Which medications in the drug class Cytotoxic agents are used in the treatment of Condyloma Acuminatum (Genital Warts)?

Updated: Oct 22, 2018
  • Author: Delaram Ghadishah, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Cytotoxic agents

Inhibit proliferation of cells at various stages of the cell cycle.

Podophyllum resin (Podocon-25, Pod-Ben-25)

Extract of various plants, which are cytotoxic. Effective in arresting mitosis in metaphase. Expect cure rate of 20-50% if used as single agent.

Podofilox (Condylox)

Purified podophyllotoxin that is antimitotic, cytotoxic, and available for patient's home use. While exact mechanism of action on condyloma is unknown, podofilox results in necrosis of genital condyloma acuminatum. Condylox is one agent containing podofilox. Slightly higher cure rates can be expected with podofilox than with podophyllin. Additionally, useful for prophylaxis.

Trichloroacetic acid topical

At various concentrations (up to 80%), these agents rapidly penetrate and cauterize skin, keratin, and other tissues. Bichloracetic acid is one such agent. Although caustic, this treatment causes less local irritation and systemic toxicity. Additionally, has low cost. Response is often incomplete, and recurrence is frequent.

5-Fluorouracil (Adrucil, Efudex, Fluoroplex)

No longer recommended for routine use.

Has antimetabolic and/or antineoplastic and immunostimulative activity. Useful in prevention of recurrence after condyloma ablation if started within 4 wk, especially in immunocompromised patients.

Bleomycin (Blenoxane)

Composed of cytotoxic glycopeptide antibiotics, which appear to inhibit DNA synthesis with some evidence of RNA and protein synthesis inhibition to a lesser degree; used in management of several neoplasms as a palliative measure; may cause a variety of adverse effects; observe patients frequently and carefully during and after treatment.

Imiquimod (Aldara)

Induces interferon production and is a cell-mediated immune response modifier. Has minimal systemic absorption but causes erythema, irritation, ulceration, and pain. Burning, erosion, flaking, edema, induration, and pigmentary changes may occur at application site.

Imiquimod 5% cream comes in single-use packets.


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