Elimite, Nix, Acticin
Generic Name
permethi
Manufacturer
Various Generic Manufacturers
Country
Global (manufactured worldwide)
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Description
Overview of the medicine
Permethrin is a synthetic pyrethroid insecticide used topically to treat infestations of scabies mites and lice (head lice, pubic lice) on the skin and hair.
Uses & Indications
Dosage
Adults
Scabies (5% cream): Apply cream to entire body from head to soles of feet. Leave on for 8-14 hours, then wash off. One application is usually sufficient, but a second application may be needed after 7-14 days. Head/Pubic Lice (1% lotion/cream): Apply to affected hair and scalp/pubic area. Leave on for 10 minutes, then rinse off. Repeat after 7-10 days if live lice are still present.
Elderly
Same as adults for topical application. Caution with fragile skin.
Renal_impairment
No specific dosage adjustment required for topical application due to minimal systemic absorption.
How to Take
For topical use only. Apply to clean, dry skin or hair as directed. Avoid contact with eyes, nose, mouth, and other mucous membranes. Wash hands thoroughly after application.
Mechanism of Action
Permethrin acts as a neurotoxin to parasites by disrupting the sodium channel current that regulates the polarization of the nerve cell membrane. This leads to delayed repolarization and subsequent paralysis and death of the parasites.
Pharmacokinetics
Onset
Rapid onset of action, killing parasites on contact.
Excretion
Metabolites are primarily excreted in the urine.
Half life
If absorbed, systemic half-life is approximately 11-12 hours.
Absorption
Minimally absorbed systemically (less than 2%) after topical application to the skin. Absorption may be higher in infants or on broken skin.
Metabolism
Rapidly metabolized by ester hydrolysis to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to permethrin, other pyrethroids, or any component of the formulation.
- Patients with asthmatic bronchitis or other respiratory conditions should use 1% products cautiously due to potential for inhalation if sprayed.
Drug Interactions
Other Topical Preparations
Avoid concomitant use of other topical medications on the same area as it may alter absorption or efficacy, though specific interactions are unlikely given permethrin's minimal systemic absorption.
Storage
Store at controlled room temperature (20-25°C or 68-77°F). Protect from freezing. Keep out of reach of children.
Overdose
Topical overdose is unlikely to cause systemic toxicity due to minimal absorption. If excessive amounts are applied, wash off with warm water and soap. In case of accidental ingestion, symptomatic and supportive treatment should be initiated. Contact a poison control center.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have shown no evidence of impaired fertility or harm to the fetus. Permethrin is minimally absorbed, so systemic exposure to the fetus is expected to be very low. Use during pregnancy only if clearly needed. It is not known if permethrin is excreted in human milk; however, due to minimal systemic absorption, adverse effects on breastfed infants are unlikely. Use with caution during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date, check product label for specific expiry.
Availability
Pharmacies, drugstores
Approval Status
FDA Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Permethrin has undergone extensive clinical trials demonstrating its efficacy and safety for treating scabies and lice. It is a well-established and WHO-recommended treatment.
Lab Monitoring
- No specific lab monitoring is required for topical permethrin.
Doctor Notes
- Emphasize proper application technique and duration of treatment.
- Advise patients on environmental disinfection (washing clothes, bedding) to prevent re-infestation.
- Instruct patients to seek medical advice if irritation persists or if re-infestation occurs after appropriate treatment.
Patient Guidelines
- Follow application instructions carefully, ensuring complete coverage of affected areas.
- Avoid contact with eyes and mucous membranes.
- Do not swallow or ingest permethrin.
- Wash hands thoroughly after application.
- For head lice, re-treat after 7-10 days if live lice are still seen.
Missed Dose Advice
Permethrin is typically applied as a single or limited number of applications. If a dose is missed for a multi-application regimen (e.g., for severe cases or re-infestation), apply it as soon as remembered and continue the prescribed schedule. Do not apply more frequently than recommended.
Driving Precautions
Permethrin is not expected to affect the ability to drive or operate machinery, as it is applied topically with minimal systemic absorption.
Lifestyle Advice
- Wash all clothing, bedding, and towels that have been in contact with the infected person in hot water.
- Vacuum carpets and upholstered furniture thoroughly. Seal non-washable items in plastic bags for at least 2 weeks.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.