Miquimod cream is a topical immunomodulatory agent used to treat genital warts and keratosis caused by sunlight.

1、 Drug name and indications

1. Drug name: Imiquimod cream, produced by Chiyoda Pharmaceuticals in Japan.

2. Indications:

Firstly, genital warts: limited to wart warts on the external genitalia or perianal area.

Secondly, solar keratosis: limited to the face or bald area.

2、 Specifications, characteristics, and main components

1. Specification: 250mg per pack, 12 packs per box.

2. Appearance: White to slightly yellow cream.

Main ingredients: Each package (250mg) contains 12.5mg (concentration of 5%) of imiquimod.

3、 Usage and dosage

1. Genital warts

Frequency: once a day, three times a week (such as Monday/Wednesday/Friday or Tuesday/Thursday/Saturday), apply before bedtime.

Operation: Take an appropriate amount and apply it to the wart area. Apply thinly and rub until the cream is no longer visible.

Retention and cleaning: After application, keep it for 6-10 hours, and wash it off with soap and water or warm water after getting up.

Course of treatment: Generally not exceeding 16 weeks.

2. Solar keratosis

Frequency: Apply once a day, three times a week, before bedtime.

Operation: Apply to the treatment area (up to 25cm ², maximum 1 pack), rub until the cream is no longer visible.

Retention and cleaning: Keep for about 8 hours after application, wash off after waking up.

Course of treatment: Apply for 4 weeks → Rest for 4 weeks → If the lesion does not disappear, apply for another 4 weeks → If still ineffective, switch to other therapies.

4、 Dose adjustment

This product is an external preparation and does not require regular dosage adjustments. However, it should be noted that:

1. Do not apply excessively, do not seal or bandage.

2. The maximum treatment area for solar keratosis is 25cm ², with a maximum use of 1 pack (12.5mg).

3. If there is severe redness, erosion, ulceration, epidermal peeling, etc. in the local area, it should be washed immediately and the medication should be stopped, and a doctor should be consulted.

5、 Medication precautions

1. Regarding application time and cleaning

Genital warts: must be washed away within 6-10 hours after application, and the application time cannot be extended, otherwise it will aggravate skin damage.

Sunlight keratosis: Wash off within about 8 hours after application.

2. Regarding missed services

General principle: If there is a long time before the next medication is administered, reapplication can be done; If it is close to the next medication time, skip the missed application and follow the original plan for the next application. Do not apply double the dose at once.

Regarding vomiting

This product is a topical cream and does not involve oral vomiting.

4. In terms of diet

No special pre - or post meal requirements. However, during the medication period and after discontinuation (including the rest period), the treatment area should be avoided from exposure to sunlight, as the skin's sensitivity to sun exposure increases. If you have already suffered from sunburn, you need to wait until the inflammation subsides before taking the medication.

5. Other important precautions

To avoid continuous daily application, it must be done "3 times a week".

Wash your hands thoroughly after applying the ointment to prevent it from accidentally touching other areas.

Avoid ointment contact with eyes, lips, nostrils, and wounds.

Avoid sexual activity after applying medication to prevent the ointment from coming into contact with your sexual partner's skin.

The oil components in the cream may damage latex condoms, and contact should be avoided during use.

When treating male foreskin warts, the foreskin should be flipped over daily and kept clean.

Women should be extra careful when applying it near the vaginal or urethral opening, and only apply it to warts to avoid pain and difficulty urinating at the urethral opening.

6、 Medication for special populations

1. Pregnant women: Use only when the benefits of treatment outweigh the risks. No teratogenic effects were found in animal experiments, but at high doses, fetal weight loss and delayed ossification were observed (related to maternal toxicity).

2. Breastfeeding women: not separately listed in the instructions, it is recommended to consult a doctor.

3. Children: The effectiveness and safety have not yet been established.

4. Immunosuppressed patients: May have poor efficacy and effectiveness has not been established.

5. Patients with chronic graft-versus-host disease or autoimmune disease: may worsen skin inflammation, and consider discontinuing medication when symptoms worsen.

7、 Adverse reactions

1. Serious adverse reactions (frequency unknown)

Severe skin damage: ulcers, erosions, erythema, edema, epidermal peeling, etc.

Difficulty urinating: When women apply it near the urethral opening, it can cause difficulty urinating due to pain and swelling.

2. Common adverse reactions (incidence rate ≥ 5%)

Application site: erythema, erosion, epidermal peeling, flaking, dryness, small blisters, cracks, bleeding, induration, papules, folliculitis, inflammation, edema, wetness, exudation, ulcers, scabs, abnormal sensations, discomfort, pain, irritation, itching, infection, scars, swelling, pigmentation, depigmentation.

Adverse reactions with an incidence rate of less than 5%

Burning sensation, tenderness, stabbing pain, allergy, rash, needle pricking sensation, acne, tinea pedis, lightening of warts, abrasion, tightness, and warmth.

4. Systemic adverse reactions (frequency unknown)

Herpes simplex, headache, worsening hemorrhoids, painful defecation, worsening atopic dermatitis, lymphadenopathy, lymphadenitis, fatigue, muscle pain, nausea, diarrhea, fever, dizziness, loss of appetite, joint pain, fatigue, weakness, chills.

5. Flu like symptoms

Before or at the same time as severe local inflammation, flu like symptoms such as chills, fever, and muscle pain may occur, and medication should be considered for discontinuation.

8、 Contraindications

1. Individuals with a history of allergies to any component of this medication.

2. Prohibited for use in the following areas: urethra, vagina, cervix, rectum, and anal canal.

9、 Drug interactions

Specific drug interactions are not explicitly listed. However, it should be noted that:

1. The oil components in the cream may damage latex condoms, so avoid contact.

2. During medication, avoid exposing the treated area to sunlight or ultraviolet rays as skin sensitivity increases.

10、 Storage method

1. Temperature: Store below 25 ℃ to avoid freezing.

2. Validity period: 2 years.

3. Other: Open before use. Any remaining ointment after opening should not be reused and should be discarded. Store out of reach of children.

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