Permethrin
 Permethrin

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|Permethrin Permethrin

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Permethrin

Pronouncation: (per-METH-rin)
Class: Scabicides, Pediculicides

Trade Names:
Acticin
- Cream 5%

Trade Names:
Elimite
- Cream 5%

Trade Names:
Permethrin
- Lotion 1%

Trade Names:
Nix Cream Rinse
- Liquid 1%

Nix Creme Rinse (Canada)
Nix Dermal Cream (Canada)

Mechanism of Action

Pharmacology

Acts on the nerve cell membrane to disrupt the sodium channel current by which the polarization of the membrane is regulated. Delayed repolarization and paralysis of the pests is the outcome.

Pharmacokinetics

Metabolism

Rapidly metabolized by ester hydrolysis to inactive metabolites.

Elimination

Excreted primarily in the urine.

Indications and Usage

Cream

Treatment of scabies ( Sarcoptes scabiei ) infestation.

Lotion/Cream rinse

Treatment of infestation with head lice ( Pediculus humanus capitis ) and its nits (eggs).

Liquid

Treatment of infestation with Pediculus humanus var. capitis (head louse) and its nits (eggs).

Contraindications

Standard considerations.

Dosage and Administration

Scabies

Cream Massage 30 g into the skin from head to soles of feet. Massage into hairline, neck, temple, and forehead of infants and geriatric patients. Remove cream by shower or bath after 8 to 14 hr. One application is generally curative.

Head Lice

Lotion/Cream rinse Apply to hair after washing with shampoo; rinse with water and towel dry. Apply a sufficient amount to saturate hair and scalp, especially behind the ears and nape of neck. Leave on hair for no longer than 10 min, then rinse with water. If lice are observed within 7 days after application, apply a second treatment. Remove remaining nits with nit comb provided.

General Advice

  • For topical use only. Not for ophthalmic, oral, or intravaginal use.
  • Avoid contact with eyes. If eye contact occurs, flush immediately and thoroughly with water.

Storage/Stability

Store at controlled room temperature (59° to 77°F).

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

CNS

Cream

Dizziness (5%), headache, seizure (rare) (postmarketing).

Dermatologic

Cream

Mild transient burning/stinging (10%); itching (7%); tingling, numbness, erythema, rash (2% or less).

Lotion/Cream rinse

Itching, redness, swelling of scalp.

GI

Cream

Abdominal pain, diarrhea, nausea, vomiting (5% [postmarketing]).

Miscellaneous

Cream

Fever (5% [postmarketing]).

Precautions

Pregnancy

Category B .

Lactation

Undetermined.

Children

Safety and efficacy established in patients greater than or equal to 2 mo.

Asthmatics

May cause breathing difficulties or exacerbate asthmatic episodes.

Dermatological effects

Elimite may temporarily exacerbate pruritus, edema, and erythema and is rarely a sign of treatment failure.

Patient Information

  • Explain name, dose, action, and potential side effects of drug.
  • Caution patient or caregiver to avoid contact with eyes and if accidental eye contact occurs, immediately flush the eyes with water to remove medication. Advise patient or caregiver to notify health care provider if eye irritation or sensitivity follows exposure to the eyes.
  • Teach patient or caregiver proper technique for applying cream: wash hands; use gloves if applying to another person; thoroughly massage cream into skin from the head to the soles of the feet; 8 to 14 hr after application, remove cream by washing (shower or bath).
  • Advise patient or caregiver that itching, mild burning, and/or stinging may occur after application of cream but that this should go away in 2 to 4 wk. If irritation persists, advise patient to notify health care provider.
  • For proper nit removal, wash all personal articles and clothing (eg, coats, linen, combs, headgear) in hot water or seal in a plastic bag for approximately 2 wk. Thorough vacuuming of rooms is recommended.
  • Advise patient to discontinue use and consult health care provider if irritation persists or infection is present or develops.
  • Consult health care provider if infestation of eyebrows or eyelashes occur.
  • Advise patient or caregiver that follow-up visits may be necessary and to keep appointments.




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