Adults: External genital warts in adults
Imiquimod cream is applied 3 times per week, for example Monday, Wednesday and Friday, or Tuesday, Thursday and Saturday. Put it on before normal sleeping hours and leave it on the skin for 6 to 10 hours. Treatment continues until the visible genital or perianal warts have cleared, or for a maximum of 16 weeks per episode of warts.
Apply a thin layer to the clean wart area and rub it in until the cream vanishes. Apply only to the affected areas and avoid any application on internal surfaces. Don't shower or bathe during the 6 to 10 hour period. After that, the cream must be washed off with mild soap and water. Too much cream, or leaving it on the skin for too long, may cause a severe application site reaction. One single use sachet covers a wart area of 20 cm2 (approx. 3 inches2). Once a sachet is opened it should not be re-used. Wash hands carefully before and after applying the cream. Uncircumcised males treating warts under the foreskin should retract the foreskin and wash the area daily.
Superficial basal cell carcinoma in adults
Apply Imiquimod cream for 6 weeks, 5 times per week (for example Monday to Friday), before normal sleeping hours, and leave it on the skin for approximately 8 hours. Before applying, wash the treatment area with mild soap and water and dry it thoroughly. Use enough cream to cover the treatment area, including one centimetre of skin around the tumour, and rub it in until it vanishes. Avoid showering and bathing during the 8 hours. After that, the cream must be washed off with mild soap and water. Opened sachets should not be re-used. Wash hands carefully before and after application.
The response of the treated tumour should be assessed 12 weeks after treatment ends. If the response is incomplete, a different therapy should be used. If the local skin reaction causes too much discomfort, or if infection is seen at the treatment site, a rest period of several days may be taken. In the case of infection, other appropriate measures should also be taken.
Actinic keratosis in adults
Treatment should be started and monitored by a physician. Imiquimod cream is applied 3 times per week (for example Monday, Wednesday and Friday) for four weeks, before normal sleeping hours, and left on the skin for approximately 8 hours. Apply enough cream to cover the treatment area. After a 4-week treatment-free period, clearance of the actinic keratosis should be assessed. If any lesions remain, treatment is repeated for another four weeks. Dosing should be interrupted if intense local inflammatory reactions occur or if infection is seen at the treatment site, and in the case of infection other appropriate measures should be taken. Missed doses or rest periods should not stretch any treatment period beyond 4 weeks.
If the area is not completely clear at a follow-up examination about 8 weeks after the last 4-week course, one more 4-week course of Imiquimod may be considered. If the lesions respond poorly to Imiquimod, a different therapy is recommended. Lesions that clear after one or two courses and then come back can be treated again with one or two further courses of Imiquimod cream, after a pause of at least 12 weeks.
Before applying, wash the treatment area with mild soap and water and dry it thoroughly. Cover the treatment area with enough cream, including one centimetre of skin around the tumour, and rub it in until it vanishes. Apply before normal sleeping hours and leave on for approximately 8 hours, avoiding showering and bathing in that time. Then wash the cream off with mild soap and water. Opened sachets should not be re-used. Wash hands carefully before and after application.
Information applicable to all indications
If a dose is missed, apply the cream as soon as you remember, then carry on with the regular schedule. The cream should not be applied more than once a day.
