Which medications in the drug class Immunomodulators are used in the treatment of Nongenital Warts?

Updated: Sep 25, 2020
  • Author: Philip D Shenefelt, MD, MS; Chief Editor: William D James, MD  more...
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Answer

Immunomodulators

Immunomodulators stimulate the release of key factors that regulate the immune system.

Imiquimod (Aldara)

Imiquimod induces secretion of interferon alpha and other cytokines; it is FDA approved for the treatment of genital warts in adults; reports indicate success in the treatment of common warts in children. It is a 5% gel that is applied daily for 3 d/wk; it may be applied before bedtime and washed off after 6-10 hours; twice-daily administration for nongenital warts has been reported, but irritation may be increased.

Interferon alfa 2b (Intron A)

Interferon alfa 2b is a naturally occurring cytokine with antiviral, antitumor, and immunomodulatory actions; intralesional administration is more effective than systemic administration and is associated only with mild flulike symptoms. Treatments may be required for several weeks to months before beneficial results are seen. Consider this treatment as third line, and reserve it for warts resistant to standard treatments.

Pegylated interferon alfa-2a (Pegasys)

PEG-IFN alfa-2a consists of IFN alfa-2a attached to a 40-kd branched PEG molecule. It is predominantly metabolized by the liver. It has immunomodulatory actions; intralesional administration is more effective than systemic administration and is associated only with mild flulike symptoms. Treatments may be required for several weeks to months before beneficial results are seen. Consider this treatment as third line, and reserve it for warts resistant to standard treatments.

5-Fluorouracil (Efudex, Carac, Fluoroplex)

5-Fluorouracil is a topical chemotherapeutic agent that is approved to treat actinic keratoses and superficial basal cell carcinoma; it has been found to be more successful in the treatment of flat warts than plantar and common warts. Apply a 5% solution or cream daily for up to 1 month; it may be used under occlusion, but the risk of irritation increases.


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