Ingenolmebutate

Author:Prof. Dr. med. Peter Altmeyer

Co-Autor:Jochen Starke

All authors of this article

Last updated on: 10.06.2024

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DefinitionThis section has been translated automatically.

Substance that occurs in garden spurge and is a member of the chemical group of diterpenes (terpenes). Ingenolmebutate is used as a medicinal substance in gel form for the topical treatment of actinic keratoses. Ingenolmebutate belongs to the esters of a group of diterpenes (Ingenane, Tigliane, Daphnane),.

Pharmacodynamics (Effect)This section has been translated automatically.

On the one hand, the active substance proves to be cytotoxic, on the other hand the substance initiates a neutrophil-mediated immune reaction. The substance stimulates the protein kinase-C-dependent cytokine release (IL-8 and TNF-alpha).

Field of application/useThis section has been translated automatically.

  • Short-term therapy for the facial area: 1x/day application of the 0.015% gel, duration: 3 days.
  • For extremities and trunk the higher dosed 0.05% gel is applied 1x/day for 2 days.

IndicationThis section has been translated automatically.

Actinic keratoses

Dosage and method of useThis section has been translated automatically.

Ingenolmebutate is used as a drug in gel form for the topical treatment of actinic keratoses.

Undesirable effectsThis section has been translated automatically.

Local skin irritation, which is classified as moderate to minor. The therapy-induced skin reactions reach their maximum between the 4th and 8th day. They subside completely after 2-4 weeks. Systemic reactions (caused by absorption of the active substance) are not to be expected.

PreparationsThis section has been translated automatically.

Trade name: Picato®

Red Hand Letter on Picato (ingenol mebutate) - January 2020

27.01.2020 - With this Red Hand Letter, the manufacturer informs about the suspension of the marketing authorization of Picato (ingenol mebutate) due to the risk of malignant skin lesions.

The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA ) has completed its review of Picato® with the conclusion that the medicine may increase the risk of skin cancer and that the risks outweigh the benefits.

Note(s)This section has been translated automatically.

A gel containing ingenolmebutate has been approved in the USA since January 2012 and in the EU countries since November 2012.

In 2020, the approval was revoked because an increased risk of skin cancer was observed during treatment.

PatientinformationThis section has been translated automatically.

In Australian folk medicine, the effectiveness of the juice of the garden spurge on warts and "skin tumors" is known.

Experimental: Successful treatments for condylomata acuminata have been reported (single dabbing of the papillomas with the ingenolmebutate gel Picato).

LiteratureThis section has been translated automatically.

  1. Gellrich FF et al (2014) Ingenolmebutat for the treatment of actinic keratosis in routine outpatient care. Act Dermatol 40: 340-346
  2. Farewell M et al (2012) Ingenol mebutate gel for actinic keratosis. N Engl J Med 366:1010-1019
  3. Braun SA et al (2015) Successful therapy of condyloma acuminata with ingenolmebutate. Dermatologist 66: 223-225

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Last updated on: 10.06.2024