Aldara Dosage/Direction for Use

(The application frequency for Imiquimod (Aldara) Cream is different for each indication.)
External Genital Warts: Imiquimod (Aldara) Cream is to be applied 3 times/week, prior to normal sleeping hours, and left on the skin for 6 to 10 hours. Patients should be instructed to apply Imiquimod (Aldara) Cream to external genital/perianal warts.
A thin layer is applied to the wart area and rubbed in until the cream is no longer visible. The application site is not to be occluded. Following the treatment period, the cream should be removed by washing the treated area with mild soap and water. Examples of 3 times/week application schedules are: Monday, Wednesday, Friday; or Tuesday, Thursday, Saturday application prior to sleeping hours.
Imiquimod (Aldara) Cream treatment should continue until there is total clearance of the genital/perianal warts or for a maximum of 16 weeks. Local skin reactions (erythema) at the treatment site are common. A rest period of several days may be taken if required by the patient's discomfort or severity of the local skin reaction. Treatment may resume once the reaction subsides. Non-occlusive dressings such as cotton gauze or cotton underwear may be used in the management of skin reactions.
The technique for proper dose administration should be demonstrated by the prescriber to maximize the benefit of Imiquimod (Aldara) Cream therapy. Handwashing before and after cream application is recommended.
Imiquimod (Aldara) 5% Cream is packaged in single-use packets which contain sufficient cream to cover a wart area of up to 20 cm²; use of excessive amounts of cream should be avoided.
Superficial Basal Cell Carcinoma: Imiquimod (Aldara) Cream is to be applied 5 times per week for 6 weeks to a biopsy-confirmed superficial basal cell carcinoma. The target tumor should have a maximum diameter of no more than 2 cm and be located on the trunk (excluding anogenital skin), neck or extremities (excluding hands and feet). The treatment area should include a 1 cm margin of skin around the tumor. (See Table 5.)

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Patients should be prescribed no more than 3 boxes (36 sachets) for the 6 week treatment period.
Unused packets should be discarded. Partially-used packets should be discarded and not reused. Imiquimod (Aldara) Cream is to be applied 5 times per week, prior to normal sleeping hours and left on the skin for approximately 8 hours. Before applying the cream, the patient should wash the treatment area with mild soap and water and allow the area to dry thoroughly. Sufficient cream should be applied to cover the treatment area, including 1 cm of skin surrounding the tumor. The cream should be rubbed into the treatment area until the cream is no longer visible. Eye contact should be avoided. Following the treatment period, cream should be removed by washing the area with mild soap and water.
An example of a 5 times per week application schedule is to apply Imiquimod (Aldara) Cream, once per day, Monday through Friday, prior to sleeping hours. Imiquimod (Aldara) Cream treatment should continue for 6 weeks. Local skin reactions in the treatment area are common.
Patients should contact their physician if they experience any sign or symptom in the treatment area that restricts or prohibits their daily activity or makes continued application of the cream is difficult. A rest period of several days may be taken if required by the patient's discomfort or severity of the local skin reaction.
The technique for proper dose administration should be demonstrated by the prescriber to maximize the benefit of Imiquimod (Aldara) Cream therapy. Handwashing before and after cream application is recommended. Early clinical clearance cannot be adequately assessed until resolution of local skin reactions. It is appropriate to have the first follow-up visit at approximately 12 weeks post-treatment to assess the treatment site for clinical clearance.
Local skin reactions or other findings (e.g. infection) may require that a patient be seen sooner than the 12 weeks post-treatment visit. If there is clinical evidence of persistent tumor at the 12-week post-treatment assessment, a biopsy or other alternative intervention should be considered; the safety and efficacy of a repeat course of Imiquimod (Aldara) Cream treatment have not been established. If any suspicious lesion arises in the treatment area at any time after 12 weeks, the patient should seek a medical evaluation. See Table 4 in Pharmacology: Pharmacokinetics: Clinical studies under Actions.