Imiquimod (On the skin)


Imiquimod (im-I-kwi-mod)

Treats genital and rectal warts that are outside the body (external). Also treats certain types of actinic keratosis (AK) and basal cell carcinoma (sBCC).

Brand Name(s)

Zyclara, Aldara

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to imiquimod.

How to Use This Medicine


  • Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
  • This medicine is for use on the skin only. Do not get it in your eyes, nose, or mouth. Do not use it on skin areas that have cuts or scrapes. If it does get on these areas, rinse it off right away.You should not use the medicine inside your vagina or anus. Do not apply the medicine to skin that has not yet healed after surgery or other skin treatments.
  • Wash your hands with soap and water before and after using this medicine.
  • Before applying the cream, wash the treatment area with mild soap and water. Wait for the area to dry.Apply a thin layer to the affected area. Rub it in gently.
  • It is best to apply the medicine right before you go to bed. In the morning, wash the treated skin area with mild soap and water.
  • The first time you use the Zyclara® cream pump you will need to prime it. Press the top of the pump until the cream appears. Use a tissue to wipe the first cream that appears and throw it away. The pump is now ready to use.
  • Use 1 or 2 packets or pumps for each dose. Throw away any medicine from the packet that you do not use .
  • Allow the medicine to stay on the treated skin for 8 hours. Do not take a bath or get the treated area wet during this time.
  • Men who are not circumcised and are treating genital warts under the foreskin should pull back the foreskin and clean the area daily.
  • Do not wrap the treated area or cover it with a bandage, unless your doctor tells you to. You may wear cotton clothing or place cotton gauze over the treated skin.
  • Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.
  • Do not use this medicine together with any other products that contain imiquimod in the same treatment area. This may increase risk for more serious side effects.
  • This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.

If a dose is missed:

  • The cream is usually applied once a day and left in place for 8 hours. If you miss a dose or forget to use the medicine, wait until it is time for your next dose and skip the missed dose. Do not apply extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Store the Zyclara® cream pump upright. Do not freeze.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of the used medicine container and any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
  • Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Do not use cosmetics or other skin care products on the treated skin areas.

Warnings While Using This Medicine

  • Make sure your doctor knows if you are pregnant or breastfeeding or if you have a weakened immune system, chronic rheumatoid arthritis, or systemic lupus erythematosus (SLE).
  • Stop using this medicine and check with your doctor right away if you have a rash, burning, pain, redness, swelling, bleeding, oozing, scabbing, or peeling on the skin where the medicine was applied.
  • Stop using this medicine and check with your doctor right away if you have severe swelling near the vagina.
  • Stop using this medicine and check with your doctor right away if you have severe skin irritation or flu-like symptoms, such as fever, chills, headache, nausea, muscle or joint pain, or unusual tiredness or weakness.
  • This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.
  • Do not have sex while you are being treated for genital warts, even if you or your partner use a condom. The cream can weaken condoms and diaphragms, so you and your partner may be unprotected during sex.
  • Imiquimod is not a cure for genital or anal warts. You may develop new warts while using the cream. The cream will not keep you from spreading genital warts to other people.
  • Do not use this medicine for a skin problem that has not been checked by your doctor.
  • Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Fever, chills, cough, sore throat, nausea, or muscle or joint pain
  • Itching, flaking, or dryness of the treated skin area
  • Severe burning, pain, redness, swelling, bleeding, oozing, scabbing, or peeling of the treated skin areas
  • Severe swelling near the vagina
  • Unusual tiredness or weakness
  • Worsening of other skin conditions

If you notice these less serious side effects, talk with your doctor:

  • Changes in the color of the treated skin
  • Headache
  • Mild skin redness, swelling, or hardening

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Version Info

  • Last Reviewed on 06/12/2013

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This page was last updated: September 18, 2013

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