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Drug Info:

Imiquimod

Brand names: Aldara™

Chemical formula:



Imiquimod skin cream

What is imiquimod skin cream?

IMIQUIMOD (Aldara™) cream is used to treat skin conditions including external genital or anal warts. Because imiquimod does not kill the virus (HPV virus) that causes genital or anal warts, new warts may appear during or after treatment. This drug is also effective at treating other skin conditions such as actinic keratosis and superficial basal cell cancers. Generic imiquimod skin cream is not yet available.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
• an unusual or allergic reaction to imiquimod, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Apply imiquimod cream to the affected areas as directed on the prescription label. Wash hands before and after applying cream. Imiquimod cream should be applied just before bedtime. A thin layer of the cream should be applied topically with the fingers; the cream should be massaged gently into the affected areas until no longer visible. Avoid contact with lips, eyes, or nose. Use imiquimod cream only on the affected area as directed by your health care provider. Do not use imiquimod cream longer than prescribed. Using too much imiquimod cream or using it too often, or for too long can increase your chances for having a severe skin reaction or other side effect. Discard packet after applying to affected area; partial packets should not be saved or reused.

• For treatment of genital or anal warts: You will usually apply this cream every other day (3 times a week) until the warts are gone, for a maximum of 16 weeks. Do not use the cream inside the vagina or rectum. Avoid getting imiquimod cream in your eyes. Uncircumcised men treating warts under the foreskin of the penis should pull back the foreskin and clean the area daily. Women should take special care if applying the cream at the opening of the vagina because local skin reactions on the delicate moist surfaces can cause pain and swelling, and may cause problems passing urine. Do not bandage or wrap the treated area. The treated area should be washed with mild soap and water 6—10 hours after applying the cream (usually upon waking).

• For the treatment of actinic keratosis: You will apply the cream to the affected area twice weekly, 3—4 days apart, for 16 weeks. Leave on skin for about 8 hours as directed, after which time the cream should be washed off using mild soap and water usually upon waking. The area you treat with imiquimod cream should be no larger than the size of your forehead or one cheek (for example, 2 inches by 2 inches).

• For the treatment of superficial basal cell cancer: You will apply the cream to the affected area 5-times per week for 6 weeks (such as Monday through Friday before going to bed). Leave the cream on your skin for about 8 hours, as directed, after which time the cream should be washed off using mild soap and water.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed. This drug has been used in adolescents for the treatment of genital or anal warts.

What if I miss a dose?

If you miss a dose, use it as soon as you can. If it is almost time for your next dose, use only that dose. Do not use double or extra doses.

What drug(s) may interact with imiquimod?

Imiquimod treatment is not recommended until the skin has healed from any previous drug (example: podofilox or podophyllin resin) or surgical skin treatment.

Tell your prescriber or health care professional about all other medicines you are using or taking, including non-prescription medicines. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking imiquimod?

• During the treatment of genital or anal warts:
Visit your health care professional for regular checks on your progress. Females should receive regular pelvic exams as recommended by their prescribers.

You will notice improvement in your condition gradually. Most patients experience improvement within 4 weeks. However, it may take up to 16 weeks to see a full clearing of the warts. Imiquimod cream is not a cure. New warts may develop during or after treatment.

Sexual (genital, anal, oral) contact should be avoided while the cream is on the skin.

Imiquimod cream will not cure genital or anal warts. It is also not known if imiquimod cream can stop you from spreading genital or anal warts to other people. The only way to prevent infecting others with the HPV virus (the virus that causes genital warts) is to avoid direct skin-to-skin contact. If warts are visible in the genital area, sexual contact should be avoided until the warts are treated. Experts advise that using latex condoms during sexual contact may reduce, but not entirely prevent, infecting others.

Do not rely on condoms, diaphragms, cervical caps or other 'barrier' devices as your sole method of birth control. Imiquimod cream may weaken these devices and make them less effective at birth control.

Do not cover the treated area with an airtight bandage. Cotton gauze dressings can be used. Cotton underwear can be worn after applying imiquimod cream to the genital or anal area.

• During the treatment of actinic keratosis or superficial basal cell cancer:
Visit your health care provider for regular checks on your progress. Actinic keratoses that were not seen before may appear during treatment and may later go away. The treatment area and surrounding area may lighten or darken after treatment with imiquimod cream. These skin color changes may be permenant in some patients.

It is common for patients to have skin reactions in areas treated. These reactions may extend beyond the application site onto the surrounding skin. Skin reactions generally decrease in intensity or resolve after stopping imiquimod therapy. If you experience a severe reaction or any sign or symptom at the treatment site that interferes or prevents you from doing any daily activity, contact your health care provider to discuss whether you require a rest period from treatment. Treatment may resume once the reaction has improved as recommended by your prescriber.

Use sunscreen during treatment and minimize or avoid exposure to natural or artificial sunlight (tanning beds or UVA/B treatments).

Do not cover the treated area with an airtight bandage. Cotton gauze dressings can be used.

What side effects may I notice from receiving imiquimod?

Side effects that you should report to your prescriber or health care professional as soon as possible:
• open sores with or without drainage
• skin infection
• skin rash
• unusual or severe skin reaction

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• back pain
• burning or itching
• changes in skin color that do not always go away
• diarrhea
• feeling like you have the flu
• headache
• muscle aches
• redness of the skin (very common but is usually not painful or harmful)
• scabbing and crusting
• skin peeling
• skin that becomes hard or thickened
• swelling of the skin

Where can I keep my medicine?

Keep out of the reach of children.

Store between 4 and 25 degrees C (39 and 77 degrees F). Do not freeze. Throw away any unused portion after the expiration date.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

 
 

A topical immune response modifier with antiviral and antineoplasia effects. Used in veterinary medicine to treat squamous cell carcinomas and viral papillomas.

 
Wikipedia: imiquimod
Imiquimod.svg
Imiquimod
Systematic (IUPAC) name
1-isobutyl-1H-imidazo[4,5-c]quinolin-4-amine
Identifiers
CAS number 99011-02-6
ATC code D06BB10
PubChem 57469
DrugBank APRD01030
Chemical data
Formula C14H16N4 
Mol. mass 240.304 g/mol
Pharmacokinetic data
Bioavailability  ?
Metabolism  ?
Half life 20 hours (topical dose), 2 hours (subcutaneous dose)
Excretion  ?
Therapeutic considerations
Licence data

EU US

Pregnancy cat.

B1(AU) C(US)

Legal status

POM(UK) -only(US)

Routes Topical

Imiquimod (INN, marketed by 3M under the trade name Aldara) is a prescription medication that acts as an immune response modifier.

Uses

Imiquimod is a patient-applied cream used to treat certain diseases of the skin, including skin cancer (basal cell carcinoma, Bowen's disease[1], superficial squamous cell carcinoma, some superfical malignant melanomas and actinic keratosis) as well as genital warts (Condylomata Acuminata). It has also been tested for treatment of Molluscum contagiosum. It causes interferon production which triggers the patient's immune response against these tumors.

It is also used pre-operatively to shrink basal cell cancer and melanoma in situ (especially Lentigo Maligna) before Mohs surgery.

Side effects include redness and irritation of the skin during treatment.

History

The original FDA approval was on February 27, 1997, FDA Application No. (NDA) 020723, by Graceway.

Since then, the label has been revised many times. Adverse side effects have been reported, in some cases serious and systemic. Some patients have been suffering from severe auto-immune or neuro-immune effects for years.[citation needed]

Mechanism of action

The exact mode in which imiquimod and its analogs activate the immune system is not yet known. Nevertheless, it is known that Imiquimod activates immune cells by ligating the toll-like receptor 7 (TLR7), commonly involved in pathogen recognition, on the cell surface.[2] Cells activated by imiquimod via TLR-7 secrete cytokines (primarily interferon-α (IFN-α), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α)). [3] There is evidence that imiquimod, when applied to skin, can lead to the activation of Langerhans cells, which subsequently migrates to local lymph nodes to activate the adaptive immune system.[4] Other cell types activated by imiquimod include natural killer cells, macrophages and B-lymphocytes.[4]

References

  1. ^ van Egmond S, Hoedemaker C, Sinclair R (2007). "Successful treatment of perianal Bowen's disease with imiquimod". Int J Dermatol 46 (3): 318-9. PMID 17343595. 
  2. ^ Hemmi, H., et al. Small anti-viral compounds activate immune cells via the TLR7 MyD88-dependent signaling pathway. Nat Immunol.. 2002 3(2):196-200. PMID 11812998.
  3. ^ Sauder, D.N., Imiquimod: modes of action. British Journal of Dermatology. 2003 149(Suppl. 66):5-8. PMID 14616337
  4. ^ a b Miller, R.L., et al. Imiquimod applied topically: a novel immune response modifier and a new class of drug. Int J Immunopharmacol. 1999 Jan;21(1):1-14. PMID 10411278

External links


 
 

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Copyrights:

Drug Info. Gold Standard. Copyright © 2008 by Gold Standard. All rights reserved.  Read more
Veterinary Dictionary. Saunders Comprehensive Veterinary Dictionary 3rd Edition. Copyright © 2007 by D.C. Blood, V.P. Studdert and C.C. Gay, Elsevier. All rights reserved.  Read more
Wikipedia. This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Imiquimod" Read more

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