Topical proapoptotic agent
Ingenol mebutate
Brand names: Picato
Adult dose
Dose: Withdrawn/restricted — see MHRA
Route: Topical
Frequency: per regimen
Clinical pearls
- Marketing authorisation suspended/withdrawn in EU/UK due to skin malignancy concerns — alternatives recommended (5-FU, imiquimod, photodynamic therapy)
Contraindications
- History of skin cancer in treatment area
- Hypersensitivity
Side effects
- Severe local skin reaction
- Increased skin malignancy risk (MHRA)
Reference: BNF; MHRA Drug Safety Update Jan 2020; https://bnf.nice.org.uk/drugs/ingenol-mebutate/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Suspicious Pigmented Lesion — Melanoma Pathway · NICE NG14 2015 / BAD
- Cellulitis and Erysipelas · NICE NG141 2019 / CREST
- Psoriasis — Severity Assessment and Step-Up Therapy · NICE NG153 2019 / BAD
- Atopic Eczema — Assessment and Step-Up Therapy · NICE NG95 2023
- Urticaria and Angioedema · BSACI / EAACI Guidelines 2022
- Acne Vulgaris — Grading and Treatment · NICE NG198 2021 / BAD