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Precautions and Warnings With Imiquimod

Treatment with imiquimod is not recommended for everyone. For example, this prescription medicine may not be safe or effective for people with an overactive or weakened immune system or those with certain other skin problems. Other safety warnings for imiquimod include taking precautions to avoid exposure to natural sunlight or sun lamps. Also, this medicine may not be appropriate for women who are pregnant or nursing.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to using imiquimod (Aldara®, Zyclara®) if you have:
 
  • A weakened immune system due to any cause
  • An overactive immune system
  • A sunburn
  • Any other skin problems
  • Any allergies, including to medications, foods, dyes, or preservatives.
 
Also, let your healthcare provider know if you are:
 
  • Undergoing treatment for actinic keratosis with surgery or other medications
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
 
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.
 

Some Imiquimod Precautions and Warnings

Some warnings and precautions to be aware of prior to using this medicine include the following:
 
  • Imiquimod usually causes skin reactions. These reactions vary from a little redness, to severe problems like painful ulceration of the skin. If your reaction is severe enough, you will have to stop using imiquimod, either temporarily or permanently.
 
  • Imiquimod may worsen existing skin conditions, particularly chronic graft-versus-host disease of the skin. If you have chronic graft-versus-host disease, imiquimod may not be an appropriate treatment for you.
 
  • Do not use imiquimod on skin that is not fully healed from surgery or other treatments, including other medications.
 
  • In some cases, flu-like symptoms occur before or along with skin reactions to imiquimod. Some of these symptoms can become bothersome enough to require people to either temporarily or permanently stop using the drug. It can take up to a month after treatment for these side effects to go away. Some of these flu-like symptoms can include:
 
    • Fatigue
    • Nausea
    • Fever
    • General ill feeling
    • Joint pain
    • Muscle pain
    • Chills.
 
  • Avoid sun exposure during treatment with imiquimod, including both natural sunlight and sun lamps. Wear sunscreen and protective clothing if sun exposure cannot be avoided.
 
  • When used to treat female genital warts, imiquimod can sometimes cause severe vulvar swelling, which could possibly lead to difficulty passing urine. Let your healthcare provider know if you develop severe vulvar swelling.
 
  • It is unknown if imiquimod is safe and effective for people with immune system problems, including underactive or overactive immune systems.
 
 
  • Imiquimod is a pregnancy Category C medicine, meaning it might not be safe for use during pregnancy, although the full risks are currently unknown (see Aldara and Pregnancy or Zyclara and Pregnancy for more information).
 
  • It is unknown if imiquimod passes through breast milk. Therefore, if you are breastfeeding or plan to start, check with your healthcare provider (or your child's healthcare provider) before using this medication (see Aldara and Breastfeeding or Zyclara and Breastfeeding).
 
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