Imiquad Cream: Targeted Topical Immunotherapy for Skin Conditions
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Imiquad Cream is a prescription topical immunomodulator indicated for the treatment of external genital and perianal warts/condylomata acuminata in adults, superficial basal cell carcinoma (sBCC), and actinic keratosis (AK). It works by activating local immune responses, enabling the body to recognize and eliminate abnormal skin cells and viral infections. This cream represents a non-invasive therapeutic option that leverages the patient’s own immune system, offering a targeted approach with minimal systemic absorption. Proper application and medical supervision are essential to maximize efficacy and manage potential local skin reactions.
Features
- Contains 5% imiquimod as the active pharmaceutical ingredient
- Available in single-use packets or multi-use tubes (250 mg, 500 mg, 1 g)
- White-to-light-yellow oil-in-water emulsion cream
- Prescription-only medication
- Shelf-stable at controlled room temperature (20–25°C)
- Applied topically, typically at bedtime
Benefits
- Stimulates localized immune-mediated destruction of abnormal tissue
- Non-invasive alternative to surgical procedures for certain indications
- Reduces recurrence rates of genital warts through immune memory
- Convenient at-home application with prescribed dosing schedules
- Minimal systemic absorption, lowering risk of widespread side effects
- Can be used on sensitive anatomical areas with appropriate medical guidance
Common use
Imiquad Cream is primarily prescribed for three dermatological conditions. For external genital and perianal warts, it is used in immunocompetent adults to clear visible warts. In superficial basal cell carcinoma, it is indicated for small, primary sBCCs on the trunk, neck, or extremities (excluding face and hands) when surgical methods are less appropriate. For actinic keratosis, it treats clinically typical, non-hyperkeratotic, non-hypertrophic lesions on the face or scalp. Treatment duration and frequency vary significantly between indications, requiring strict adherence to the prescribing physician’s instructions.
Dosage and direction
Apply a thin layer of Imiquad Cream to the treatment area and rub in until the cream is no longer visible. Use the medication just prior to normal sleeping hours and leave on the skin for approximately 8 hours. Wash the treated area with mild soap and water after this time period. The application frequency depends on the condition being treated: for genital warts, apply 3 times per week; for sBCC, apply 5 times per week; for actinic keratosis, apply 2 times per week. Treatment typically continues for up to 16 weeks for warts, 6 weeks for sBCC, and 16 weeks for AK, or until clearance is achieved. Do not exceed the prescribed amount or treatment duration.
Precautions
Avoid contact with eyes, lips, and nostrils. Do not apply to open wounds or broken skin. Sexual contact should be avoided while the cream is on the skin. The medication may weaken condoms and diaphragms. Wash hands thoroughly before and after application. Sun exposure should be minimized during treatment, and sunscreen should be used. Occlusive dressings should not be used over treated areas. Patients should be monitored for severe local skin reactions and systemic symptoms such as flu-like syndrome. Not recommended for use in children under 18 years of age.
Contraindications
Hypersensitivity to imiquimod or any component of the formulation. Should not be used on patients with autoimmune disorders or those undergoing immunosuppressive therapy. Contraindicated in patients with known defects in innate or adaptive immunity. Not for ophthalmic use. Should not be applied to internal genital areas (vagina, cervix, urethra, or intra-anal tissue). Not recommended for treatment of pigmented basal cell carcinoma or morphoeic basal cell carcinoma.
Possible side effects
Very common (≥10%): application site reactions (erythema, erosion, flaking, edema, itching, burning, induration), headache, fatigue, myalgia, influenza-like symptoms. Common (1-10%): application site pain, ulceration, scabbing, bleeding, vesicles, rash; nausea, diarrhea; fever, chills. Uncommon (0.1-1%): application site infection, skin discoloration, paraesthesia; lymph node enlargement; insomnia, dizziness. Rare (<0.1%): severe skin reactions, autoimmune disorders exacerbation, angioedema. Most local reactions peak in severity during weeks 2-3 of treatment and typically resolve within 2-4 weeks after treatment cessation.
Drug interaction
No formal drug interaction studies have been conducted. Theoretical interactions may occur with other topical medications applied to the same area. Concurrent use with other immune-modulating therapies may potentiate inflammatory responses. No known interactions with systemic medications, though caution is advised when using with drugs that affect immune function. May interfere with the efficacy of condoms and diaphragms.
Missed dose
Apply the missed dose as soon as remembered, unless it is nearly time for the next application. Do not apply extra cream to make up for a missed dose. Resume the regular dosing schedule. Do not double the dose or apply more frequently than prescribed. If unsure, contact the prescribing physician for guidance.
Overdose
Topical overdose may result in severe local skin reactions including intense erythema, edema, erosion, ulceration, and pain. Systemic overdose is unlikely due to minimal absorption, but if accidentally ingested, may cause flu-like symptoms, nausea, and fatigue. In case of topical overdose, wash the area thoroughly with soap and water. For accidental ingestion, seek medical attention promptly. Symptomatic and supportive care is recommended.
Storage
Store at controlled room temperature 20-25°C (68-77°F). Do not freeze. Keep the tube or packets tightly closed. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Discard any remaining cream after the prescribed treatment course is completed.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Imiquad Cream is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Always follow your physician’s instructions regarding dosage, application, and treatment duration. Report any severe reactions or concerns to your healthcare provider immediately. The full prescribing information should be consulted before use.
Reviews
Clinical studies demonstrate complete clearance rates of 50-85% for genital warts after 8-16 weeks of treatment, with recurrence rates of 13-19% over 6-month follow-up. For superficial basal cell carcinoma, histological clearance rates of 82-88% have been observed. In actinic keratosis, complete clearance rates of 45-57% have been reported. Patient satisfaction surveys indicate high acceptability despite local skin reactions, with most patients reporting willingness to use the treatment again if needed. Many clinicians note the importance of proper patient education regarding expected local reactions and adherence to the prescribed regimen for optimal outcomes.