Iminod

Indications

Imiquimod 5% cream is used on the skin to treat external genital and perianal warts in adults, certain flat, scaly precancerous skin patches caused by sun damage (actinic keratosis) on the face or scalp, and small superficial basal cell carcinomas (a type of skin cancer) when surgery is not suitable.

How It Works

Imiquimod is an immune response modifier. It activates receptors (toll-like receptor 7) on immune cells in the skin, which then release interferon and other substances. This boosts the body's own immune attack against the virus that causes warts and against abnormal skin cells. It does not kill the virus directly.

Dosage and Administration

For genital and perianal warts in adults, apply a thin layer to the warts 3 times a week (for example Monday, Wednesday and Friday) at bedtime, rub in until the cream disappears, leave on for 6 to 10 hours, then wash off with mild soap and water. Continue until the warts clear, for up to 16 weeks. For actinic keratosis and superficial basal cell carcinoma, use only as prescribed, as the schedule is different.

• Wash hands before and after applying.
• Do not cover with airtight dressings and avoid bathing or showering soon after applying.
• Use a new sachet each time; do not save opened sachets.

Interactions

No important interactions with tablets or injections are known. Do not use other treatments on the same area at the same time unless advised. The cream can weaken condoms and diaphragms, so avoid sexual contact while the cream is on the skin. Tell your doctor if you take medicines that suppress the immune system.

Contraindications

• Allergy to Imiquimod or any ingredient in the cream.
• Not for use inside the vagina, urethra, anus or on open wounds.

Side Effects

Skin reactions at the treated area are common and often show the medicine is working: redness, itching, burning, flaking, scabbing, swelling, small sores and pain. Some people get flu-like symptoms such as tiredness, headache, fever and muscle aches. Skin colour changes may occur and can be permanent.

Stop using it and get urgent medical help if you have a severe skin reaction with open sores or bleeding, severe pain or swelling, difficulty passing urine (for women treating the genital area), signs of infection, or signs of an allergic reaction such as swelling of the face or difficulty breathing. A doctor may advise a rest period if reactions are strong.

Pregnancy and Lactation

There is limited information on use in pregnancy, and it should be used only if the doctor advises it. It is not known whether it passes into breast milk; ask your doctor before using it while breastfeeding.

Precautions and Warnings

Avoid contact with the eyes, lips and nostrils. Avoid sunlight and sunlamps on treated skin, and use protective clothing. Uncircumcised men treating warts under the foreskin should pull it back and wash the area daily. It does not cure HIV or other sexually transmitted infections and does not prevent passing warts to partners. Use with care in people with autoimmune disease or a weakened immune system.

Overdose

Applying too much increases local skin reactions; wash it off with mild soap and water. If swallowed, it may cause nausea, vomiting, headache and low blood pressure; seek medical advice.

Therapeutic Class

Topical immune response modifier.

Storage

Store below 25°C, away from light. Do not freeze. Keep out of the reach of children.