Podophyllotoxin

Podophyllotoxin is an active substance for the treatment of anogenital warts (genital warts). It comes from the roots of the May apple (Podophyllum peltatum L.) and belongs to the barberry family (Berberidaceae). Podophyllotoxin belongs to the group of cytostatics and is a spindle poison, which means that it inhibits cell division. It is extracted from the May apple and then purified. It consists of 4 ring systems with a hydroxyl group, an acetal, a lactone and three methoxy groups as functional groups. In 60-80% of cases the genital warts disappear again. Unfortunately, recurrences (new warts) form in 7-38% of all cases.

How podophyllotoxin works is not yet fully understood. Hypothesis 1 states that it works by binding to tubulin in the cells and thus preventing the formation of microtubules. Mitosis (cell division) is inhibited, the cells die and as a result the warts also die. Hypothesis 2 states that podophyllotoxin binds to topoisomerase 2 in the S or G2 phase. Binding to this enzyme inhibits the unwinding and replication of DNA and the cell also dies. Local application to the skin means that there is no absorption into the body and therefore no bioavailability or plasma concentration.

Always take Podophyllotoxin exactly as described in the package leaflet or as advised by your doctor.

Podophyllotoxin 0.5% solution should be applied to the wart(s) twice a day for 3 days. This is followed by a 4-day break. This 7-day rhythm should be repeated 4 times .

The solution can be applied with a cotton swab. It is important that only one cotton bud is used per wart and that it is not dipped back into the solution after application.

The following side effects may occur:

Very common:

• local irritation
• itching
• burning sensation
• pain
• redness
• Ulceration
• Loss of the outer mucosal layer

Frequency unknown:

• Adhesion and inflammation of the glans or foreskin

Interactions may occur if the following medicines are taken at the same time:

• other podophyllotoxin-containing drugs
• Alcohol - extreme intensification of undesirable effects may occur

Podophyllotoxin must NOT be taken in the following cases:

• if you are allergic to podophyllotoxin
• in the case of inflamed or bleeding genital warts
• if other podophyllotoxin-containing medication is being used at the same time

Podophyllotoxin is approved for use from the age of 12.

Podophyllotoxin should NOT be used during pregnancy and breastfeeding, as it can cause serious damage to the unborn child.