Common or periungual warts: Topical: Apply directly to lesion and to 1 mm surrounding margin; once dry, cover with nonporous tape; remove tape in 24 hours and replace with a loose bandage; may re-treat in 1 to 2 weeks, if needed.
Molluscum contagiosum: Topical: Apply directly to the top of each lesion; once dry, cover large or resistant lesions with nonporous tape for 4 to 6 hours. May re-treat once weekly for new or resistant lesions.
Plantar warts: Topical: Remove keratin covering wart while avoiding cutting viable tissue, apply to lesion and to 1 to 3 mm surrounding margin; once dry, cover with nonporous tape; debridement may take place 1 to 2 weeks after treatment. May re-treat, if necessary (3 or more treatments may be needed for large lesions).
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing. Note: Neither product insert specifies minimum age requirement for use in children.
There are dosage adjustments provided in the manufacturer’s labeling.
There are no dosage adjustments provided in the manufacturer’s labeling.
Refer to adult dosing.
No
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Liquid:
Cantharone: Cantharidin 0.7% in a film-forming vehicle (7.5 mL)
Not available in the US
Topical: For external use only; may be fatal if ingested. Not for use in or near the eyes, on face or mucous membranes, or anogenital area. Do not apply to inflamed or irritated skin. If contact with healthy skin, wipe off with acetone or alcohol, then wash area with warm soapy water and thoroughly rinse. If contact with mucous membranes or eyes, flush with water, remove precipitated film, then flush with water for additional 15 minutes. Apply to clean skin using an applicator stick. No cutting or prior treatment is required. Occasionally, nails must be trimmed to expose subungual warts to medication. Using a wooden applicator stick, apply to lesion(s); allow to dry for a few minutes. Large or resistant lesions due to molluscum contagiosum should be covered with a piece of nonporous adhesive tape for 4 to 6 hours. Common and periungual warts should be covered with a piece of nonporous adhesive tape for 24 hours and then replaced with a loose bandage. Plantar warts should be covered with a piece of nonporous adhesive tape (doughnut pad over the tape may be helpful) and then secured with additional tape; after 24 hours, remove tape to bathe and then replace. Within 24 hours, a blister forms, and healing is typically evident within 7 days; blisters may be punctured as recommended by a health care provider. Additional treatment may be necessary for resistant lesions. Medication may be used for pain and itching at night. Area may be soaked in cool water for 10 to 15 minutes, as needed once sufficient time has elapsed for the medication to penetrate the affected area.
Topical: For external use only; avoid eyes and mucous membranes; do not use if tissue is inflamed or irritated. Apply to clean skin.
No curettage method: No cutting or prior treatment is required. Occasionally, nails must be trimmed to expose subungual warts to medication. Using a wooden applicator stick or cotton swab, apply to lesion(s) and a 1 to 3 mm margin around the wart. Allow to dry for a few minutes. Cover with a piece of nonporous plastic adhesive tape for at least 4 hours (up to 24 hours). Within 24 hours, a blister forms which is often painful and inflamed. Reevaluate in 1 to 2 weeks. Remove necrotic tissue and treat as before if any viable wart tissue remains. Allow tissue to re-epithelialize before re-treatment.
Curettage method: Proceed as in no curettage except have patient return in 1 day for curettage. Local anesthesia may be necessary. Treatment with this method (next day curettage) enhances identification of tissue planes, increases separability of wart tissue, and re-treatment is rarely necessary. Reevaluate in 4 weeks. Usual healing time is within 1 to 3 weeks. Apply a mild antimicrobial agent until treated area heals.
Mild analgesics (eg, acetaminophen) may be necessary. To minimize pain after application, bandage should be removed shortly after symptom onset and after allowing sufficient time for absorption, and (if needed) the area then soaked in cool water for 10 to 15 minutes. If persistent pain, puncture blister then apply antimicrobial and cover with sterile bandage.
Note: Not approved in the US.
Benign epithelial growths: Removal of benign epithelial growths such as common warts, molluscum contagiosum, and periungual warts.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.
Central nervous system: Tingling of skin
Dermatologic: Burning sensation of skin, skin blister, skin depigmentation (temporary), warts (annular)
Hematologic & oncologic: Lymphangitis (chemical)
Local: Local pain, localized tenderness
Use in patients with diabetes or in individuals with impaired peripheral circulation; use near eyes or on face or mucous membranes; in anogenital, intertriginous, or axilla areas.
Concerns related to adverse effects:
• Dermatologic: Strong vesicant that may cause blistering of normal skin or mucous membranes; reactions may be more severe in patients with fair complexion and/or blue eyes. Do not apply to irritated or inflamed skin. Residual pigmentation has been reported (rarely) with use.
Other warnings/precautions:
• Appropriate personnel: Should be applied only by a physician; not recommended for dispensing to patient.
• Appropriate use: For external use only; may be fatal if ingested. Not for use near the eyes, on mucous membranes, in anogenital, intertriginous, or axilla areas. Do not reapply to the same lesion >1 time per week. Avoid treating large areas or multiple lesions until sensitivity has been established. Do not use in combination with other chemical wart therapies. Do not apply to inflamed or irritated tissue; delay retreatment if area is inflamed.
None known.
There are no known significant interactions.
Use is not recommended during pregnancy.
Treated areas for adequate healing; pain and tolerability of treatment
Cantharidin is a vesicant thought to cause wart exfoliation via its acantholytic actions.
