the eyes, lips, nostrils, or near the opening or inside the vagina or anus. Severe pain or swelling that can make peeing difficult can happen if topical imiquimod is applied near the opening or inside the vagina. If topical imiquimod gets into your mouth or eyes, rinse your eyes or mouth with water right away.

Avoid having oral, genital, or anal sex when the medicine is applied to the skin for genital warts. Topical imiquimod may weaken condoms and vaginal diaphragms, thereby making them less effective in preventing pregnancy.

Do not cover the application site with bandages or tight dressings.

Safely throw away an open packet even if all of the topical imiquimod was not used and leftover medicine after you complete your treatment course.

Topical imiquimod is not a cure for genital warts. New warts may appear while using the medicine.

Your skin color may change at the application site of topical imiquimod. Color changes usually go away after treatment; however, it may be permanent in some people.

Keep all appointments to have your skin checked. Skin cancer can come back.

What should I tell my healthcare provider before using topical imiquimod?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if topical imiquimod is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

Autoimmune diseases
Unhealed skin from a recent surgery or other medicines
Other skin problems or sunburn
Chronic graft versus host disease
Problems with your immune system

Other Medicines and Supplements. Topical imiquimod may interact with other medicines and supplements. Before using topical imiquimod, tell your healthcare provider about any prescription or OTC medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section below for more details.

Pregnancy. It is not known if or how topical imiquimod could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should use topical imiquimod while you are pregnant or trying to get pregnant.

Breastfeeding. It is not known if topical imiquimod passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use topical imiquimod while breastfeeding.

Interactions

Does topical imiquimod interact with foods or drinks?

There are no known interactions between topical imiquimod and foods or drinks.

It is unknown if drinking alcohol will affect topical imiquimod.

Does topical imiquimod interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any other products that contain imiquimod before using topical imiquimod.

Does Imiquimod topical interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much topical imiquimod?

If you or someone else has used too much topical imiquimod, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of topical imiquimod?

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses. Stop using the medicine after completing your prescribed course; do not continue using the medicine even if you miss doses.