Imiquad Cream is a prescription-only topical immunomodulator containing imiquimod 5% as its active ingredient. It is indicated for the treatment of external genital and perianal warts/condylomata acuminata in adults, superficial basal cell carcinoma (sBCC), and actinic keratosis (AK) on the face or scalp. The cream functions by stimulating the local immune response, enhancing the body’s natural ability to combat viral infections and abnormal skin cells. Its mechanism involves the induction of cytokines, including interferon-alpha, which promotes a targeted antiviral and antitumor environment. Proper application and adherence to prescribed dosing schedules are critical for achieving optimal therapeutic outcomes and minimizing potential local skin reactions.

Features

• Contains 5% imiquimod as the active pharmaceutical ingredient
• Available in single-use packets or multi-use tubes (e.g., 12-packet box or 5g tube)
• White-to-light-yellow oil-in-water emulsion cream
• Each gram contains 50 mg of imiquimod
• Inactive ingredients include benzyl alcohol, cetyl alcohol, stearyl alcohol, white petrolatum, and purified water
• Stored at controlled room temperature (20°C to 25°C; 68°F to 77°F)

Benefits

• Effectively clears external genital and perianal warts through immune-mediated action
• Provides a non-invasive treatment option for superficial basal cell carcinoma, avoiding surgical procedures in selected cases
• Reduces the risk of progression of actinic keratosis to squamous cell carcinoma
• Localized application minimizes systemic exposure and associated side effects
• Can be self-administered by patients after proper instruction, enhancing convenience and adherence
• Demonstrates high complete clearance rates in clinical studies when used as directed

Common use

Imiquad Cream is primarily prescribed for the management of external genital and perianal warts (condylomata acuminata) in immunocompetent adults aged 18 years and older. It is also approved for the treatment of clinically typical, non-hyperkeratotic, non-hypertrophic actinic keratosis on the face or scalp in adults, and for superficial basal cell carcinoma (sBCC) with a maximum diameter of 2.0 cm located on the trunk, neck, or extremities (excluding hands and feet) in immunocompetent adults. Treatment should be initiated under the guidance of a healthcare professional experienced in the diagnosis and management of skin cancers or viral infections.

Dosage and direction

For external genital/perianal warts: Apply a thin layer to the wart area 3 times per week (e.g., Monday, Wednesday, Friday) prior to normal sleeping hours. Leave on the skin for 6 to 10 hours, then wash off with mild soap and water. Treatment should continue until complete clearance of warts or for a maximum of 16 weeks.

For actinic keratosis: Apply to the affected area on the face or scalp (including the forehead) 2 times per week (e.g., Monday and Thursday) for a full 16-week treatment period. Apply prior to sleeping, leave on for approximately 8 hours, then wash area thoroughly.

For superficial basal cell carcinoma: Apply 5 times per week (e.g., Monday through Friday) for 6 weeks. Apply prior to sleeping, leave on for 8 hours, then wash area thoroughly.

Use the supplied single-use packet or an appropriate measured amount. Wash hands before and after application. Avoid occlusive dressings unless directed by a physician.

Precautions

• For external use only. Avoid contact with eyes, lips, and nostrils.
• Not for oral, intravaginal, or intra-anal use.
• Local skin reactions are common and may include erythema, edema, induration, vesiculation, erosion, ulceration, and flaking/scaling.
• Sexual contact should be avoided while the cream is on the skin.
• The treatment area should not be covered unless directed by a physician.
• Sun exposure should be minimized during treatment, and sunscreen/protective clothing used.
• Do not use on open wounds or broken skin.
• May weaken condoms and diaphragms; avoid contact with these products.
• Use with caution in patients with autoimmune disorders or those on immunosuppressive therapy.

Contraindications

• Hypersensitivity to imiquimod or any component of the formulation.
• Not recommended for use in children or adolescents under 18 years of age.
• Should not be used by pregnant women unless potential benefit justifies potential risk to the fetus.
• Not studied in patients with congenital or acquired immunodeficiencies.

Possible side effects

Very common (≥1/10): Application site reactions (erythema, erosion, flaking, edema, scabbing, induration), itching, burning. Common (≥1/100 to <1/10): Headache, fatigue, fever, nausea, diarrhea, myalgia, influenza-like symptoms. Uncommon (≥1/1,000 to <1/100): Local skin discoloration, fungal infections, lymph node enlargement. Rare (<1/1,000): Severe skin reactions, autoimmune disorders flare-up, herpes simplex reactivation. Systemic absorption is minimal, but if excessive application occurs, systemic adverse effects such as fatigue, fever, and myalgia may be observed.

Drug interaction

Formal drug interaction studies have not been conducted. However, concomitant use with other topical medications on the same area should be avoided unless directed by a physician. Use with other immunomodulators or immunosuppressive agents may potentiate or diminish effects. Consult a healthcare provider regarding potential interactions with systemic medications.

Missed dose

If a dose is missed, apply it as soon as remembered, unless it is nearly time for the next application. Do not double the dose to make up for a missed one. Resume the regular dosing schedule. If uncertain, contact a healthcare provider for guidance.

Overdose

Excessive application may lead to severe local skin reactions and increased systemic absorption, potentially causing flu-like symptoms (fever, fatigue, myalgia). In case of suspected overdose, wash the treatment area thoroughly with soap and water and seek medical attention. Symptomatic and supportive care is recommended. There is no specific antidote.

Storage

Store at controlled room temperature between 20°C to 25°C (68°F to 77°F). Excursions permitted between 15°C to 30°C (59°F to 86°F). Do not freeze. Keep out of reach of children and pets. Discard any unused cream appropriately after the treatment course. Do not use beyond the expiration date printed on the packaging.

Disclaimer

This information is intended for educational purposes only and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting any new medication or treatment regimen. Individual results may vary. Follow the prescribed dosage and instructions provided by your physician. Do not discontinue or modify treatment without medical consultation.

Reviews

Clinical studies demonstrate that Imiquad Cream achieves complete clearance of external genital warts in approximately 50% of patients after 16 weeks of treatment. In actinic keratosis, complete clearance rates range from 45% to 55%, and in superficial basal cell carcinoma, histologic clearance at 12 weeks post-treatment is approximately 82%. Patient-reported outcomes indicate high satisfaction with the non-invasive nature of treatment, though local skin reactions are frequently noted and generally manageable. Long-term follow-up data show sustained efficacy and low recurrence rates in responsive patients.