Imiquimod Topical: MedlinePlus Drug Information

pronounced as (i mi kwi’ mod)

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Imiquimod cream is used to treat certain types of actinic keratoses (flat, scaly growths on the skin caused by too much sun exposure) on the face or scalp. Imiquimod cream is also used to treat superficial basal cell carcinoma (a type of skin cancer) on the trunk, neck, arms, hands, legs, or feet and warts on the skin of the genital and anal areas. Imiquimod is in a class of medications called immune response modifiers. It treats genital and anal warts by increasing the activity of the body’s immune system. It is not known exactly how imiquimod cream works to treat actinic keratoses or superficial basal cell carcinoma.

Imiquimod cream does not cure warts, and new warts may appear during treatment. It is not known whether imiquimod cream prevents the spread of warts to other people.

Imiquimod comes as a cream to apply to the skin.

If you are using imiquimod cream to treat actinic keratoses, you will probably apply it once a day for 2 days a week, 3 to 4 days apart (e.g., Monday and Thursday or Tuesday and Friday). Do not apply the cream to an area larger than your forehead or cheek (about 2 inches by 2 inches). Imiquimod cream should be left on the skin for approximately 8 hours. Continue using imiquimod cream for a full 16 weeks, even if all the actinic keratoses are gone, unless you are told otherwise by your doctor.

If you are using imiquimod cream to treat superficial basal cell carcinoma, you will probably apply it once a day for 5 days a week (e.g., Monday through Friday). Apply the cream to the basal cell carcinoma and the immediate surrounding area. Imiquimod cream should be left on the skin for approximately 8 hours. Continue using imiquimod for a full 6 weeks, even if the superficial basal cell carcinoma appears to be gone, unless you are told otherwise by your doctor.

If you are using imiquimod cream to treat genital and anal warts, you will probably apply it once a day for 3 days a week (e.g., Monday, Wednesday, and Friday or Tuesday, Thursday, and Saturday). Imiquimod cream should be left on the skin for 6 to 10 hours. Continue using imiquimod until all of the warts are healed, up to a maximum of 16 weeks.

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use imiquimod exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Do not cover the treated area with a tight bandage or dressing unless told to do so by your doctor. Cotton gauze dressings may be used if needed. Cotton underwear may be worn after treating the genital or anal areas.

If you are using imiquimod cream to treat genital or anal warts, you should avoid sexual (oral, anal, genital) contact while the cream is on your skin. Imiquimod cream may weaken condoms and vaginal diaphragms.

Uncircumcised men who are treating warts under the penis foreskin should pull the foreskin back and clean daily and before each treatment.

Imiquimod cream is only for use on the skin. Do not apply imiquimod cream in or near your eyes, lips, nostrils, vagina, or anus. If you get imiquimod cream in your mouth or eyes, rinse well with water right away.

Imiquimod cream comes in single-use packets. Dispose of any open packets if you do not use all of the cream.

To use the cream, follow these steps:

1. Wash your hands.
2. Wash the area to be treated with mild soap and water and allow it to dry.
3. Apply a thin layer of cream to the area to be treated, just before going to sleep.
4. Rub the cream into the skin until it disappears.
5. Wash your hands.
6. Leave the cream on the area for the amount of time your doctor has told you to do so. Do not bathe, shower, or swim during this time.
7. After the treatment time is over, wash the area with mild soap and water to remove any cream.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before using imiquimod,

• tell your doctor and pharmacist if you are allergic to imiquimod, any of the ingredients in imiquimod cream, or any other medications. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any other treatments for genital or anal warts, actinic keratoses, or superficial basal cell carcinoma.
• tell your doctor if you have a sunburn or if you have or have ever had unusual sensitivity to sunlight, any skin disease such as psoriasis, graft vs. host disease, recent surgery to the affected area or any condition that affects the immune system (such as human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS).
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using imiquimod, call your doctor.
• plan to avoid exposure to sunlight as much as possible and to wear protective clothing (such as a hat), sunglasses, and sunscreen if you go outside during daylight hours. Do not use tanning beds or sunlamps. Imiquimod cream may make your skin sensitive to sunlight.
• you should know that imiquimod cream may cause changes in your skin color. These changes may not go away after you finish treatment with imiquimod cream. Tell your doctor if you notice any changes in your skin color.

Unless your doctor tells you otherwise, continue your normal diet.

Apply the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not apply extra cream to make up for a missed dose.

Imiquimod cream may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• redness, itching, burning, or bleeding of the treated area
• flaking, scaling, dryness, or thickening of the skin
• swelling, stinging, or pain in the treated area
• blisters, scabs, or bumps on the skin
• headache
• diarrhea
• back pain
• tiredness

Some side effects can be serious.

If you experience any of these symptoms, call your doctor immediately:

• skin breakdown or sores that may have drainage, especially during the first week of treatment
• flu-like symptoms such as nausea, fever, chills, tiredness, and muscle weakness or pain

Imiquimod may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not freeze.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

If someone swallows imiquimod cream, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

• fainting
• dizziness
• blurred vision
• nausea

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Last Revised – 01/15/2018

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Imiquimod Topical: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

This medication is used to treat certain types of growths on the skin. These are precancerous growths (actinic keratoses), a certain type of skin cancer (superficial basal cell carcinoma), and warts on the outside of the genitals/anus. Treating these conditions can decrease complications from them. Imiquimod belongs to a group of drugs called immune response modifiers. It is believed to work by helping to activate your immune system to fight these abnormal skin growths.This product is not recommended for use on children under 12 years of age unless specifically directed by your doctor.

How to use imiquimod topical

Read the Patient Information Leaflet provided by your pharmacist before you start using imiquimod and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Use this medication on the skin only. Apply this medication to the affected area(s) as directed by your doctor, usually just before you go to sleep for the night. If you are using the single-use packets, use a new packet for each dose. If you are using the pump, prime the pump as directed before using it for the first time.

Before applying, wash your hands and the area to be treated with mild soap and water. Dry the area well. Apply a thin layer of medication on the affected area(s) as directed and rub in. Wash your hands with soap and water after each application. Do not cover the treated area with bandages or waterproof coverings. However, you may cover the area with cotton gauze, or wear cotton underwear if treating the genital area. Leave the cream on overnight, usually for about 8 hours if treating actinic keratoses or basal cell carcinoma, or 6 to 10 hours for warts. Do not shower or bathe during this time. In the morning, wash the treated area with soap and water to remove the cream. Do not leave imiquimod cream on longer than prescribed.

The dosage and length of treatment is based on your medical condition and response to treatment. When treating actinic keratoses, this medication is usually applied twice a week for 16 weeks. When treating superficial basal cell carcinoma, this medication is usually applied 5 times a week for 6 weeks. When treating warts, this medication is usually applied 3 times a week for up to 16 weeks. Use this medication regularly to get the most benefit from it. To help you remember, it may help to mark your calendar.

Do not apply this medication in the eyes, nose, mouth, rectum, or vagina. If you get this medication in those areas, flush with plenty of water. If irritation occurs, contact your doctor right away.

Tell your doctor if your condition lasts or gets worse, or if new growths appear during treatment.

Side Effects

Treatment area reactions may include redness, swelling, itching, burning, pain/tenderness, thickening/hardening of the skin, peeling/flaking/scabbing/crusting, or leaking a clear fluid. Also, changes in skin color may occur and may not go away. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

If the skin reaction is severe (bleeding, formation of sores/blisters/ulcers), imiquimod may need to be temporarily stopped so that the skin can heal. Follow your doctor’s directions.

Flu-like symptoms (such as fever, tiredness, muscle aches), runny/stuffy nose, cough, diarrhea, nausea, and back pain may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: swollen glands (lymph nodes), new unusual skin growths/changes, chest pain, trouble urinating.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before using imiquimod, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: recent/unhealed surgery on the skin area to be treated, immune system problems (including HIV infection), a certain complication of bone marrow or some organ transplants (chronic graft-versus-host disease), autoimmune diseases (such as rheumatoid arthritis, scleroderma, lupus).

This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.

Genital/anal warts are caused by a virus called human papillomavirus (HPV). Since imiquimod does not destroy the virus but only helps to eliminate the wart, new warts may form, even while you are being treated. You may also be able to infect any sexual partner who comes into contact with the areas of skin infected with HPV.

To reduce the risk of spreading HPV to others, always use effective barrier protections (such as latex or polyurethane condoms, dental dams) during all sexual activity. Consult your doctor or pharmacist for more details.

During treatment of genital/anal warts, avoid all sexual contact while the cream is on the skin. Condoms, dental dams, and diaphragms may be weakened by the cream, so they may not work as well to prevent pregnancy or spreading of HPV or HIV.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Does imiquimod topical interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

Do not share this medication with others.

Keep all medical appointments.

If you miss a dose, wait until the next night to apply it. Do not double the dose to catch up. Continue with your regular scheduled doses as directed.

Store the US product in the refrigerator or at room temperature. Store the Canadian product at room temperature. Do not freeze. Discard any medication that has been frozen. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

imiquimod 5 % topical cream packet

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imiquimod 5 % topical cream packet

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imiquimod 5 % topical cream packet

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imiquimod 5 % topical cream packet

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imiquimod 5 % topical cream packet

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This medicine is a cream

imiquimod 5 % topical cream packet

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This medicine is a cream

imiquimod 5 % topical cream packet

Color: off-whiteShape: Imprint:

This medicine is a cream

imiquimod 5 % topical cream packet

Color: off-whiteShape: Imprint:

This medicine is a cream

imiquimod 5 % topical cream packet

Color: off-whiteShape: Imprint:

This medicine is a cream

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

IMIKVIMOD CREAM – Recommendations of the British Association of Dermatologists (translated and adapted by Prof. Svyatenko)

What is the purpose of this article?

This article has been written to help you better understand Imiquimod Cream . It tells you what it is, how it works, how it is used and where you can learn more about it.

What is imiquimod and how does it work?

Imiquimod is a cream that, when applied to the skin, activates the immune system to recognize abnormal cells and causes a reaction that removes them.

Two formulations of imiquimod: Aldara and Ziklara

Two formulations of Imiquimod cream are available in the UK – 5% cream (trade name Aldara ) and 3.75% cream ( Ziklara) ).

What skin conditions are treated with imiquimod?

5%-imiquimod is used to treat sun exposure in superficial precancerous (actinic keratoses) and “mild” skin cancers (superficial basal cell carcinoma). It can also be used to treat superficial genital warts. Cream 3.75% is used only for actinic keratoses.

Recent evidence suggests that 5% imiquimod may be more effective than other non-surgical treatment options for superficial basal cell carcinoma.

Imiquimod may also be used for other conditions such as non-genital viral warts, molluscum contagiosum, keloid scars, melanoma metastases, other precancerous and cancerous lesions such as Bowen’s disease, actinic porokeratosis, lentigo maligna, cutaneous T-cell lymphoma, vulvar intraepithelial neoplasia and Paget’s disease.

Although imiquimod is sometimes used for these conditions, it is not currently licensed for them.

Will imiquimod improve skin conditions?

Imiquimod may improve many of the skin problems listed above and in some cases cure the condition, but the effects of treatment may not be permanent. If imiquimod is right for your condition, your skin will usually be red and sore after applying the cream before getting better. Redness and soreness should decrease and disappear approximately 2 weeks after treatment is stopped.

If imiquimod is used for solar keratosis, the skin will eventually become smoother after treatment. If you have a more severe medical problem, you may need to repeat treatments in the future to maintain the benefits.

How often should I use imiquimod?

Your doctor will prescribe the number of applications of imiquimod per week and the duration of treatment depending on the skin condition you are treating and the dosage of cream you are using. Your doctor will discuss your treatment schedule with you.

If you have a very extensive lesion, it is recommended to apply it on small areas of the affected area, and not in general, usually not using more than one or two sachets per application, depending on what dosage of cream is used: for example, skin treatment first head, then face. The more cream is used in one application, the more serious the side effects can be.

How should I use imiquimod?

Usually you should apply the cream at night and wash it off in the morning. Make sure you always cleanse your skin before applying cream. Cut off the corner of the sachet and squeeze some cream onto your finger to apply it to the affected area. You can apply the cream along the edge of the affected area, capturing the surrounding healthy skin (about 1 cm).

You should not mask or cover the treated area with a bandage unless your doctor tells you otherwise.

Do not apply anything to the skin for at least eight hours after using imiquimod . A mild moisturizer can be used after 8 hours if needed to soothe the skin, but should be washed off before using imiquimod again.

Moisturizer can also be used to soothe the skin for several weeks after treatment is complete.

You must wash your hands thoroughly before and immediately after applying the cream.

What are the precautions for using imiquimod?

• The cream can be used with caution on the eyelids and lips and will be advised by your doctor about use in this area.
• Do not use imiquimod if you are allergic to any of the ingredients.
• Do not use the cream if you are pregnant or breastfeeding.
• Do not use imiquimod if you spend a lot of time in the sun or in a tanning bed.

What are the common side effects of imiquimod?

• Skin treated with imiquimod may become red and sore within 3-5 days. Even the normal skin around the treated area may be affected as it may contain invisible abnormal cells. The skin may become wet, flaky, crack, or even blister and then scab. The area may be itchy and unhealthy, painful and glowing. This is caused by the death of abnormal cells and is an indication that the treatment is working. The skin reaction tends to worsen after 2-3 weeks of use. For most cases, the more it hurts and reddens, the better the treatment works. Redness is normal, and some crusting persists about 2 weeks after the end of the course of treatment.
• It may appear that the number of actinic keratoses increases at the beginning of the treatment period. This is due to the fact that the cream caused inflammation and actinic keratoses appeared, which were already there, but were not visible. They will also improve with treatment.
• Some patients develop flu-like symptoms such as swollen and tender lymph nodes, pain, mild fever, and generally feeling unwell. Paracetamol may be used.
• If a skin or general reaction becomes too severe to endure, stop using the cream for a week or so.
• As the abnormal cells die, the skin becomes damaged and therefore susceptible to infection.
• If you notice unusual symptoms during treatment, you should contact your doctor.

What are the rare side effects of imiquimod?

• If you have a severe reaction to the cream, the treated area may become ulcerated. This risk is high on the legs.
• Skin color may become darker or lighter after severe inflammation. Rarely, this color change may persist permanently.
• After a severe reaction with ulcers, there is a small risk of scarring and hair loss in the treated area.
• Cream activates the immune system and there have been very rare reports of outbreaks of pre-existing autoimmune diseases.
• Very rarely, the patient may be allergic to the cream, which manifests itself in a severe allergic rash.

This article was translated from the recommendations of the British Association of Dermatologists “Overview information for the patient”, adapted into Russian by Professor TV Svyatenko, Dnipro, Ukraine.

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Comprehensive approach to the treatment of HPV-induced skin diseases

Author:
M.R. Anfilova

11/13/2017

PDF article

On October 11-13, 2017, with the support of the Ukrainian Academy of Dermatovenereology, the UBI Conference Hall hosted the second large-scale professional event this year – the 12th Kyiv Dermatological Days. This time, more than 700 specialists from all over Ukraine took part in the forum. Recall that at the spring symposium, the number of registered participants was more than 500. Thus, this year more than 1,300 people had the opportunity to get acquainted with the latest developments, share their experience and discuss the most relevant topics in the field of dermatovenereology, among which were leading domestic experts in the field dermatovenereology, oncology, as well as doctors of aesthetic medicine, trichologists, cosmetologists, etc. As part of these events, many interesting reports were offered, the abstracts of which we would like to present to our readers. We offer you to get acquainted with a brief overview of one of the reports that interested us, since a significant amount of information and the format of the publication do not allow us to tell our readers about everything at once.

The topic of modern methods of treatment of epidermal formations of the anogenital region associated with the human papillomavirus (HPV) was disclosed in her report by Associate Professor of the Department of Skin and Venereal Diseases of Vinnitsa National Medical University named after I. I. N.I. Pirogova, Candidate of Medical Sciences Marina Rodionovna Anfilova.

– Anogenital warts – diseases caused by a DNA-containing virus, which belongs to the genus papillomavirus ( Papillomavirus ) of the papavirus family ( Papavaviridae ). Papillomaviruses are the only group of viruses for which it has been proven that they induce the formation of tumors in humans under natural conditions. Most anogenital warts are caused by infection with HPV types 6 and 11 (S. Syrjanen, 2003).

In turn, HPV is a group of viruses that are extremely widespread throughout the world. In middle- and low-income countries, the infection rate of the population reaches an average of 85%.

It is also reliably known that the presence of HPV is associated with a high risk of developing cervical cancer, which, in turn, is the fourth most common form of cancer in women and occupies one of the leading positions in the structure of mortality from malignant processes (World Health Organization, 2012) .

Risk factors for the development of anogenital warts include: young age (about 25 years), early onset of sexual activity (before 16 years), as well as the presence of a large number of sexual partners. In addition, it should be borne in mind that if a woman’s partner is sexually promiscuous, this is also one of the main risk factors. An important role in the development of anogenital warts is played by the presence of HIV infection (anogenital warts are observed in almost a quarter of HIV-infected patients).

When diagnosing HPV, it is mandatory to adhere to the generally accepted algorithm of actions, the first stage of which is an examination of the skin and mucous membranes of the external genital organs. The next step to identify morphological changes in cells, including those caused by HPV, is a cytological examination of smears (taken from the mucous surface of the cervix) according to Papanicolaou – PAP test.

For a more detailed study of the surface of the cervix, one should resort to colposcopy – an instrumental diagnostic method, thanks to which a dermatovenereologist can examine the condition of the tissues of the cervix under a thirty-fold increase with a further assessment of the most characteristic signs of subclinical forms of HPV (acetowhite epithelium, mosaic, puncture, abnormal transformation zone).

For many years, one of the most informative methods for the specific diagnosis of HPV has been the polymerase chain reaction, which allows the determination of HPV DNA, but in some cases this method can give a false positive result. In this regard, for a more accurate diagnosis, it is advisable to conduct a Digene test (hybrid capture method), which makes it possible not only to detect the presence of HPV, but also to determine its type, as well as the degree of its oncogenicity.

Thus, the doctor should have the most informative research methods in his arsenal, allowing timely diagnosis of HPV infection, which, in turn, will allow choosing the most rational treatment tactics for the manifestations of this infection (anogenital warts).

First of all, the therapy method should have a high safety and efficacy profile, as well as be characterized by a low risk of relapse.

Treatment tactics are considered optimal if they achieve clinical and therapeutic efficacy in relation to the entire field of dysplasia. Also an important factor of choice is minimal pain and discomfort.

To date, the optimal methods of conservative treatment of HPV infection include drug therapy, which involves the appointment of drugs for external use (imiquimod cream 5% and 3.75%; podophyllotoxin 0.5% solution or 0.15% cream; sinekatechin ointment 15%) in order to eliminate neoplasms associated with HPV infection on the skin and mucous membrane of the external genitalia.

Therapeutic efficacy and a brief description of the mechanism of action and characteristics of currently used treatments for HPV infection are presented in tables 1 and 2.

When choosing a remedy, one should pay attention to the fact that a high degree of elimination of the clinical manifestations of HPV, in particular anogenital warts, does not always guarantee a decrease in the frequency of relapses. For example, imiquimod 5% in the form of a cream induces the secretion of cytokines that reduce the viral load of HPV DNA, is characterized by a high level of elimination of genital warts (56%) and a low level of their recurrence (up to 14%).

The mechanism of action of imiquimod allows it to bind to immune cells through TLR-7 receptors (Toll-like receptors), triggering the release of pro-inflammatory cytokines (interferon-α, interleukin-1, tumor necrosis factor). In turn, these cytokines activate the reactions of innate and acquired immunity (Fig. 1). Thus, a fast non-specific response is achieved, leading to regression of HPV infection, as well as a slow specific response, leading to remission of the disease (Fig. 2).

Imiquimod 5% cream is recommended for use by various international guidelines for the treatment of genital warts and is widely used in the clinical practice of dermatovenereologists. Its undoubted advantage is the possibility of using it at home, the so-called “home therapy” – the patient applies the drug on his own, which determines his high adherence to this method of therapy.

Imiquimod 5% cream is effective in the treatment of anogenital warts with a high recovery rate (50-61. 8%) and a low recurrence rate (9-14%) after a 3-month course of treatment. It is important to note that the effectiveness of therapy does not depend on the initial area of ​​the lesion, the duration of the disease, or previous treatment (H.W. Buck et al., 2002; D.N. Sauder, 2002).

At present, imiquimod 5% is represented on the Ukrainian pharmaceutical market by Meda’s Aldara. The drug is available in the form of a cream and is conveniently packaged in sachets of 250 mg (No. 12). The doctor determines the frequency and duration of use individually for each patient. A special form of packaging allows you to independently carry out treatment at home. At the same time, it is necessary to take into account Aldara cream guidelines:

• Aldara cream is applied to the skin at bedtime;
• before application, wash hands and treatment area with a mild detergent, then dry the skin thoroughly;
• the cream should be applied to the affected area with the capture of a small area around the formation (no more than 1 cm) and gently rubbed into the skin;
• the drug should be on the skin for about 8 hours, during which time water should not come into contact with this area of ​​the skin;
• After 8 hours, the treated area can be washed with a mild detergent.

Due to the ability to treat the field of dysplasia, the frequency of recurrence of warts after 3 months of therapy with Aldara is only 9-14% compared with cryotherapy (21-37.5%), electrosurgery (25-33%) and surgical removal of warts – 13-18 % (Challenor et al., 2002; Lacey et al., 2003).

When using Aldara cream, the most common “undesirable” phenomenon is localized erythema. In most cases, it is mild or moderate in severity and gradually disappears after treatment is stopped. The manifestation of erythema should be considered as an individual immune response, which indicates a response to treatment (L. Edvards et al., 1998) (Fig. 3).

All co-infections must be eradicated prior to initiating treatment with Aldara. Let’s consider this statement on the example of a clinical case.

Patient, 13 years old, diabetes, history of multiple genital warts, signs of candidiasis. After the treatment of candida infection, the use of Aldara 3 times a week made it possible to achieve complete elimination of genital warts after 8 weeks of therapy. A slight erythema that appeared during the treatment disappeared after it was completed. It is important that in such situations the doctor needs to psychologically set up and arrange the patient for therapy, be sure to inform him about possible skin reactions.

Aldara (5% imiquimod cream):

• Stimulates the immune system where it’s needed!
• Imiquimod can be used with any destructive therapies.
• The only treatment for the “dysplasia field”!
• Etiotropic therapy of OK with imiquimod provides “cell immune memory” in relation to HPV, which is manifested by a minimal number of relapses (only 9-14%).

Thus, Aldara (imiquimod 5% cream) is an effective drug in the treatment of anogenital warts and is characterized by a minimal risk of recurrence. Convenient form of release and packaging allow the patient to carry out treatment independently at home, which, in turn, greatly increases his adherence to this method of therapy.

Prepared by Marina Titomir

• Number:
• Thematic issue “Gynecology, Obstetrics, Reproductology” No. 3 (27), February 2017

06/29/2023

Obstetrics/gynecologyTherapy and family medicineVagility and rheumatic diseases: current aspects of care in light of international recommendations

Choice of management tactics for vaginal women with rheumatic diseases – an important interdisciplinary problem, rheumatic pathology, zocrema rheumatoid arthritis, systemic rheumatoid arthritis, and scleroderma spit on the excess of pregnancy and become a healthy mother of the fetus. Current aspects of therapy in the category of vaginal drugs are used to treat various drugs, which have proven to be effective and safe in controlling inflammation and pain syndrome, and non-steroidal antiseptic drugs.
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06/29/2023

Obstetrics/gynecology Micronization of progesterone in obstetric practice: efficiency and safety

qi, ovaries, milk deposits and the brain, as well as repairing a sing infusion on non-reproductive tissues of the cardiovascular, cystic , central nervous, immune and metabolic systems (replacement of water, electrolytes, lipids, carbohydrates, proteins, zocrema components in hemostasis and fibrinolysis). The most important role played by progesterone during the hour of vagity, which is seen in the name of the hormone itself – “pro gestatio” (for vagity).