Imiquimod topical cream side effects: A detailed guide

Specifically, the Food and Drug Administration (FDA) has approved imiquimod topical cream to treat:

• actinic keratoses (sun or age spots) on the face or scalp of adults
• warts around the genitals or anus in adults and certain children
• a certain type of skin cancer in adults

These uses vary depending on the strength of imiquimod topical cream your doctor prescribes.

This article describes possible side effects of imiquimod topical cream. You’ll also find information on cost savings and coupon options for imiquimod.

Imiquimod topical cream is a generic version of the brand-name drug Zyclara.

More common side effects of imiquimod

Imiquimod topical cream may cause mild or serious side effects. Below are some of the more common side effects of this medication.

Commonly reported side effects of imiquimod topical cream include:

• nausea
• headache
• mild skin reactions*

These side effects were reported in studies of imiquimod 3.75% topical cream and imiquimod 5% topical cream.

* To learn more about this side effect, see the “Side effects of imiquimod in detail” section below.

Mild side effects of imiquimod

Imiquimod may cause certain mild side effects. Most often, mild side effects are temporary and can be easily managed. Tell your doctor or pharmacist if you have side effects that don’t go away or become bothersome.

Mild side effects of imiquimod topical cream that occurred in studies include:

• loss of appetite
• diarrhea
• dizziness
• fever
• headache
• joint or muscle pain
• nausea
• tiredness
• mild skin reactions*
• mild allergic reactions*†

These side effects were reported in studies of imiquimod 3.75% topical cream and imiquimod 5% topical cream. Imiquimod topical cream may cause more side effects than those listed above.

* To learn more about this side effect, see the “Side effects of imiquimod in detail” section below.
† An allergic reaction is possible with imiquimod topical cream. (Allergic reactions weren’t noted in studies of imiquimod 3.75% topical cream or imiquimod 5% topical cream but have been reported since then.)

Serious side effects of imiquimod

Imiquimod may cause certain serious side effects. If you have any serious side effects from imiquimod topical cream, call your doctor right away. But if you think you’re having a medical emergency or your side effects feel life threatening, take immediate action. Call 911 or a local emergency number, or go to the nearest emergency room.

After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Visit MedWatch’s website if you’d like to notify the FDA about a side effect you’ve had with imiquimod.

Serious side effects of imiquimod topical cream that occurred in studies include:

• flu-like symptoms*
• serious skin reactions*
• severe allergic reactions*†

These side effects were reported in studies of imiquimod 3.75% topical cream and imiquimod 5% topical cream. Imiquimod topical cream may cause more side effects than those listed above.

* To learn more about this side effect, see the “Side effects of imiquimod in detail” section below.
† An allergic reaction is possible with imiquimod topical cream. (Allergic reactions weren’t noted in studies of imiquimod 3.75% topical cream and imiquimod 5% topical cream but have been reported since then.)

Common questions about side effects of imiquimod

Here are answers to some common questions about side effects of imiquimod topical cream. If you have other questions, talk with your doctor or pharmacist.

How long do side effects of imiquimod typically last?

It depends. Side effects caused by imiquimod are usually mild, and they tend to go away on their own. Rarely, though, the drug can cause side effects that are severe or don’t go away.

If you have bothersome or persistent side effects while using imiquimod topical cream, talk with your doctor. They can review your symptoms and recommend a treatment, if appropriate. They can also decide whether you should stop treatment with imiquimod topical cream.

Can imiquimod cause hair loss or eye-related side effects?

Imiquimod may cause hair loss, but it’s not expected to cause eye-related side effects. Hair loss wasn’t reported by people using imiquimod 3.75% topical cream in studies, but it was rarely reported in studies of imiquimod 5% topical cream. Eye-related side effects weren’t reported in studies of either drug strength.

But be careful to avoid getting imiquimod topical cream in your eyes. Don’t touch your eyes after using your fingers to apply the cream. If you get imiquimod cream in your eyes, it could cause eye irritation and pain. Rinse your eyes immediately with water and call your doctor if this happens.

Does imiquimod cause long-term side effects?

No, long-term side effects aren’t expected with imiquimod topical cream. Specific side effects weren’t seen in people who had used the drug for a long time in studies of imiquimod 3.75% topical cream or imiquimod 5% topical cream. Long-lasting side effects after treatment ended also weren’t reported.

Talk with your doctor if questions about possible long-term side effects with imiquimod.

Coupon for imiquimod

Visit this page to access Optum Perks coupons and get price estimates for imiquimod when you use the coupons. These coupons can provide significant savings on your prescription costs. 

Note: Optum Perks coupons cannot be used with insurance copays or benefits.

Side effects of imiquimod in detail

Below you’ll find details on some of the side effects of imiquimod topical cream.

Mild skin reactions

Mild skin reactions were common in people treated with imiquimod in studies of imiquimod 3.75% topical cream and imiquimod 5% topical cream.

Mild skin reactions reported with imiquimod topical cream include any of the following where you apply the cream:

• crusting, flaking, scabbing, or scaling
• dryness
• itching
• pain
• redness or discoloration
• swelling

Certain factors can increase the risk of mild skin reactions with imiquimod topical cream. These include having skin that hasn’t fully healed from a previous treatment, such as a surgery, or skin-related side effects caused by another drug.

Ways to manage

If you get a mild skin reaction from using imiquimod cream, tell your doctor. They’ll likely recommend making an appointment or sending a picture of your reaction. Your doctor can determine whether you should temporarily stop using imiquimod cream until the symptoms go away or if it’s OK to keep using the drug.

Serious skin reactions

Serious skin reactions were rare in people treated with imiquimod in studies of imiquimod 3.75% topical cream and imiquimod 5% topical cream.

Serious skin reactions reported with use of imiquimod cream include:

• skin ulcers
• weeping (skin drainage)
• swelling outside the vagina

Certain factors can increase the risk of serious skin reactions with imiquimod topical cream. These include having skin that hasn’t finished healing from another treatment, such as surgery, or skin-related side effects caused by another medication.

Ways to manage

If you experience symptoms of a serious skin reaction from imiquimod cream, tell your doctor right away. They’ll likely recommend you stop using imiquimod cream until your symptoms go away. Then, they can determine whether it’s safe for you to resume using imiquimod cream.

Flu-like symptoms

Flu-like symptoms were rare in people treated with imiquimod in studies of imiquimod 3.75% topical cream and imiquimod 5% topical cream. This side effect is often mild but may be serious.

With flu-like symptoms, you may experience fatigue (low energy), chills, and generally feeling unwell. In some cases, flu-like symptoms occur before or at the same time as skin reactions caused by imiquimod cream.

Ways to manage

If you experience flu-like symptoms, tell your doctor. They’ll likely recommend temporarily stopping treatment with imiquimod cream. Your doctor may also suggest making an appointment so they can review your symptoms and see if you have an infection.

Allergic reaction

For some people, imiquimod topical cream may cause an allergic reaction.

Allergic reactions weren’t noted in studies of imiquimod 3.75% topical cream or imiquimod 5% topical cream, but they have been reported since then.

Symptoms can be mild or serious and may include:

• itchiness
• skin rash
• swelling under the skin, usually affecting eyelids, lips, hands, or feet
• swelling of the mouth, tongue, or throat, which can make it hard to breathe
• flushing (temporary warmth, redness, or deepening of skin color)

Ways to manage

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know if you should keep taking the medication.

For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to imiquimod topical cream, your doctor may recommend taking a different medication instead.

Warnings for imiquimod

Below are some factors you may want to discuss with your doctor before taking imiquimod topical cream.

Warnings

It may not be safe for you to take imiquimod topical cream if you have specific health conditions. These are sometimes called drug-condition interactions. Other things may also affect whether imiquimod topical cream is a safe treatment option for you.

Before taking imiquimod topical cream, tell your doctor about your health and medications you take. Things to consider include:

• previous treatment for actinic keratosis or warts
• prolonged sun exposure due to your occupation
• a weakened immune system
• past allergic reaction to imiquimod

Imiquimod and pregnancy

It’s unknown whether you should use imiquimod topical cream during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before using this medication.

Imiquimod and breastfeeding

It’s not known whether you should use imiquimod topical cream while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before using this medication.

Imiquimod and alcohol

Imiquimod topical cream is not known to interact with alcohol.

If you drink alcohol, talk with your doctor about whether it’s safe to consume it during your treatment with imiquimod topical cream.

What to ask your doctor

This article describes common and serious side effects of imiquimod topical cream. If your doctor prescribes this medication, they can discuss possible side effects with you. Let your doctor know if you have concerns or questions about treatment with this medication.

Here’s a list of some questions you may want to ask your doctor:

• How long do I need to wait before handling food after applying imiquimod cream?
• Is it safe to take a beach vacation while I’m using imiquimod cream?
• Does imiquimod cream affect my risk of skin cancer?
• Are side effects of imiquimod cream similar to those of other treatments for my condition?

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.