Cimetidine for Warts
Posted: Tuesday, May 04, 2010
by Vita Li
In the last 5 years, double-blind, placebo-controlled studies have finally been performed on cimetidine in the treatment of common warts. These studies have shown it to be ineffective; this ineffectiveness is shown most clearly in adults. Some still advocate consideration of its use at a dose of 40 mg/kg/day, but most reviewers do not.
A trend toward efficacy was suggested for younger subjects. Moreover, a prospective, randomized, controlled trial of 40 patients (62% less than 15 years old) yielded negative results. Thus, in cases where the use of topical medications is not possible, cimetidine might still have a role in the treatment of warts in children.
Interestingly, however, a recently reported case described marked improvement in a 16 year old boy with epidermodysplasia after three months of oral cimetidine at 40mg/kg/day. No relapse occurred over a six month follow up period. One promising avenue for the use of cimetidine for treating warts is in conjunction with other therapies.
Parsad et al. have reported that a combination regimen of cimetidine and levamisole is superior to cimetidine alone in treating warts in adults and in children. Levamisole is an immunomodulator that is approved by the FDA for use with 5-fluorouracil in the treatment of colon cancer. The original use of levamisole was as an antihelminthic.
Cimetidine has been shown to be useful in the treatment of condylomata acuminata and papillomatosis. Four children treated with extensive condylomata acuminata of the genital and perigenital areas were treated with cimetidine 3040 mg/kg; clearing of their condylomata was noted at 24 months following treatment.
Cimetidine was effective in the treatment of recurrent respiratory papillomatosis and recalcitrant, diffuse conjunctival papillomatosis. Cimetidine has yet to be proven to be an effective monotherapy for dermatological diseases. It seems that cimetidine is probably most effective when used in conjunction with other medications.
In the same fashion that levamisole eventually was proven to be an effective secondary medication along with 5-fluorouracil in the treatment of cancer of the colon, cimetidine will probably be proven useful outside of its use as an antacid. Promising uses include treating urticaria in conjunction with other antihistamines, and treating warts in conjunction with levamisole.
In addition, cimetidine's inhibitory effect on the metabolism of dapsone, chloroquine, and pyrimethamine can aid dermatological therapy by maintaining medication levels and decreasing toxicity. The multiple immunomodulating effects of cimetidine are significant but poorly understood. As its immunological effects are elucidated, new uses will emerge.
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