To apply the medicine:

• Wash your hands before and after using the medicine . Avoid getting the medicine into your eyes, lips, or nostrils or in vagina or anus.
• Use the medicine only as directed by your doctor . Do not use more of it, do not use it more often, and do not use it longer than directed.
• Allow medicine to stay on skin for 8 hours if you are using it for actinic keratoses and 6 to 10 hours for genital warts, then wash area thoroughly with soap and water.
• Throw out any unused cream from the single-dose packet.
• Do not apply an occlusive dressing (airtight covering, such as kitchen plastic wrap) over the medicine, unless told to do so by your doctor. To do so may cause irritation of the skin. Other materials that are not airtight, such as cotton gauze or cotton underclothes, may be used.

Dosing

The dose of imiquimod will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of imiquimod. If your dose is different, do not change it unless your doctor tells you to do so.

• For topical dosage form (cream):
  • For skin condition on face and scalp called actinic keratoses:
    • Adults Apply a thin film to the treatment area two times a week before normal sleeping hours Monday and Thursday or Tuesday and Friday. Rub in well and leave on for about 8 hours. Remove medicine from skin by washing with mild soap and water. Continue treatment until skin condition is gone or for up to sixteen weeks.
    • Children Use and dose must be determined by doctor.
  • For warts on the skin outside of the genital or rectal areas (condyloma acuminatum):
    • Adults Apply a thin film to wart once every other day (three times a week) before normal sleeping hours. Rub in well and leave on for six to ten hours. Remove medicine from wart by washing with mild soap and water. Continue treatment until wart is gone or for up to sixteen weeks.
    • Children Use and dose must be determined by doctor.

Missed dose

If you miss a dose of this medicine, wait until the next evening to apply it. Then go back to your regular dosing schedule.

Storage

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Keep the medicine from freezing. Do not refrigerate.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For imiquimod, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to imiquimod or parabens. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy Imiquimod has not been shown to cause birth defects or other problems in humans. However, studies in animals using doses higher than recommended for humans have shown that imiquimod causes bone problems, brain problems, or low birth weight in pregnancies. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding It is not known whether imiquimod passes into breast milk. However, this medicine has not been reported to cause problems in nursing babies.

Children Studies of this medicine have been done only in adult patients, and there is no specific information comparing use of imiquimod in children up to 12 years of age with use in other age groups.

Older adults Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of imiquimod in the elderly with use in other age groups. However, older adults may be more sensitive to the effects of imiquimod.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your doctor and pharmacist if you are using any other topical prescription or nonprescription (over-the counter [OTC]) medicine that is to be applied to the same area of the skin.

• Allergy to imiquimod, parabens, or any ingredients in the product This drug should not be used

• Inflamed skin May make condition worse

• Lower immune response (your body is not able to fight infections as well) It is not known if imiquimod is safe to use with this condition

• Medicine that you have taken recently for the same skin problem or
• Surgery (recent) Imiquimod should not be used until the skin is completely healed from any previous treatments that you have had with medicine or surgery

• Sensitive to sunlight Use caution as you may have a higher risk of getting a sunburn

• Sunburn Should not use until sunburn is gone