Imiquimod Topical : Uses, Side Effects, Interactions & More

Why is this medication prescribed?

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 areas and anal. Imiquimod is in a class of medications called immune response modifiers. 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 keratosis or superficial basal cell carcinoma.

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

How should this medicine be used?

Imiquimod comes as a cream to apply to the skin.

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

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 (for example, 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 about 8 hours. Continue using imiquimod for a full 6 weeks, even if the superficial basal cell carcinoma seems to have disappeared, unless your doctor tells you otherwise.

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 (for example, 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 warts have 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 parts you do not understand. Use imiquimod exactly as directed. Do not use more or less or use it more often than prescribed by your doctor.

Do not cover the treated area with a tight bandage or dressing unless directed by your doctor. Cotton gauze dressings can be used if necessary. Cotton underwear can 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 contact (oral, anal, genital) while the cream is on your skin. Imiquimod cream can weaken condoms and vaginal diaphragms.

Uncircumcised men who are treating warts under the foreskin of the penis should pull the foreskin back and clean it every day and before each treatment.

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

Imiquimod cream comes in single-use packets. Discard opened packages if you don’t 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 on the skin until it disappears.
  5. Wash your hands.
  6. Leave the cream on the area for as long as your doctor has told you to. 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 the cream.

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

Other uses for this medicine

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

What special precautions should I follow?

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 conditions such as psoriasis, graft-versus-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 breastfeeding. If you become pregnant while using imiquimod, call your doctor.
  • Plan to avoid exposure to sunlight as much as possible and 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 can make your skin sensitive to sunlight.
  • You should know that imiquimod cream can cause changes in the color of your skin. These changes may not go away after you finish treatment with imiquimod cream. Tell your doctor if you notice any change in the color of your skin.

What special dietary instructions should I follow?

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

What should I do if I forget a dose?

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

What side effects can this medication cause?

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.

What should I know about storage and disposal of this medication?

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

It is important to keep all medicines out of the sight and reach of children, since many containers (such as those containing weekly pills and those for eye drops, creams, patches and inhalers) are not resistant to children and small children can easily open them. To protect young children from poisoning, always close the safety caps and immediately place the medicine in a safe place, one that is upright and out of their sight and reach.

Unnecessary medications must be disposed of in special ways to ensure that pets, children, and others cannot consume them. However, you should not flush this medicine down the toilet. Instead, the best way to dispose of your medications is through a drug take-back program. Talk to your pharmacist or contact your local garbage / recycling department to find out about take-back programs in your community. See the FDA Safe Drug Disposal website ( for more information if you do not have access to a take-back program.

In case of emergency/overdose

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

Symptoms of overdose may include:

  • fainting
  • dizziness
  • blurred vision
  • nausea

What other information should I know?

Keep all your appointments with your doctor. If you are using imiquimod cream to treat superficial basal cell carcinoma, it is important that you have regular follow-up visits with your doctor. Ask your doctor how often you should have a skin exam.

Don’t let anyone use your medicine. Ask your pharmacist any questions you have about refilling your prescription.

It is important that you keep a written list of all prescription and over-the-counter (over-the-counter) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should take this list with you each time you visit a doctor or if you go into hospital. It is also important information to take with you in case of emergencies.

Brand Names

  • Aldara®
  • Zyclara®

Disclaimer: We have made every effort to ensure that all information is factually accurate, comprehensive and up-to-date. However, this article should not be used as a licensed health care professional’s choice of knowledge and expertise. You should always consult your doctor or other health care professional before taking any medication. The information given here is subject to change and it has not been used to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions or adverse effects. The lack of warning or other information for any drug does not indicate that the combination of medicine or medication is safe, effective or appropriate for all patients or all specific uses.    

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