Imiquimod


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : Topical Anogenital warts; Perianal warts As 3.75% cream: Apply thinly onto affected area once daily until total clearance or for a Max duration of 8 weeks. As 5% cream: Apply 3 times weekly for up to 16 weeks. Superficial basal cell carcinoma As 5% cream: Apply 5 times weekly for 6 weeks. Actinic keratoses As 2.5% or 3.75% cream: Apply unto face or scalp once daily for 2 weeks, repeat course after a 2 weeks treatment-free interval. As 5% cream: Apply 3 times weekly for 4 weeks, repeat for further 4 weeks with a 4-week interval, if necessary; alternatively, apply 2 times weekly for 16 weeks.
Dosage Details
Topical/Cutaneous
Anogenital warts, Perianal warts
Adult: As 3.75% cream: Apply thinly onto affected area once daily until total clearance or for a Max duration of 8 weeks. As 5% cream: Apply 3 times weekly (non-consecutive days) for up to 16 weeks.

Topical/Cutaneous
Actinic keratoses
Adult: As 2.5% or 3.75% cream: Apply unto face or scalp once daily before bedtime for 2 weeks, repeat course after a 2 weeks treatment-free interval, assess response 8 weeks after 2nd course. As 5% cream: Apply 3 times weekly before bedtime for 4 weeks, repeat for further 4 weeks with a 4-week interval, if necessary; or alternatively, apply 2 times weekly for 16 weeks.

Topical/Cutaneous
Superficial basal cell carcinoma
Adult: As 5% cream: Apply 5 times weekly (on consecutive days) before bedtime for 6 weeks, assess response 12 weeks after completing treatment.
Special Precautions
Patient with pre-existing autoimmune conditions, reduced haematologic reserve. Organ transplant patients. Not indicated for urethral, intravaginal, cervical, rectal, or intra-anal human papilloma viral disease. Pregnancy and lactation.
Adverse Reactions
Significant: Local inflammatory reactions (e.g. skin weeping, erosion), photosensitivity, flu-like symptoms, vulvar swelling, hypersensitivity.
Gastrointestinal disorders: Nausea, diarrhoea.
General disorders and administration site conditions: Fatigue.
Musculoskeletal and connective tissue disorders: Myalgia, back pain.
Nervous system disorders: Headache.
Skin and subcutaneous tissue disorders: Burning, itching, excoriation, crusting, flaking, oedema.
Patient Counseling Information
Avoid contact with eyes, lips, nostrils and broken skin. Avoid use of occlusive dressing. Avoid exposure to direct sunlight, UV lights, and tanning beds.
MonitoringParameters
Assess for reduction in lesion size. Monitor for local skin reactions and signs and symptoms of hypersensitivity.
Action
Description: Imiquimod, an immune response modifier, is a Toll-like receptor 7 agonist that activates immune cells. The exact mechanism of action is not yet elucidated. It has no direct viral activity, however, it is effective against viral infection and acts as antitumour agent by induction of interferon-α (IFN-α) and other cytokines.
Pharmacokinetics:
Absorption: Minimal systemic absorption. Time to peak plasma concentration: 9-12 hours.
Excretion: Via urine (<3% as unchanged drug and metabolites).
Chemical Structure

Chemical Structure Image
Imiquimod

Source: National Center for Biotechnology Information. PubChem Database. Imiquimod, CID=57469, https://pubchem.ncbi.nlm.nih.gov/compound/Imiquimod (accessed on Jan. 21, 2020)

Storage
Store below 25°C.
ATC Classification
D06BB10 - imiquimod ; Belongs to the class of topical antivirals used in the treatment of dermatological diseases.
References
Aldara Cream (Valeant Pharmaceuticals North America LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 03/04/2018.

Anon. Imiquimod. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com/. Accessed 03/04/2018.

Anon. Imiquimod. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/04/2018.

Buckingham R (ed). Imiquimod. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/04/2018.

Joint Formulary Committee. Imiquimod. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/04/2018.

Zyclara Cream (Valeant Pharmaceuticals North America LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 03/04/2018.

Disclaimer: This information is independently developed by MIMS based on Imiquimod from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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