Is Imiquimod compatible with breastfeeding? Do we have alternatives for Imiquimod?

Imiquimod

June 10, 2018 (Very Low Risk)

This is a immune-response modifier, used in the local treatment of genital and perianal warts, cutaneous basal cell tumors and actinic keratosis.
Administered topically, once a day or every two days for several weeks, according to pathology.

Since the last update we have not found any published data on its excretion in breastmilk.

The cutaneous absorption to the patient's blood is extremely low: 0.6% with a Cmax of 0.32 to 1.6 ng/mL (EMA 2016, Wu 2012, Kulp 2010, Harrison 2004, FDA 2004), which makes it very unlikely that there is transfer in significant amounts to breastmilk.

As with any product applied to the skin, it is prudent to avoid its use in areas near the breast and nipple so that there is no risk of swallowing by the infant.

Alternatives

We do not have alternatives for Imiquimod since it is relatively safe.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Writings

  • Ιμικιμόδη (Greek)
  • إيميكيمود (Arabic)
  • Имихимод (Cyrillic)
  • 咪喹莫德 (Chinese)
  • イミキモド (Japanese)
  • C14 H16 N4 (Molecular formula)
  • 4-Amino-1-isobutil-1H-imidazo[4,5-c]quinolina (Chemical name)
  • D06BB10 (ATC Code/s)

References

  1. EMA. Imiquimod (Aldara). Drug Summary. 2106 Full text (in our servers)
  2. EMA. Imiquimod (Aldara). Ficha técnica. 2016 Full text (in our servers)
  3. Wu J, Feldman R, Barry GT, Kulp J, Adams MP, Levy S. Pharmacokinetics of daily self-application of imiquimod 3.75% cream in adult patients with external anogenital warts. J Clin Pharmacol. 2012Abstract
  4. Kulp J, Levy S, Fein MC, Adams M, Furst J, Meng TC. Pharmacokinetics of imiquimod 3.75% cream applied daily for 3 weeks to actinic keratoses on the face and/or balding scalp. Arch Dermatol Res. 2010Abstract
  5. Harrison LI, Skinner SL, Marbury TC, Owens ML, Kurup S, McKane S, Greene RJ. Pharmacokinetics and safety of imiquimod 5% cream in the treatment of actinic keratoses of the face, scalp, or hands and arms. Arch Dermatol Res. 2004Abstract
  6. FDA. Imiquimod (Aldara). Drug Summary. 2004 Full text (in our servers)