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Common or periungual warts: Topical: Apply to lesion and to 1-3 mm surrounding margin; once dry, cover with nonporous tape; remove tape in 24 hours. Treat once weekly for new or resistant lesions (2-3 treatments may be necessary). Patients scheduled for curettage should return 24 hours after treatment for procedure; reassess in 4 weeks for resolution and/or healing.

Molluscum contagiosum: Topical: Apply directly to lesion; once dry, cover large or resistant lesions with nonporous tape for 4-6 hours (Cantharone®) or 6-8 hours (Canthacur®). May retreat once weekly for new or resistant lesions.

Plantar warts: Topical: Apply to lesion and to 1-3 mm surrounding margin; once dry, cover with nonporous tape for up to 1 week; may retreat in 1-2 weeks if necessary Dosing: Pediatric Children ≥3 years and Adolescents: Refer to adult dosing.

Note: Canthacur® product insert does not specify minimum age requirement for use in children. Dosing: Geriatric Refer to adult dosing. Dosing: Renal Impairment No dosage adjustment provided in manufacturer’s labeling. Dosing: Hepatic Impairment No dosage adjustment provided in manufacturer’s labeling. Dosage Forms: Canada Excipient information presented when available (limited, particularly for generics); consult specific product labeling. Liquid: Canthacur®: Cantharidin 0.7% in a film-forming vehicle (7.5 mL) Cantharone®: Cantharidin 0.7% in a film-forming vehicle (7.5 mL) Generic Equivalent Available: U.S. No Product Availability Not available in U.S. Administration For external use only; apply to clean skin. 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. Palpebral warts treated with Canthacur® should be left uncovered. Avoid touching normal skin or applying inside eyelash; instruct patients not to touch eyelid. Large or resistant lesions due to molluscum contagiosum should be covered with a piece of nonporous adhesive tape for 4-6 hours (Cantharone®) or 6-8 hours (Canthacur®). Other lesions should be covered with a piece of nonporous adhesive tape for 4-6 hours for up to 1 week. Within 24 hours, a blister forms and healing is typically evident within 7 days. Additional treatment may be necessary for resistant lesions. Medication may be used for pain and itching at night. Use Removal of common warts, molluscum contagiosum, and periungual warts Adverse Reactions Significant Frequency not defined. Dermatologic: Annular warts, depigmentation (temporary) Local: Blisters, burning, pain, tenderness, tingling Miscellaneous: Chemical lymphangitis Contraindications Canthacur®: Hypersensitivity to cantharidin or any component of the formulation; alcoholic beverages for several hours after treatment; use on mosaic warts Cantharone®: Use in diabetics or in individuals with impaired peripheral circulation; use near eyes or on face or mucous membranes; in anogenital, intertriginous, or axilla areas Warnings/Precautions

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.

For external use only. Not for use near the eyes, on mucous membranes, in anogenital, intertriginous or axilla areas. Avoid treating multiple lesions during the first visit to determine patient tolerability. Delay retreatment if area is inflamed. Metabolism/Transport Effects None known. Drug Interactions (For additional information: Launch Lexi-Interact™ Drug Interactions Program ) There are no known significant interactions. Pregnancy Implications Use is not recommended during pregnancy. Lactation Not recommended Monitoring Parameters Treated areas for adequate healing; pain and tolerability of treatment International Brand Names Canthacur (CA); Cantharone (CA) Mechanism of Action Cantharidin is a vesicant thought to cause wart exfoliation via its acantholytic actions. Use of UpToDate is subject to the Subscription and License Agreement . Topic 8838 Version 33.0 © 2013 UpToDate, Inc. All rights reserved. | Subscription and License Agreement | Release: 21.6- C21.56 Licensed to: AsanBook Dig. Med. Lib. | Support Tag: [0504-27.109.116.13-BBD231414A-S244013.14]