Efudex vs. Picato

Efudex (fluorouracil) topical contains an antineoplastic antimetabolite used to treat scaly overgrowths of skin (actinic or solar keratoses).

Efudex may also be used in the treatment of superficial basal cell carcinoma.

Efudex and Picato belong to different drug classes. Efudex contains an antineoplastic antimetabolite and Picato induces cell death.

Side effects of Efudex and Picato that are similar include application site reactions local skin (irritation, redness, pain, tenderness, itching, dryness, flaking, scaling, peeling).

Side effects of Efudex that are different from Picato include application site reactions (skin burning or swelling), rash, changes in skin color at the site of application, eye irritation (e.g., stinging, watering), trouble sleeping, irritability, temporary hair loss, or abnormal taste in the mouth.

Side effects of Picato that are different from Efudex include application site reactions (skin infection, crusting, blisters, pus, ulcers, breakdown of skin), sore throat, sinus pain, stuffy or runny nose, and headache.

Both Efudex and Picato may interact with other prescription or over-the-counter skin products.

Common side effects of Efudex include:

• skin irritation,
• burning,
• redness,
• dryness,
• pain,
• swelling,
• tenderness,
• scaling,
• peeling (exfoliation),
• rash,
• changes in skin color at the site of application, or other local reactions.
• Other side effects of Efudex include eye irritation (e.g., stinging, watering),
• trouble sleeping,
• irritability,
• temporary hair loss, or
• abnormal taste in the mouth.

Tell your doctor if you have rare but very serious side effects of Efudex including:

• stomach or abdominal pain,
• bloody diarrhea,
• vomiting,
• signs of infection (e.g., fever, chills, persistent sore throat),
• easy bruising or bleeding, or
• mouth sores.

Common side effects of Picato include:

• application site reactions (local skin irritation, pain, itching, dryness, infection, flaking, scaling, crusting, blisters, pus, ulcers, breakdown of skin),
• sore throat,
• sinus pain,
• stuffy or runny nose, and
• headache.

Picato gel may cause severe side effects if it comes in contact with eyes.

Efudex (fluorouracil) topical contains an antineoplastic antimetabolite used to treat scaly overgrowths of skin (actinic or solar keratoses). Efudex may also be used in the treatment of superficial basal cell carcinoma. It works by causing the death of cells that are growing fastest, such as abnormal skin cells. Efudex is available in generic form.

Picato (ingenol mebutate) gel is indicated for the topical treatment of actinic keratosis.

Do not use other prescription or over-the-counter skin products without first talking to your doctor during treatment with Efudex topical. They may interfere with treatment or increase irritation to the skin. Other drugs may also interact with Efudex topical. Talk to your doctor before taking any prescription or over-the-counter medicines. Efudex topical must not be used during pregnancy. It may harm a fetus. It is not known if this medication passes into breast milk. Due to the potential risk to a nursing infant, breastfeeding is not recommended while using this drug.

Picato may interact with other drugs. Tell your doctor all medications and supplements you use. It is not known if Picato gel is harmful to unborn babies. Picato gel should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown if Picato passes into breast milk. Consult your doctor before breastfeeding.

The dose of Efudex topical is to apply a small amount of the cream to the area that is to be treated, once or twice daily after cleansing. Treatment lasts 2-6 weeks depending on the condition being treated. Wash hands immediately afterward.

For the treatment of actinic keratosis on the face and scalp Picato gel, 0.015% should be applied to the affected area once daily for three consecutive days. For the treatment of actinic keratosis on the trunk and extremities Picato gel, 0.05% should be applied to the affected area once daily for two consecutive days.