1 What is Picato?

Brand: Picato

Generic: Ingenol topical

Picato is a topical medication approved to treat actinic keratosis, a skin condition caused by chronic exposure to sun’s rays and UV radiation from tanning beds. Actinic keratosis can progress to skin cancer (squamous cell carcinoma) if left untreated.

In actinic keratosis, UV radiation cause changes to the cells of the skin and causing it to become thick, scaly and hyperpigmented. These abnormal cells may regress, remain this way for years, or become cancerous.

Picato works by causing cell death, and it causes the skin cells affected by actinic keratosis to die when applied to lesions. Ingenol must be applied to the lesions only to avoid harm to the normal skin cells. Picato is a prescription drug.

2 What to Know Before Using

If you are about to start using Picato, speak with your doctor about what you need to know.

The doctor may consider the following before prescribing Picato to you:

Tell your doctor if you are pregnant or nursing a baby before using Picato. Picato is an FDA pregnancy category C drug, which means it can harm unborn babies. Whether Picato is passed onto breastmilk is not yet known, but because many medicines can be expressed in the breastmilk, you may have to stop nursing if you are using Ingenol.

Tell the doctor all the medications you take before you use Ingenol. If used properly, very little Ingenol is absorbed in the blood so the possibility of interaction is very low.

Tell the doctor all your allergies, including food, medications and animal products. Before using Ingenol, tell the doctor if you have other skin or health conditions.

If you underwent previous treatments for actinic keratosis, you must wait until the skin has healed before using Ingenol. Ingenol is not safe for children and patients below 18 years of age. Keep out of reach of children and pets.

3 Proper Usage

To use Picato properly, you must follow all instructions given by your doctor. Make sure you read the information leaflet that comes with the medication. If you have more questions, ask your doctor or your pharmacist.

Ingenol is available in gel form in two strengths, 0.015%, and 0.05%. A single tube (one unit-dose tube) can cover up 2 x 2 inches (5 cm x 5 cm) square area of lesions.

The 0.015% gel is used to treat actinic keratosis on the face and scalp and is applied for 3 days in a row. The 0.05% gel is for lesions in the arms or legs and must be applied 2 days in a row.

Ingenol should be applied to the affected skin once a day only. To apply Ingenol, squeeze gel onto a fingertip and spread evenly on the lesions. Allow to dry for 15 minutes. Avoid touching or washing the treated area for at least 6 hours. Wash hands immediately after applying Ingenol. After 6 hours, you can wash the treated area with mild soap.

Here are important precautions you must follow when using Picato:

  • Do not apply Ingenol after taking a shower or less than 2 hours before bedtime.
  • Do not use Ingenol if there is visible inflammation or irritation on the lesions. Wait until the lesions are healed and completely dry before applying Ingenol.
  • Apply Ingenol to lesions only. Avoid dabbing the gel on the normal skin to reduce irritation.
  • Take care not to apply Ingenol to eyes, nose, mouth or vagina. You can prevent this from happening by washing the hands immediately after application and not touching the treated areas.
  • Do not cover the treated areas with bandages or dressings.
  • After applying Ingenol, avoid activities that induce heavy sweating so sweat will not wash the medication onto the normal skin.
  • Avoid touching treated lesions.

You must only use one tube of Ingenol at a time. After treatment, the tube, and any leftover medication must be disposed of properly. Make sure that the spent tubes are disposed of in a way that is inaccessible to children and pets.

If you miss a dose of Ingenol, apply it as soon as you remember. If it is almost time for the next dose, skip the missed dose. Do not apply more than needed and do not apply the medication twice a day.

4 Precautions to Take

In using Picato, you must be careful and take some precautions as advised by your doctor. Picato gel is an irritant, especially if applied to mucous membranes. Apply Eugenol on affected skin areas only. If you accidentally applied Eugenol on normal skin, wash the affected area immediately with water.

When applied on the eyes, Eugenol may cause serious side effects like severe eye pain, swelling of the eyes and drooping eyelids. It can happen if the medication applied on lesions on is washed down with sweat or water. If the medication gets into your eyes, flush it immediately with flowing water and seek medical attention.

Ingenol may cause skin reactions such as mild redness, flaking, scaling and swelling at the application site. Call your doctor there is blistering, presence of pus, open sores or severe redness at the application site.

If you became pregnant or breastfed while taking Ingenol, call your doctor at once.

Ingenol can cause poisoning if swallowed. In that case, contact local poison control center or head to the nearest hospital right away. Keep opened and disposed tubes away from the reach of children and pets.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Picato.

Seek medical attention if you have the following side effects in using Picato:

  • Severe allergy including hives, rash, difficulty breathing, swelling of the face, mouth, and tongue)
  • Formation of blisters, open sores, ulcers or pus at the application site
  • Severe redness, flaking or scaling, and swelling at the application site

If you have these symptoms, call your doctor immediately. Below are the common but minor side effects of Picato.

You can call the doctor for help if these symptoms persist or become bothersome:

  • Headache
  • Mild pain
  • Itching
  • Irritation
  • Mild redness, flaking or scaling and swelling at the application site

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