Imiquimod

Last Reviewed: Sep 10, 2024

Warnings

Imiquimod (Zyclara) Risks, Warnings, and Complications

Imiquimod can cause serious side effects or worsen health problems in some people. Talk to your doctor or pharmacist about other treatments for your skin condition if you are at increased risk of complications from imiquimod.

Local Skin Reactions: Some people develop intense local skin reactions, including skin breakdown and drainage, after a few applications of imiquimod cream. In addition, imiquimod can potentially worsen inflammatory skin conditions such as chronic graft versus host disease. Severe local inflammatory reactions of the female external genitalia can occur after treatment of external warts. An allergic reaction following imiquimod application can cause severe vulvar swelling and urinary retention. You will need to stop using imiquimod if you develop a severe skin reaction. Do not apply imiquimod until your skin has healed from any previous medical or surgical treatment.
Systemic Reactions: In addition to local skin reactions, there are reports of systemic reactions, including flu-like symptoms (fatigue, nausea, fever, chills, muscle aches, joint pain, and lack of energy) after using imiquimod. You may need to stop imiquimod and undergo an assessment if you develop these symptoms. Enlarged lymph nodes have also been reported - these typically resolve within 4 weeks of completing treatment.
Risks Associated with UV Light Exposure: Imiquimod can make your skin more sensitive to ultraviolet (UV) light. Minimize exposure to sunlight and avoid sunlamps and tanning beds during use of imiquimod cream. Wear protective clothing such as long sleeves, a hat, sunglasses, and sunscreen while using imiquimod. Do not apply imiquimod if you have a sunburn until your skin heals. Before starting treatment, tell your doctor if you have a significant amount of sun exposure due to your job or have sunlight-sensitive skin.
Concomitant Use of Multiple Products: Concomitant use of more than one imiquimod product in the same treatment area can lead to an increased risk of severe local skin reactions and systemic reactions.
Risk of Immune Cell Activation in Autoimmune Disease: Tell your health care professional if you have any pre-existing autoimmune diseases. Imiquimod may make your condition worse by activating immune cells.

Precautions Before Starting Imiquimod (Zyclara)

Tell your doctor if you are allergic to imiquimod, any of the active or inactive ingredients in imiquimod cream, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, supplements, herbal products, and topical skin products, including other treatments for actinic keratoses, basal cell carcinoma, and genital or anal warts. This can help avoid possible drug interactions between your medications.

Imiquimod may not be safe for people with certain medical conditions. Tell your doctor if you have a history of sun sensitivity, skin conditions such as psoriasis, or immune system conditions such as graft versus host disease or HIV/AIDS.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant soon, or are nursing an infant with breast milk.

Precautions During Use of Imiquimod (Zyclara)

Keep all your medical and lab appointments while using imiquimod.

Tell your doctor if you become pregnant while using imiquimod.

Wear protective clothing (long sleeves, hat, sunglasses, sunscreen) and avoid too much sun exposure. Tell your doctor if you notice any changes in skin color (these may or may not go away after you finish treatment).

Imiquimod (Zyclara) Drug Interactions

Certain other drugs can affect how imiquimod works. Possible interactions between imiquimod and your other medicines can increase the risk of severe adverse effects.

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medications, dietary supplements, herbal remedies, and topical medications. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription and over-the-counter medications.

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