How does this medication work? What will it do for me?

Permethrin 5% belongs to a group of medications called synthetic pyrethroids, which are insecticides. Permethrin 5% works by paralyzing mites that cause scabies, killing them and their eggs. This medication works to get rid of scabies infestation, but skin itching may take up to 2 weeks to disappear after treatment.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor or pharmacist may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor or pharmacist.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor or pharmacist has not recommended it.

What form(s) does this medication come in?

Each g of off-white, vanishing dermal cream contains permethrin 50 mg (5%). Nonmedicinal ingredients: butylated hydroxytoluene, carbomer 974P, coconut oil, glycerin, glyceryl monostearate, isopropyl myristate, lanolin alcohols, mineral oil, polyoxyethylene cetyl ethers, purified water, and sodium hydroxide. Formaldehyde 1 mg (0.1%) added as preservative.

How should I use this medication?

For adults and children 12 years of age and older, the usual amount of cream needed per treatment is approximately one tube (30 g). For children 5 to 12 years of age, the usual amount of cream needed per treatment is ½ of a tube (15 g), and for children 2 to 4 years of age is ¼ of a tube (7.5 g). If the head, neck, scalp, and outer ears require treatment, more cream may be needed to cover these areas.

Before using this product, make sure that your skin is clean, dry, and cool. Do not take a hot bath or shower before using permethrin.

For the lotion form of this medication, shake the bottle before use. For both the lotion and the cream, massage the product into the skin covering the entire area from the neck to the soles of the feet. Pay extra attention to the areas between the fingers and toes, underneath the fingernails and toenails, wrists, armpits, genital area, and buttocks.

Do not apply permethrin to the head or face.

Permethrin will disappear as it is absorbed into the skin, and it is not necessary to coat the skin in a visible layer. If you wash your hands within 8 hours of applying the cream or lotion, reapply the product to the hands. After applying permethrin, put on clean clothes and leave the cream or lotion on for 12 to 14 hours. After this length of time, wash the permethrin off in the bath or shower, and put on a new set of clean clothes.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions and other medications. If your doctor or pharmacist has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor or pharmacist.

This medication often gets rid of a scabies infestation after one application. Most people do not need a second application.  need a second application. However, if you see live scabies mites or new lesions on your skin 7 to 10 days after the first application, a second application should be used, in the same manner as the first treatment.

If you are using any other topical medications or cosmetic products, discuss with your doctor or pharmacist whether you should continue to use them while you are using this medication. Most other products should be discontinued when using permethrin.

Since scabies are spread through contact, you should make sure that your family members and sexual partner(s) are examined for scabies infestation. If they are infested, they should speak to their doctor or pharmacist immediately about using this product.

To prevent reinfestation, all clothing, bedding and towels used by an infested person 2 days before treatment should be machine-washed with hot water, and dried in the dryer on the hot cycle for at least 20 minutes, or dry-cleaned. Mattresses used by an infested person should not be used for 48 hours, and toilet seats and combs should be disinfected.

It is important that this medication be used exactly as recommended by your doctor or pharmacist.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Permethrin 5% should not be used by anyone who is allergic or sensitive to permethrin, any synthetic pyrethroid or pyrethrins, ragweed, chrysanthemums, or to any of the ingredients of the medication.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is used in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • itching
  • mild burning or stinging
  • redness, numbness, tingling, or rash

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • skin puffiness
  • skin pain

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Accidental swallowing: Consult your doctor or a poison control centre immediately.

Eye irritation: If this product gets into your eyes, rinse with clear water immediately to minimize eye irritation.

Symptoms: Symptoms of scabies infestation include itching, redness, and swelling. This product may temporarily make these symptoms worse. You may be itchy for several weeks following treatment because eggs and fecal pellets might still be left behind in your skin. This does not mean you need to repeat the treatment. Only repeat the treatment if you see live mites or new lesions on your skin. If itching continues for more than 4 weeks, talk to your doctor or pharmacist.

Pregnancy: This medication should only be used during pregnancy if the benefits outweigh the risks. Talk to your doctor or pharmacist before using this product.

Breast-feeding: It is not known if permethrin passes into the breast milk. If you are a breast-feeding mother and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of this medication has not been established for children less than 2 two years of age. When using this medication on a young child, cover their arms and legs, hands and feet to prevent them from ingesting any medication from the skin.

Seniors: People over the age of 70 are more likely to have this medication absorbed through the skin, causing additional side effects. Talk to your doctor or pharmacist before using this product.

What other drugs could interact with this medication?

There may be an interaction between permethrin 5% and any of the following:

  • corticosteroids (e.g., hydrocortisone, betamethasone)

If you are using any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.