Before using imiquimod cream

Before using imiquimod cream make sure your doctor or pharmacist knows:

• If you have ever had a problem with your immune system.
• If you are pregnant, trying for a baby or breast-feeding.
• If you have ever had an allergic reaction to this or any other medicine.
• If you know you have an abnormal blood count.
• If you are a male using this cream for genital warts and have not been circumcised.
• If you have recently had transplant surgery.
• If you are using any other preparations, including those available to buy without a prescription, herbal and complementary medicines.

How to use imiquimod cream

• Before starting this treatment, read the manufacturer's printed information leaflet from inside the pack.
• Use this preparation exactly as directed by your doctor. You will be told how often to apply the cream and how long to use it for. This will depend upon the reason why you are using the cream.
• If you forget to apply the cream, use it when you remember and then continue with your regular schedule but do not apply the cream more than once a day.
• Do not apply this cream to any broken or inflamed areas of skin.
• Do not cover the treated area with bandages or dressings after you have applied the cream.
• If the treated area becomes too uncomfortable, wash the cream off with mild soap and water. As soon as the area feels more comfortable you may restart to apply the cream.
• Avoid getting the cream on your lips, nostrils or eyes. If contact occurs, remove the cream by rinsing with water.
• Only use each sachet once and carefully discard each sachet after use.

1. Wash your hands and the treatment area with mild soap and water before applying the cream. Dry thoroughly.
2. Apply imiquimod cream three times a week or as directed by your doctor.
3. It should be applied at night, for example on Monday, Wednesday and Friday nights.
4. Apply a thin layer of cream onto the wart area and gently rub it into the skin until the cream vanishes. Wash your hands with soap and water again after applying the cream.
5. The following morning (6-10 hours later) it is important that you wash the cream off with mild soap and water.

1. Wash your hands and the treatment area with mild soap and water before applying the cream. Dry thoroughly.
2. Apply enough cream to cover the affected area and 1cm around it. It should be applied at night for 5 nights of each week or as directed by your doctor.
3. Rub the cream in gently until it vanishes.
4. Wash your hands again after applying the cream.
5. Leave for 8 hours until the next morning and then it is important that you wash the cream off with mild soap and water.

1. Apply imiquimod cream three times a week or as directed by your doctor.
2. It should be applied at night, for example on Monday, Wednesday and Friday nights.
3. Wash your hands and the treatment area with mild soap and water before applying the cream. Dry thoroughly.
4. Apply a thin layer of cream to the affected area and gently rub it into the skin until the cream vanishes. Wash your hands with soap and water again after applying the cream.
5. The following morning (8 hours later) it is important that you wash the cream off with mild soap and water.

Getting the most from your treatment

For anal or genital warts:

• Treatment usually continues until the warts have cleared, but if after 16 weeks the area has not cleared, you must stop using imiquimod and see your doctor.
• Be careful to ensure the cream is applied only to the wart. If the cream spreads to normal skin or if you use too much cream it may result in a severe local skin reaction including reddening, swelling, flaking or breaking of the skin.
• Men treating warts underneath the foreskin should wash the affected area every day.
• Imiquimod cream should not be applied before sexual activity.
• The cream may damage latex condoms or diaphragms so effective contraception should be discussed with your doctor or pharmacist.

• Do not use sunlamps or tanning beds and avoid sunlight as much as possible during treatment.

• Continue treatment for four weeks. If the lesions have not all cleared up 4 weeks after this, a further four weeks treatment may be necessary.
• Do not use sunlamps or tanning beds and avoid sunlight as much as possible during treatment.

Can imiquimod cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

If you experience any other symptoms which you think may be due to this cream, discuss them with your doctor or pharmacist.

How to store imiquimod

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

References

• Manufacturer's PIL, Aldara® 5% Cream, Meda Pharmaceuticals, electronic Medicines Compendium. Dated April 2010.
• British National Formulary; 61st Edition (March 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF)