From the Guidelines
Oral medications for treating warts include cimetidine, zinc sulfate, and occasionally oral retinoids, with cimetidine typically dosed at 30-40 mg/kg/day divided into three doses for 2-3 months, and zinc sulfate usually prescribed at 10 mg/kg/day (up to 600 mg daily) for 2-3 months. These medications work by enhancing cell-mediated immunity against the human papillomavirus (HPV) that causes warts, supporting immune function, and potentially inhibiting viral replication 1. Some key points to consider when using these medications include:
- Cimetidine may help by enhancing cell-mediated immunity against HPV
- Zinc sulfate works by supporting immune function and potentially inhibiting viral replication
- Oral retinoids like isotretinoin might be considered under close medical supervision for severe or resistant cases
- These oral treatments are generally reserved for extensive, recurrent, or resistant warts when topical treatments have failed
- They work systemically by enhancing the immune response against HPV
- Oral treatments typically have a slower response time than direct treatments and may cause side effects, so they should be used under medical supervision after discussing risks and benefits with your healthcare provider 1.
From the Research
Oral Medications for Wart Treatment
- Cimetidine is an oral medication that has been used to treat warts, particularly genital and perigenital warts in children 2.
- The effectiveness of cimetidine in treating warts is thought to be due to its immunomodulatory effects, which enhance the expression of IL-2 and IFN-gamma in lesional skin 3.
- Studies have shown that high doses of cimetidine (30-40 mg/kg/day) are more effective in treating multiple viral warts than lower doses (<20 mg/kg/day) 3.
- Other oral medications that have been reported to be effective in treating warts include zinc sulfate, levamisole, and oral retinoids, although the evidence for these treatments is limited 4.
Comparison with Other Treatments
- Topical treatments such as salicylic acid and imiquimod are also commonly used to treat warts, although their effectiveness can vary depending on the type and location of the wart 5, 6.
- Cryotherapy is another treatment option for warts, particularly for recurrent or difficult-to-treat lesions, although it can be painful and may require multiple sessions 5.
- Systemic immunotherapy, including oral medications such as cimetidine, may be considered for recalcitrant or multiple warts that have not responded to other treatments 4.