imiquimod at a glance
Medicine class
Topical immune-response modifier
Licensed uses
External genital or perianal warts, selected superficial basal cell carcinomas and certain facial or scalp actinic keratoses in adults
Where to apply
Only to the external area specified by the prescriber; avoid eyes, lips, nostrils and internal surfaces
Presentation
Cream in single-use foil sachets; discard any remainder after opening
What is imiquimod used for?
Licensed adult uses for the selected product include:
External genital and perianal warts.
Small superficial basal cell carcinomas.
Clinically typical, non-thickened actinic keratoses on the face or scalp in immunocompetent adults when specified alternatives are unsuitable or less appropriate.
Specialists may also use it without a licence for selected anogenital high-grade squamous intraepithelial lesions.
How does imiquimod work?
Imiquimod stimulates local immune cells to release interferon-alpha and other cytokines. This helps the immune system respond to HPV-infected or abnormal cells; it does not directly kill viruses.
imiquimod preparations and strengths
Cream
Route: Cutaneous
Strengths: 50 mg/g, 3.75%, 5%
How to take imiquimod
Follow the application instructions supplied for your diagnosed condition because directions differ between uses.
Wash your hands and clean the treatment area with mild soap and water, then dry thoroughly.
Apply only to the area identified by the prescriber and rub in until the cream disappears.
Wash your hands afterwards and do not cover the area with an airtight dressing.
Avoid bathing or showering while the cream is in place, then wash it off as instructed.
Use a new sachet for each application and discard any remainder.
Protect treated actinic keratosis or basal-cell-carcinoma skin from sunlight.
imiquimod side effects
Common or expected effects
- Redness, itching, burning, pain or irritation at the application site
- Flaking, erosion, swelling, crusting or scabbing of treated skin
- Headache, tiredness, muscle aches or flu-like symptoms
- Skin infection or pustules at the treatment site
Get urgent medical advice
- Intense inflammation with weeping, ulceration or extensive skin breakdown
- Severe skin reaction with blistering, target-like lesions, mouth sores or eye symptoms
- Difficulty passing urine or increasing difficulty retracting the foreskin
- Worsening of an autoimmune condition
- Unusual bruising, recurrent infection or marked fatigue suggesting reduced blood-cell counts
imiquimod in pregnancy
Human pregnancy data are limited. Animal studies have not shown direct or indirect reproductive harm, but a prescriber should weigh the expected benefit against uncertainty. Tell them if you are pregnant or planning pregnancy.
imiquimod while breastfeeding
No quantifiable blood levels were found after topical use, but evidence is insufficient for a firm recommendation. Discuss treatment with the prescriber before using imiquimod while breastfeeding.
imiquimod interactions
Systemic interactions are expected to be limited because skin absorption is low, but formal interaction studies are lacking.
Immunosuppressive medicines
Caution is required because imiquimod stimulates immune responses and may oppose immunosuppression or increase risks in transplant and autoimmune settings.
Common questions about imiquimod
Answers are fully visible for fast scanning and source review.
Does imiquimod kill HPV directly?
No. It stimulates local immune responses that help the body act against HPV-infected tissue.
Can it be used on internal surfaces?
The selected product is for external treatment and is not recommended on internal vaginal, cervical, urethral, rectal or intra-anal surfaces.
Is redness normal?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.