From the Guidelines
Cimetidine is not recommended as a primary treatment for warts, as there is no evidence in the provided guidelines to support its use for this condition. The treatment of warts should be guided by the preference of the patient, the available resources, and the experience of the health-care provider 1. The available treatments for visible genital warts are patient-applied therapies (i.e., podofilox and imiquimod) and provider-administered therapies (i.e., cryotherapy, podophyllin resin, trichloroacetic acid {TCA}, bichloroacetic acid {BCA}, and surgery) 1.
Some key points to consider when treating warts include:
- The size, number, and location of the warts
- The patient's preference and ability to apply treatment
- The potential for adverse effects and the need for follow-up care
- The importance of educating patients about the treatment options and the natural history of the disease 1
In general, treatment of genital warts should be individualized, and the choice of treatment should be based on the specific characteristics of the patient and the warts 1. The most effective treatment for warts is often a combination of patient-applied and provider-administered therapies, and cimetidine is not a recommended treatment option.
From the Research
Cimetidine and Wart Treatment
- Cimetidine, an H2-receptor antagonist, has been used to treat warts due to its immunomodulatory effects 2, 3, 4.
- Studies have shown that cimetidine can be effective in treating multiple and recalcitrant warts in children, with cure rates ranging from 60% to complete resolution of lesions 2, 3, 4, 5.
- The dosage of cimetidine used in these studies varied, with some using 25-30 mg/kg daily 2 and others using 30-40 mg/kg daily 3, 4.
- Cimetidine has been compared to other treatments, such as zinc sulphate, with some studies suggesting that zinc sulphate may be more effective 6.
- The use of cimetidine in treating warts has been shown to be safe, with few adverse events reported, including mild gynecomastia 3.
- Cimetidine may be a useful alternative treatment option for multiple warts in pediatric patients, including those with compromised immune systems, such as heart transplant recipients 3.
Specific Patient Populations
- Cimetidine has been used to treat warts in pediatric heart transplant recipients, with complete resolution of lesions in all but one patient 3.
- Cimetidine has also been used to treat genital and perigenital warts in children, with all patients showing complete resolution of lesions after treatment 4.
- A case study reported the successful treatment of recalcitrant periungual warts in a 12-year-old girl using cimetidine 5.