Class: Immune Response Modifier
Dosage Forms. Topical Cream: 2.5%, 3.75%, 5%
Common FDA Label Indication, Dosing, and Titration.
1. Actinic keratosis: Apply topically to defined treatment area 2 times per week at bedtime for 16 wk
2. Condyloma acuminatum, external: Apply topically to affected area 3 times per week until total clearance or up to a max duration of 16 wk
3. Superficial basal cell carcinoma, on trunk, neck, or extremities; when surgical methods are less appropriate and follow-up is assured: Apply topically once daily 5 times per week for 6 wk
Off-Label Uses. Condyloma acuminatum, external-HIV infection: Apply topically to lesion at bedtime 3 times per week on nonconsecutive nights for up to 16 wk; wash with soap and water 6-10 h after each application.
MOA. Toll-like receptor 7 agonist that induces cytokines, including interferon-alpha and others
Drug Characteristics: Imiquimod
Medication Safety Issues: Imiquimod
Drug Interactions: Imiquimod. None known
Adverse Reactions: Imiquimod
Efficacy Monitoring Parameters. Resolution of skin lesions.
Toxicity Monitoring Parameters. Seek medical attention if signs/symptoms of severe rash, burning, or itching.
Key Patient Counseling Points. Apply at bedtime and leave on skin for 8 h; when you get up, wash the treated skin area with mild soap and water. Do not cover treated skin areas with bandages. Do not use cosmetics or other skin care products on the treated skin areas. Apply on same days of each week. May increase sensitivity to sun.
Clinical Pearls. Condyloma acuminata are also known as genital warts and are sexually transmitted. Patients should be advised to abstain from sex while being treated. Imiquimod is not a cure for genital or anal warts; patients may develop new warts or spread warts while using the cream.