Medication Information Leaflet

What is this medication for?

Imiquimod works on the skin immune system and is indicated for the treatment of external genital and perianal warts in adults, actinic keratosis (solar keratosis) and cancerous skin conditions (superficial basal cell carcinoma).
This cream may also be used for other skin conditions as determined by your doctor.

How should I take/use this medication?

  • Apply imiquimod cream before going to sleep.
  • Before applying the cream, wash your hands and the treatment area with mild soap and water and pat dry. Squeeze a small amount of cream onto your fingertip.

  • Apply a thin layer of the cream to the treatment area and rub gently into the skin until the cream vanishes. Only use enough cream to cover the treatment area.

  • After applying the cream, wash your hands with mild soap and water.

  • Leave the cream on the affected area for 6 - 10 hours. Do not shower or bathe during this time.

  • After 6 - 10 hours, wash the area where the cream was applied with mild soap and water.

  • After several applications according to the course of treatment prescribed by your doctor, the lesions will shrink or dry up upon healing.

What should I do if I forget to take/use this medication?

If you miss an application, apply it as soon as possible. However, if it is almost time for your next application, skip the missed application and go back to your regular usage schedule.

What precautions should I take?

  • Avoid contact with the eyes, lips and nostrils.
  • Imiquimod cream administration is not recommended until the treatment area has healed from any previous drug or surgical treatment.
  • The treatment area should NOT be wrapped or covered with occlusive dressing.
  • For patients using it for external genital and perianal warts:
    • Sexual contact should be avoided while the cream is on the skin.
    • Imiquimod cream may weaken condoms and vaginal diaphragms, thus concurrent use is not recommended.
    • Not to be used in pregnant women.

Inform your healthcare professional if: 
  • You are allergic to this medication or any of the other ingredients of this medication.
  • You are pregnant, planning to become pregnant, or breastfeeding. 

What are some common side-effects of this medication?

  • Skin reddening, swelling and flakiness
    • These reactions are normal as they are signs of your immune system fighting the abnormal cells. Even if these symptoms are not present, the medication may still be working.
  • Formation of crust during healing
  • Itching
  • Burning sensation
  • Stinging 
  • Lighter skin colour on the warts or around the warts
Should the skin reactions become too uncomfortable, remove the cream by washing with mild soap and water. Take a short break of 3 to 4 days before continuing it again. If any side effects persist or are severe, please consult your doctor.

What are some rare but serious side-effects that I need to seek medical advice immediately?

  • Flu-like symptoms such as swollen lymph nodes, aches and pains, mild fever and may generally feel unwell
For genital or perinanal warts
  • Vaginal pain or swelling
  • Difficulty passing urine
  • Severe tightness, swelling or skin tearing
If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children. 

How should I throw away this medication safely?

Pack this medication into a black trash bag and seal it tightly before throwing into the rubbish chute or bin. 

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information. 

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

Last updated on Apr 2021 

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