Imiquimod

This patient-friendly article is about chemotherapy drug, Imiquimod also known by its trade names Zyclara and Aldara. It is used for non-hypertrophic actinic keratoses on the face or scalp, primary superficial basal cell carcinoma (sBCC) and condylomata acuminata (External Genital warts).

Aldara was approved by the FDA since 1997 and is available as ‘Aldara cream 5%’.

Zyclara cream was approved by the FDA in 2010 for treating actinic keratosis and in 2011, approved as a treatment for condylomata acuminate. 

How to use the creams:

Using Aldara -

For Actinic Keratosis-

• Apply 2 times per week for a complete 16 weeks on the face or scalp but not simultaneously.
•  Apply as a thin layer to the area and rub until no longer visible. 
• should be applied and left on the applied area for approximately 8 hours before removing by washing using water and a small amount of soap. Therefore it is recommended that it is applied before bedtime.
• Recommended that patients wash their hands with mild soap and water and left to dry before use.
• Avoid contact with eyes, lips and nostrils.

For Superficial basal cell carcinoma -

• Apply only if it is biopsy-confirmed
• Apply 5 times per week for a complete 6 weeks. 
• should be applied and left on the applied area for approximately 8 hours before removing by washing using water and a small amount of soap. Therefore it is recommended that it is applied before bedtime.
• Recommended that patients wash their hands with mild soap and water and left to dry before use.
• Avoid contact with eyes, lips and nostrils.

For External Genital Warts -

• Apply 3 times a week until clearance of the area applied (maximum 16 weeks) 
• Apply as a thin layer to the area and rub until no longer visible should be applied and left on the applied area for approximately 8 hours before removing by washing using water and a small amount of soap. Therefore it is recommended that it is applied before bedtime.
• Recommended that patients wash their hands with mild soap and water and left to dry before use.
• Avoid contact with eyes, lips and nostrils.

Using Zyclara -

Actinic Keratosis-

• Can use both Zyclara Cream, 2.5% and 3.75%
• Only for people aged 18 years and above
• Apply once a day for 2 weeks, separated by a 2-week no-treatment period 
• Apply as a thin layer to the area and rub until no longer visible 
• should be applied and left on the applied area for approximately 8 hours before removing by washing using water and a small amount of soap. Therefore it is recommended that it is applied before bedtime.
• Recommended that patients wash their hands with mild soap and water and left to dry before use.
• Avoid contact with eyes, lips and nostrils.

Condylomata Acuminata/ External Genital Warts 

• Can use Zyclara Cream, 3.75% or Aldara 5% cream  
• Only for people aged 12 years and above. 
• Apply once a day up 8 weeks or unit clearance 
• The area should be covered with a sufficient amount of cream
• should be applied and left on the applied area for approximately 8 hours before removing by washing using water and a small amount of soap. Therefore it is recommended that it is applied before bedtime.
• Recommended that patients wash their hands with mild soap and water and left to dry before use.
• Avoid contact with eyes, lips and nostrils.

Common adverse reactions are erythema, oedema, itching, fatigue, nausea, burning, flaking and dryness, etc. 

Precautions:

• (Aldara and Zyclara) Intense local inflammatory reactions - For example, skin weeping and erosion
• (Aldara and Zyclara) Flu-like symptoms (fatigue, nausea, fever etc.) 
• (Aldara and Zyclara) Treatment of Urethral, intra-vaginal, cervical, rectal and internal-anal viral diseases are not recommended
• (Aldara) Severe local inflammatory reactions- can lead to severe swelling of the external genitalia of females which could result in urinary retention.
• (Aldara) Avoid exposure to sunlight 

Go to: 10 ways to improve your chemotherapy success and reduce side-effects

Other articles that you may find interesting are:

1. A diet for Chemotherapy
2. Immunotherapy overview
3. A to Z Guide to Complementary Therapies

Go to: Return to the CANCERactive drug list