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At a glance

Imiquimod cream is used for the topical treatment of external genital and perianal warts, small superficial basal cell carcinomas, and actinic keratoses on the face or scalp.

Indications
  • External genital and perianal warts (adults)
  • Small superficial basal cell carcinomas (adults)
  • Actinic keratoses on face or scalp (immunocompetent adults)
Pharmacology

Imiquimod is a toll-like receptor-7 agonist enhancing both innate and acquired immune response. It activates production of numerous compounds including IFN-α, IL-1, -6, -8, -10, -12, and TNF-α, stimulates natural killer cells and B-cell proliferation. It also activates Langerhans cells and promotes their migration to regional lymph nodes. Imiquimod stimulates TH-1 cells to produce IFN-γ, which can activate cytotoxic T lymphocytes providing long-term immune memory.

Dosage

Adult Dose (Topical):

  • External Genital & Perianal Warts (5% cream): Apply 3 times weekly (non-consecutive days) before bedtime, leave for 6-10 hours; max 16 weeks
  • External Genital & Perianal Warts (3.75% cream): Apply once daily until clearance or max 8 weeks
  • Superficial Basal Cell Carcinoma (5% cream): Apply 5 times weekly (consecutive days) for 6 weeks, leave for 8 hours; assess response 12 weeks after treatment
  • Actinic Keratoses (2.5% or 3.75% cream): Apply daily on face/scalp for 2 weeks, 2-week break, assess response 8 weeks after 2nd course
  • Actinic Keratoses (5% cream): Apply 3 times weekly for 4 weeks, 4-week break, repeat if necessary

Child Dose: Safety and efficacy not established in children <12 years

Side effects

Common Side Effects:

  • Dry skin
  • Application site itching, burning, redness, swelling, skin ulceration

Others: Pustules, genital candidiasis, vaginitis, bacterial/fungal infections, upper respiratory tract infection, headache, dizziness, migraine, nausea, diarrhea, myalgia, arthralgia

Use in pregnancy

Use in Pregnancy: May be unsafe; animal studies have shown harmful effects; use only if potential benefit justifies potential risk to fetus.

Precautions & warnings

Precautions:

  • Avoid direct contact with eyes; if contact occurs, wash with water and seek immediate medical attention
  • Inform doctor if pregnant, planning pregnancy or breastfeeding
  • Inform doctor if any kidney or liver disease
  • Caution in patients receiving immunosuppressive medication
  • Application of excess cream or prolonged contact may cause severe local reactions
Overdose effects

Systemic overdosage unlikely with topical use; accidental ingestion (200 mg) may cause nausea, vomiting, headache, myalgia, fever; hypotension reported with multiple oral doses ≥200 mg.

Storage conditions

Store in a cool & dry place, protected from light; store at 4°-25°C.

Imiquimod — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.