Wart pills

A common dermatological lesion in the form of warts is caused by the human papillomavirus (HPV), which infects the epithelial cells of the skin. In the complex treatment of papillomatosis, agents that stimulate the immune system are used. Patients often define drugs of this pharmacological group as antiviral tablets for warts.

Indications wart pills

It should be borne in mind that there are no special tablets for the human papillomavirus and warts, as there is no single therapeutic method that is effective in all cases. And this is a fairly serious problem associated with the fact that after the introduction of the HPV genome into epithelial cells, the virus is able to evade innate immune reactions, suppress cellular immunity and not show its presence for a long time. And it is still unknown how this happens, that is, what is the specific immunosuppressive mechanism of the papillomavirus. Obviously, HPV can uniquely affect the differentiation of the immune cells themselves (macrophages, neutrophils, T-helpers, killer cells, etc.), recognizing foreign pathogenic structures. [ 1 ]

Indications for the use of tablets for warts and papillomas are adjuvant treatment of common skin warts (Verruca vulgaris), plantar warts (Verruca plantaris), genital warts or condyloma acuminata – pointed condylomas, which often recur and do not respond to other treatments.

In such cases, the goal of immunomodulation is to strengthen the adaptive immune response. Although experts explain the spontaneous disappearance of warts and papillomas not by humoral, but by cell-mediated immunity. [ 2 ]

Release form

Names of immunostimulant drugs that can be prescribed for warts: Isoprinosine (other trade names - Inosine pranobex, Inosiplex, Groprinosin, Methizoprinol, Dimepranol, Imunovir, Novirin); Alpizarin; Likopid (Glycopene); Cycloferon; Levamisole (Levazol, Levotetramisole, Dekaris, Ergamizole, Levoripercol).

In fact, they are all analogues, the mode of action of which is non-specific, that is, it leads to an increased immune response to a number of infectious agents. But the antiviral drug Acyclovir is used only for herpes simplex virus infection, as well as for shingles caused by the Herpes zoster virus.

Pharmacodynamics

As stated in the description of the drug Isoprinosine, its pharmacological action is due to the alkylamino-alcohol complex of the nitrogen-containing glycosylamine inosine, 4-acetamidobenzoic acid and N, N-dimethylamino-isopropanol. Although the exact mechanism of action of inosine pranobex is unknown, it can induce T-cell differentiation, enhance the lymphoproliferative response against transformed or virus-infected cells, and induce the production of cytokines (IL-1 and IL-2), chemotaxis and phagocytosis of neutrophils, monocytes and macrophages.

The active substance of the drug Alpizarin is 2-C-β-D-(glucopyranosyl)-1,3,6,7-tetraoxyxanthone - polyphenol mangiferin of the roots of the legume plant Hedisarum flavescens (yellow sweetvetch or licorice) and Hedysarum alpinum (Altai sweetvetch). This polyphenol inhibits the growth and reproduction of bacteria and the replication of viral DNA, enhances humoral and cellular immune function, increasing the rate of proliferation of lymphocytes and macrophages and the synthesis of γ-interferon by T-cells.

The effect of Likopid on immunocompetent cells is exerted by glucosaminyl muramyl dipeptide of bacterial cell membranes, which binds to the cytoplasmic receptor NOD2 expressed in phagocytic monocytes of the blood. This activates macrophages and neutrophilic granulocytes, stimulates the division of T- and B-lymphocytes, the production of γ-interferon, IL-1, IL-6 and IL-12.

The pharmacodynamics of Cycloferon is based on the action of its active substance - meglumine acridonacetate or N-methylglucamine 2-(9-oxoacridine-10(9H)-yl)acetate, which is a derivative of monocarboxylic acridoneacetic acid. The use of this immunostimulant, according to the official instructions, leads to stimulation of T-lymphocytes, an increase in α- and β-interferon. But how this happens is not explained.

As an immunomodulator, the antihelminthic drug Levamisole acts due to levamisole hydrochloride, a derivative of a nitrogen-containing heterocyclic imidazole compound that restores the activity of phagocytes, macrophages and T-lymphocytes that provide immune protection to cells. [ 3 ]

Pharmacokinetics

With almost 100% bioavailability, the maximum plasma level of Isoprinosine is observed approximately 60 minutes after oral administration of a standard dose, but after two hours the concentration decreases due to the high rate of its transformation by liver enzymes. It is excreted from the body in urine, partly unchanged, and also in the form of uric acid and other metabolites.

Absorbed in the gastrointestinal tract, Likopid also enters the systemic bloodstream, but its bioavailability does not exceed 13% with the highest concentration in the blood plasma 90 minutes after taking the tablet. The half-life by the kidneys is slightly more than four hours.

The active component of the drug Cycloferon reaches its highest concentration in plasma within three hours after oral administration, the average duration of its half-life is 4.5 hours; excretion is renal.

Levamisole reaches its peak plasma level after an average of two hours; metabolism occurs in the liver; metabolites are excreted by the kidneys and, to a lesser extent, the intestines – with a half-life of about six hours.

Dosing and administration

For the treatment of recurrent warts, adults are recommended to take two tablets (0.5 g each) of Isoprinosine orally three times a day; the daily dose for children is calculated based on body weight - 0.5 g of the drug per 10 kg, and divided into three doses. The course of treatment can last from two to weeks to a month.

The dosage of Alpizarin is determined by the doctor, but the maximum daily dose should not exceed eight tablets, i.e. 800 mg (for children - 300 mg). The duration of use is from five days to two weeks.

Likopid tablets can be taken orally (half an hour before meals) or placed under the tongue (for gradual absorption). The exact dosage and duration of use of this product is determined individually by the attending physician.

Cycloferon should be taken one tablet (0.15 g) once a day half an hour before meals.

Levamisole (tablets of 50 and 150 mg) is prescribed at 150 mg (the daily dose for children is 1 mg per kg of body weight) - for three days with a week's break; the course of treatment consists of two to three cycles.

• Wart pills for children

Contraindicated for children under 3 years of age - Isoprinosine, Alpizarin and Likopid; for children under 5 years of age - Cycloferon; for children under 7 years of age (according to other sources - up to 14 years of age) - Levamisole.

Use wart pills during pregnancy

Any pharmacological agents that directly or indirectly affect the immune system are prohibited for use during pregnancy.

Contraindications

Contraindications to the use of Isoprinosine include gout, bladder stones, chronic renal failure and cardiac arrhythmia.

Contraindicated for use:

• Likopid - for fever and autoimmune thyroiditis;
• Cycloferon – for decompensated liver cirrhosis;
• Levamisole – for low levels of white blood cells in the blood.

Side effects wart pills

Taking Isoprinosine may cause side effects in the form of: a feeling of general malaise, headaches and dizziness, abdominal pain, bowel dysfunction, sleep problems, itchy skin, increased urine output, joint pain.

Side effects of Alpizarin include headache and dizziness, nausea and weakness, upset stomach and immediate allergic reactions.

Likopid can cause a short-term increase in body temperature, and Cycloferon can cause an allergic reaction.

The use of Levamisole may be accompanied by skin rashes, nausea, vomiting, diarrhea, changes in the perception of smells and tastes, weakness and fever, as well as muscle and joint pain.

Overdose

There is no information on overdose of Isoprinose, Alpizarin, Likopid and Cycloferon.

In case of overdose of Levamisole, convulsions and cardiac arrhythmia may occur; gastric lavage should be performed and enterosorbent (activated carbon) should be taken. Treatment is symptomatic.

Interactions with other drugs

Isoprinosine should not be taken with drugs used to treat gout or diuretics.

Alpizarin is not used simultaneously with enterosorbents, and Likopid is not used simultaneously with tetracycline antibiotics and sulfonamide drugs.

It is necessary to take into account the ability of Likopid to enhance the effect of antibacterial drugs and polyene antimycotics.

Levamisole hydrochloride is not compatible with ethanol and oil-based drugs; it potentiates the action of anticonvulsants and drugs of the indirect anticoagulant group.

Storage conditions

All listed drugs in tablet form should be stored at room temperature (not higher than +22-25°C).

Shelf life

The shelf life of Isoprinosine, Alpizarin and Likopid is 5 years; Levamisole – 3 years; Cycloferon – 2 years.

Immunotherapy has become one of the most important therapeutic options for treating warts, but clinically proven evidence of their effectiveness is often lacking. Taking into account the opinions of specialists, it should be borne in mind that there is no single, absolutely effective treatment, and various types of treatment – surgical excision, cryo- and laser surgery, topical agents and immunotherapy – can be combined. It is also necessary to take into account the possibility of spontaneous regression of papillomas, especially in children, so an overly aggressive approach to their treatment should be avoided.