Imiquimod: Price, Dosage & Where to Buy

Imiquimod is a topical immune-activating medicine used to treat actinic keratoses on the face or balding scalp in adults whose immune system functions normally. It works by stimulating an immune response in the treated skin, rather than directly removing the affected tissue. Imiquimod is available as a cream and requires a prescription in the United Kingdom.

Imiquimod works by activating immune cells in the skin. This encourages the release of chemical messengers that help the immune system recognise and respond to affected cells. Its action is therefore an immune response in the treated area, rather than a direct chemical removal of a lesion.

This local immune activity can also cause inflammation, which helps explain reactions such as redness, irritation and swelling during treatment. The response can sometimes be accompanied by flu-like symptoms.

Imiquimod cream is indicated for actinic keratoses on the face or balding scalp in adults whose immune system functions normally. The indication covers typical lesions that are visible or can be felt on examination. It is also indicated for external genital warts and warts around the anus in people aged 12 years or older whose immune system functions normally.

These indications relate to the 3.75% cream. Treatment of external warts does not include use inside the anus or vagina. Safety and effectiveness for actinic keratoses in children have not been established.

The label lists topical cream strengths of 2.5 mg/g, 12.5 mg/0.25 g, 37.5 mg/g and 50 mg/g. The label lists 3.75% cream for the treatment schedules described here. The label lists actinic keratosis treatment as a thin layer once daily at bedtime to either the entire face or balding scalp, for two 2-week treatment cycles separated by a 2-week no-treatment period, with up to 0.5 grams at each application.

The label lists external genital and perianal wart treatment as a thin layer once daily at bedtime until complete clearance or for up to 8 weeks, with up to 0.25 grams at each application. The label lists approximately 8 hours of skin contact before removal with mild soap and water.

Treatment is for external skin use only, not oral, eye, intra-anal or intravaginal use. Temporary interruptions may be needed for skin reactions; actinic keratosis treatment cycles are not extended because of missed doses or rest periods.

Store at 20° to 25°C and avoid freezing. Imiquimod cream pump bottles should be kept upright. Keep the medicine out of the reach of children.

A missed application does not call for an extra application to make up for it. The label lists the next dose at the regularly scheduled time after a missed dose.

For actinic keratoses, treatment cycles are not extended because of missed doses or rest periods. A pharmacist can clarify the prescribed schedule if needed.

Available case reports and case series have not established a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes. There are no controlled or large-scale epidemiological studies or pregnancy exposure registries. There is no information about imiquimod in human milk, effects on breastfed infants or milk production.

Blood concentrations after topical use are low, so transfer into breast milk is likely to be low. Breastfeeding benefits should be weighed against the mother's treatment needs and possible infant risks. Treatment areas should not expose a breastfeeding child to accidental ingestion or eye contact.