Imiquimod Cream 5% 24 Sachets/Pack

Imiquimod general information

What is Imiquimod used for?

Imiquimod Cream 5% is a topical treatment for several skin conditions in immunocompetant adults, caused by sun damage, viral infection or cancer.  These include solar or actinic keratoses, which are patches of scaly, sun-damaged, pre-cancerous skin on the face and scalp.  Imiquimod Cream 5% is also used to treat superficial basal cell carcinoma, the most common form of skin cancer, where the lesion cannot be removed by surgery because of the location, especially the face and lower legs; or is not considered appropriate for other reasons.  Imiquimod Cream 5% is also used to treat external genital and perianal warts (condyloma acuminate), which are warts on the surface of the genitals and around the anus and are caused by a virus called human papillomavirus.

How does Imiquimod work?

Imiquimod Cream 5% contains imiquimod, an immunomodifier that acts as antiviral and antitumour agent by stimulating a local cell-mediated immune response in the area of skin where the cream is applied.  Imiquimod in Imiquimod Cream 5% activates immune cells in the outer layer of the skin by binding to a specific receptor, toll-like receptor 7 or TLR7 that is involved in recognising pathogens like viruses.  Immune cells activated via TLR7 secrete chemicals called cytokines, such as interferon and interleukin-6 that are involved in fighting invasion by pathogens like papillomavirus, which causes genital and perianal warts.  The immune cells in the skin that are activated by Imiquimod Cream 5% to produce cytokines, also stimulate the infiltration of other immune cells like macrophages, specialised T-lymphocytes and dendritic cells, which work together to destroy tumour cells when Imiquimod Cream 5% is used for basal cell carcinoma lesions.  They also induce inflammatory reactions in the skin, which help destroy the lesions caused by pre-cancerous solar keratoses, which are sun-damaged skin cells.  When the inflammation settles and the damaged cells are destroyed, the scaly lesions are replaced by new skin. 

What does Imiquimod contain?

Imiquimod Cream 5% contains the active ingredient imiquimod (12.5gm imiquimod in 250mg cream for a single application), an immunomodifier used to treat various skin conditions caused by sun damage, viral infection or cancer.  It also contains oleic acid, methylparaben, propylparaben, oleyl alcohol, polysorbate 60, white petrolatum, cetyl alcohol, stearyl alcohol, sorbitan monostearate, glycerin, benzyl alcohol, xanthan gum and purified water.

Treating skin carcinoma with Imiquimod

Imiquimod Cream 5% contains imiquimod, an immunomodifier that acts as an antitumour agent by stimulating a local cell-mediated immune response in the area of skin where the cream is applied.  Basal cell carcinoma is the most common form of skin cancer and is caused by too much exposure to sun and/or repeated sunburn.  Imiquimod in Imiquimod Cream 5% activates immune cells in the outer layer of the skin to produce chemicals called cytokines, such as interferon and interleukin-6, and stimulate the infiltration of other immune cells like macrophages, specialised T-lymphocytes and dendritic cells, which work together to destroy tumour cells, as well as inducing an inflammatory reaction in the skin, which helps destroy the lesions.  When the inflammation settles and the damaged cells are destroyed, the scaly lesions are replaced by new skin. 

Imiquimod for genital warts

Imiquimod Cream 5% contains imiquimod, an immunomodifier that acts as antiviral agent by stimulating a local cell-mediated immune response in the area of skin where the cream is applied.  External genital and perianal warts, are warts on the surface of the genitals and around the anus that are caused by infection of the skin by a virus called human papillomavirus.  Imiquimod in Imiquimod Cream 5% activates immune cells in the outer layer of the skin to produce chemicals called cytokines, such as interferon and interleukin-6 that are involved in fighting invasion by pathogens like the human papillomavirus.  Imiquimod Cream 5% helps destroy papillomavirus in the skin cells of the warts and this allows the warts to clear up and relieves symptoms like pain, bleeding and itching.

What are the side effects of Imiquimod?

The most commonly reported side effects when taking Imiquimod Cream 5%  include tenderness, itching, burning, redness (erythema) or pain at the site of application; also swelling (oedema), ulceration (sores), thickened, peeling or crusting skin, scabbing.  Less common systemic side effects include: changes in skin colour that may be permanent, headache, back pain, muscle aches, tiredness, flu-like symptoms, swollen lymph nodes, diarrhoea.

When should Imiquimod not be used?

You should not use Imiquimod Cream 5% if you:

• are allergic to imiquimod or any ingredients in Imiquimod
• are pregnant or are breastfeeding, without discussion with your doctor
• you have internal warts such as inside the vagina, anus or urethra
• are immuno-compromised or HIV positive
• are taking medicines that interact with Imiquimod: such as immunosuppressive drugs

How should Imiquimod be used?

Before applying your Imiquimod Cream 5% ensure your hands are clean; apply the contents of one sachet with a fingertip and rub into the affected area until all the cream has gone into the skin.  You should apply your Imiquimod Cream 5% once daily, just before bedtime and leave it on your skin for 6-10 hours, then wash the cream off.  You should not apply Imiquimod cream in or near the eyes, nose, mouth or ears.  The recommended treatment period depends on your condition, depends on what you are being treated for and you doctors recommendations.  For actinic keratoses your treatment with Imiquimod Cream 5% should be 3 times per week for 4-8 weeks.  For basal cell carcinoma your treatment should be applied for five consecutive days with 2 rest days and should continue for 6 weeks.  For external genital/perianal warts your treatment with Imiquimod Cream 5% should be 3 times per week, with 2 rest days, for up to 16 weeks, until your warts have disappeared.

How long should you use Imiquimod?

You should continue to use your Imiquimod Cream according to the recommended treatment period and depending on your condition, what you are being treated for and you doctor’s recommendations.  This may be from 4-16 weeks.

Missed dose of Imiquimod

If you miss a dose of Imiquimod Cream 5% apply it as soon as you remember, unless it is time to apply the next dose, then skip the missed dose.  Do not apply a double dose.

How should Imiquimod be stored?

You should store your Imiquimod Cream 5% below 25°C in a cool dry place.