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Here’s what to ask a doctor about hereditary angioedema


Generic Name: Ingenol Mebutate (IN je nol MEB u tate)
Brand Name: Picato

Uses of Picato:

  • It is used to treat a precancerous skin problem called actinic keratosis.

What do I need to tell my doctor BEFORE I take Picato?

  • If you have an allergy to ingenol or any other part of Picato (ingenol mebutate).
  • If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.

This medicine may interact with other drugs or health problems.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this medicine with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take Picato?

  • Tell all of your health care providers that you take Picato. This includes your doctors, nurses, pharmacists, and dentists.
  • If you get this medicine in your eyes, it may cause eye problems like very bad eye pain, eyelid swelling or droop, or swelling around the eyes. Do not touch your eyes while using Picato. If you get this medicine in your eyes, flush with water and call your doctor.
  • Do not use more than what your doctor told you to use. Do not use more often or longer than what you were told. Doing any of these things may raise the chance of very bad side effects.
  • Make sure sores near the area to be treated are healed before using Picato.
  • Talk with your doctor before you use other drugs or products on your skin.
  • This medicine may cause harm if swallowed. If this medicine is swallowed, call a doctor or poison control center right away.
  • People using Picato may have skin reactions where this medicine is used. These reactions may include change in skin color, crusting, flaking, redness, scaling, scarring, or swelling. If these reactions get very bad, a break from using Picato may be needed as told by the doctor. Talk with the doctor.
  • Call your doctor right away if you have a skin reaction that bothers you or if the reaction makes it hard to keep putting this medicine on. Call your doctor right away if you have a skin reaction that causes problems with daily living.
  • Very bad skin reactions and eye injuries have happened when Picato is not put on as told by the doctor. Talk with the doctor.
  • Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using this medicine while you are pregnant.
  • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

How is this medicine (Picato) best taken?

Use Picato (ingenol mebutate) as ordered by your doctor. Read all information given to you. Follow all instructions closely.

  • Follow how to use as you have been told by the doctor or read the package insert.
  • Do not take this medicine by mouth. Use on your skin only. Keep out of your mouth, nose, and eyes (may burn).
  • Do not put Picato on the lips. Do not put near or around the eyes or mouth.
  • Wash your hands before and after use. Do not wash your hands after use if putting this on your hand.
  • Use a new tube of gel each time you use this medicine.
  • Do not put on right after taking a shower or less than 2 hours before bedtime.
  • Put a thin layer on the affected skin.
  • Put on affected part only.
  • Allow gel to dry for 15 minutes after using.
  • Do not touch area where gel was put on your skin.
  • Leave on the skin for 6 hours, then wash off.
  • Do not bathe, shower, or swim for 6 hours after putting on.
  • Avoid actions that may cause sweating for 6 hours after the gel is put on your skin.
  • Do not cover with dressings.
  • This medicine has gotten in the eyes on accident even after hand washing. This includes when putting on make-up or putting in contact lenses. Do not put on make-up or put in contact lenses right after using Picato. Use care to avoid getting this medicine in the eyes.
  • If you get Picato in the eyes, flush right away with cool water and get medical help.
  • Do not get this medicine on other parts of your body or on other people.

What do I do if I miss a dose?

  • Put on a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not put on 2 doses or extra doses.

Dosage Information (comprehensive)

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of skin infection like oozing, heat, swelling, redness, or pain.
  • Skin ulcers.
  • Skin breakdown where Picato is used.
  • Dizziness or passing out.

What are some other side effects of Picato?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

  • Headache.
  • Nose and throat irritation.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at

Side Effects (complete list)

If OVERDOSE is suspected:

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

How do I store and/or throw out Picato?

  • Store in a refrigerator. Do not freeze.
  • Throw away any part not used after use.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Check with your pharmacist about how to throw out unused drugs.

Consumer Information Use and Disclaimer

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else's drugs.
  • Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
  • Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.
  • Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this medicine, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

This information should not be used to decide whether or not to take Picato or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Picato. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

Review Date: December 6, 2017