Picato (ingenol) works by causing the death of certain cells in the body.
Picato gel is used to treat actinic keratosis (a condition caused by too much sun exposure).
Picato may also be used for purposes not listed in this medication guide.
Important information
Use Picato gel exactly as prescribed by your doctor. Using too much of this medicine, or using it for too long can increase your risk of severe skin reactions. Follow the directions on your prescription label.
Wash your hands with soap and water before and after applying Picato gel. Do not use Picato on sunburned skin, or on areas of skin that are still healing after surgery or treatment with other medications. Wait until these conditions have healed before using Picato. Do not get this medication in your eyes. If this does happen, rinse with water and call your doctor at once. Avoid getting the medication in your mouth or vagina. If it does get into any of these areas, rinse with water.
Avoid letting treated skin areas come into contact with other people. Avoid touching a treated skin area and then touching your eyes.
Call your doctor if your skin condition does not improve or if it gets worse during treatment.
Before using Picato
You should not use Picato gel if you are allergic to ingenol.
FDA pregnancy category C. It is not known whether Picato will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether ingenol passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
See also: Pregnancy and breastfeeding warnings (in more detail)
How should I use Picato?
Use Picato gel exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
Picato gel comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.
For 0.015% gel: To treat actinic keratosis on the face and scalp, Picato is usually applied once daily for 3 days in a row.
For 0.05% gel:To treat actinic keratosis on the arms and legs or trunk, Picato is usually applied once daily for 2 days in a row.
Using too much of this medicine, or using it for too long can increase your risk of severe skin reactions.
Wash your hands with soap and water before and after applying this medication.
Allow the skin to dry for at least 15 minutes after applying Picato gel.
Avoid touching or washing the treated skin for 6 hours after applying Picato gel. Avoid activities that may cause heavy sweating. After 6 hours have passed, you may wash the treated skin with a mild soap.
Do not cover the treated skin with a bandage.
Do not use Picato gel on sunburned skin, or on areas of skin that are still healing after surgery or treatment with other medications. Wait until these conditions have healed before using Picato. Call your doctor if your skin condition does not improve or if it gets worse during treatment.
Each single use tube of this medicine is for one use only. Throw away after one use, even if there is still some medicine left in it after applying your dose.
Store Picato gel in the refrigerator, do not freeze.
What happens if I miss a dose?
Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include severe skin irritation.
What should I avoid?
Do not get the gel in your eyes. If this does happen, rinse with water. Avoid getting this medication in your mouth or vagina. If it does get into any of these areas, rinse with water.
Avoid letting treated skin areas come into contact with other people. Avoid touching a treated skin area and then touching your eyes.
Picato side effects
Get emergency medical help if you have any of these signs of an allergic reaction to Picato gel: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Wash off the medicine and call your doctor at once if you have a serious skin reaction such as severe itching, burning, oozing, blisters, redness, swelling, or skin changes where the medication is applied.
Stop using Picato and call your doctor at once if you have a serious side effect such as:
Less serious Picato gel side effects may include:
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headache; or
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mild skin irritation, itching, dryness, flaking, or crusting of the skin where the medicine was applied;
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sore throat, sinus pain.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
What other drugs will affect Picato gel?
It is not likely that other drugs you take orally or inject will have an effect on topically applied Picato. But many drugs can interact with each other. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
