Ingenol Mebutate

Products

Ingenol mebutate was commercially available as a gel (Picato). It was approved in many countries in 2013, and in the EU and the U.S. as early as 2012. In 2020, approval was withdrawn because an increased risk of skin cancer was observed with the treatment.

Structure and properties

Ingenol mebutate (C25H34O6, Mr = 430.5 g/mol) is a hydrophobic diterpene ester that exists as a white to yellow crystalline powder. It is an ingredient from the milky sap of the garden spurge in the spurge family (Euphorbiaceae). The milk sap has been used in folk medicine for a long time.

Effects

Ingenol mebutate (ATC D06BX02) has cytotoxic, proinflammatory, and wound-healing properties. The exact mechanism of action is not known.

Indications

For one cycle of topical treatment of nonhyperkeratotic, nonhypertrophic actinic keratoses in adults.

Dosage

According to the SmPC. The gel is applied locally. The application instructions must be followed exactly!

Contraindications

  • Hypersensitivity

For complete precautions, see the drug label.

Interactions

There are no known interactions with other drugs.

Adverse effects

The most common possible adverse effects include local reactions at the site of application, such as pustules, erosions, swelling, pain, and redness. These adverse reactions are due to the mechanism of action.