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Imiquimod Brand Names- Aldara | Zyclara
What is Imiquimod
Imiquimod is a topical agent for the treatment of actinic keratosis, basal cell carcinoma, and external genital and perianal warts (i.e., condylomata acuminata) caused by human papillomavirus (HPV).
Like podofilox, imiquimod can be self-administered by the patient, whereas other treatments for condyloma acuminata (e.g., intralesional interferon alfa, podophyllum resin, trichloroacetic acid) must be administered by a health-care provider.
Imiquimod, like other currently available therapies for exophytic genital and perianal warts, does not eradicate HPV or affect the natural history of HPV infection.
Despite destruction of HPV warts, latent or subclinical HPV infection can persist and recurrence of visible warts is common.
Imiquimod cream was granted final FDA approval for the treatment of condylomata acuminata in March 1997. In March 2004 and July 2004, the FDA approved imiquimod cream for the treatment of actinic keratosis and basal cell carcinoma, respectively.
Indications
- actinic keratosis
- basal cell carcinoma
- condylomata acuminata
- herpes genitalis
- herpes simplex virus infection
- herpes simplex virus type 1
- herpes simplex virus type 2
- human papillomavirus (HPV)
- human papillomavirus (HPV) infection
- lentigo maligna
- molluscum contagiosum
- vulvar intraepithelial neoplasia (VIN)
Side Effects
- abdominal pain
- agitation
- alopecia
- anemia
- angioedema
- anorexia
- anxiety
- arrhythmia exacerbation
- arthralgia
- atrial fibrillation
- back pain
- bleeding
- capillary leak syndrome
- cardiomyopathy
- cheilitis
- chest pain (unspecified)
- chills
- cough
- depression
- diarrhea
- dizziness
- dyspepsia
- dyspnea
- dysuria
- eczema vaccinatum
- edema
- erythema
- erythema multiforme
- exfoliative dermatitis
- fatigue
- fever
- headache
- heart failure
- infection
- insomnia
- lethargy
- leukopenia
- lymphadenopathy
- myalgia
- myocardial infarction
- nausea
- new primary malignancy
- palpitations
- pancytopenia
- paresis
- pharyngitis
- proteinuria
- pruritus
- pulmonary edema
- rash
- rhinitis
- seizures
- sinus tachycardia
- sinusitis
- skin discoloration
- skin erosion
- skin hyperpigmentation
- skin hypopigmentation
- skin irritation
- skin ulcer
- stroke
- supraventricular tachycardia (SVT)
- syncope
- thrombocytopenia
- thrombotic thrombocytopenic purpura (TTP)
- urinary retention
- vasculitis
- vesicular rash
- vomiting
- xerosis
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- accidental exposure
- benzyl alcohol hypersensitivity
- breast-feeding
- children
- contraceptive devices
- human immunodeficiency virus (HIV) infection
- immunosuppression
- infants
- neonates
- occlusive dressing
- ocular exposure
- paraben hypersensitivity
- pregnancy
- sunburn
- sunlight (UV) exposure
- surgery
Interactions
- Podofilox
- Podophyllum
Podofilox: (Minor) While no drug interactions have been reported with imiquimod, there is no clinical experience with imiquimod cream therapy immediately following the treatment of genital/perianal warts with other cutaneously applied drugs, such as podofilox. Therefore, imiquimod cream administration is not recommended until skin is healed from any previous topical drug treatments or surgery.
Podophyllum: (Minor) While no drug interactions have been reported with imiquimod, there is no clinical experience with imiquimod cream therapy immediately following the treatment of genital/perianal warts with other cutaneously applied drugs, such as podophyllum resin. Therefore, imiquimod cream administration is not recommended until skin is healed from any previous topical drug treatments or surgery.
