Why is Aldara prescribed?

Imiquimod (Aldara) is prescribed for the treatment of actinic keratosis (rough and scaly patches due to sun exposure for several years) on the face, hands, or scalp. It is also used in the treatment of superficial basal cell carcinoma (a type of skin cancer) and warts found on the skin of the genital areas.

What does it do?

Imiquimod is classified as an immune response modifier. To treat genital warts, it works by boosting and increasing your body’s immune system and makes it more active. However, Imiquimod does not directly attack the virus causing the warts and only controls wart production. Thus, new warts may still form and appear during treatment.

The action of Imiquimod in treating actinic keratoses or superficial basal cell carcinoma is not exactly known.

How should I apply it?

Aldara is a 5% cream available in 250mg sachets. It is intended only for topical administration.

To apply Aldara cream:

• Wash your hands and the area to be treated with soap and water. Allow the skin to dry before applying the cream.
• Apply a thin layer of Aldara to the affected area and rub it into the skin until it disappears.
• Wash your hands after applying the cream to the affected area.
• Leave the cream on the affected area for the amount of time your doctor has instructed. Do not take a shower, bathe, or swim during this time.
• When the time is done, wash the areas where the cream was applied with soap and water.

The frequency and amount of cream to be applied depends on your condition. Always follow your doctor’s instructions. If you apply too much or use it for a longer period than your doctor’s prescription, you may increase your risk of developing severe skin reactions.

For actinic keratosis, apply Aldara twice a week for 16 weeks. Apply it at bedtime and leave it on for 8 hours. After 8 hours, wash the cream off with water and mild soap.

For superficial basal cell carcinoma, apply Aldara 5 times in a week for 6 weeks. Apply it to the affected area and the area surrounding it and leave it on for 8 hours. Apply it at bedtime. After 8 hours, wash the cream off with water and mild soap.

For genital warts, apply Aldara 3 times in a week for no longer than 16 weeks. Apply it at bedtime and leave it on for 6 to 10 hours. After 6 to 10 hours, wash off the cream with water and mild soap. For uncircumcised men with warts under the penis foreskin, pull the foreskin back and clean the area before applying the cream each time.

When using Aldara for genital warts, avoid all forms of sexual intercourse while the cream is on your skin. It can weaken condoms or diaphragms that may break and cause an unplanned pregnancy.

The treated areas should not be covered with a bandage or dressing unless instructed by your doctor.

If some cream is left over after applying it to the affected areas, discard it and do not reuse the remaining cream in the sachet.

In cases of accidental application of Aldara to your eyes, nose, or mouth, wash these areas with plenty of water immediately.

What if I missed a dose?

If a dose is missed, apply it when you remember. However, skip the missed dose if it is almost time for your next dose and continue with your regular schedule. Do not apply extra cream to make up for the dose you missed.

What are the special precautions before applying Aldara?

Inform your doctor if you are allergic to Imiquimod, any component of Aldara, or other medications.

Inform your doctor if you have a sunburn or other skin problems, a weak immune system or an autoimmune disease, graft vs. host disease, surgery to the affected areas, conditions that affect your immune system such as human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS).

Imiquimod may cause your skin to be more sensitive to sunlight. Avoid exposing yourself to direct sunlight and wear protective clothing and apply sunscreen when going outdoors during the day.

Imiquimod may cause changes to your skin color even after finishing your treatment. Inform your doctor about any observable changes in your skin color.

For the drug label information of Aldara, click here.

Does it have any side effects?

It is important to note that all drugs have corresponding side effects and adverse reactions. Additional information may be obtained when you ask your doctor or pharmacist.

Common side effects may include:
• Back pain
• Burning sensation on the skin
• Fatigue
• Headache
• Skin itching
• Skin redness

Serious side effects may include:
• Blisters on the skin
• Body ache
• Chills
• Fever
• Muscle weakness
• Open skin sores or scabs
• Rashes
• Severe redness of the skin

Is it safe to take it with another drug?

Some drug interactions may cause serious or life-threatening reactions when administered together. Immediately inform your doctor if you are taking Aldara with any of the following medications:

• Abametapir
• Aminolevulinic acid
• Cenobamate
• Haloperidol
• Inebilizumab
• Lopinavir
• Magnesium
• Methoxsalen
• Methyl aminolevulinate
• Porfimer
• Prograf
• Ritonavir
• Satralizumab
• Trastuzumab
• Tucatinib
• Verteporfin

Tell your doctor of any prescription and non-prescription medications, vitamins, supplements, and herbal products you are taking to prevent interactions with these medications. Ask your doctor or pharmacist for other possible interactions not listed within this section.

How should I store it?

Store Aldara at (4-25 °C). Do not freeze and keep it in the container it came it. Keep each sachet unopened until ready for use. Keep out of reach from children and pets. Throw away unused or expired medications properly. Consult your pharmacist on the proper disposal of this medication.

What action should I take in case of overdose?

In the event of an overdose, inform your doctor and seek immediate medical attention. Some symptoms of overdose may include the following:

• Severe irritation of the skin
• Lightheadedness
• Fainting
• Dizziness
• Blurred vision
• Nausea

In the event of an overdose, inform your doctor and seek immediate medical attention.

Is it safe for pregnant or breastfeeding women?

There are limited studies and data regarding the safety of Imiquimod in pregnant women and whether it will harm the fetus. According to the US FDA, it is categorized as Pregnancy Category C which states that there are no adequate and well-controlled studies in humans, but animal studies have shown adverse effects to the fetus.

It is not known if Imiquimod passes into human milk and if it can harm a breastfeeding infant. Inform your doctor if you are breastfeeding an infant.

The use of Imiquimod in pregnant and breastfeeding women should be avoided unless the potential benefits outweigh the risks.

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