Permethrin


Generic Medicine Info
Indications and Dosage
Topical/Cutaneous
Head pediculosis
Adult: As 1% cream rinse or lotion: Before application, wash hair with a mild regular shampoo and towel dry. Apply sufficient amount to completely saturate the hair and scalp (especially behind the ears and nape of the neck). Leave on the hair for 10 minutes then rinse thoroughly with water; remove nits with fine-toothed comb as necessary. May repeat treatment 7-10 days after initial application if live lice or nits are found. Dosage and treatment recommendations may vary among individual products or between countries (refer to detailed product guideline).

Topical/Cutaneous
Scabies
Adult: As 5% cream: Apply a thin layer of up to 30 g to the whole body including the neck, palms of the hands and soles of the feet. The head and face may be left untreated unless indicated. As 5% lotion: Apply up to 50 mL from the neck to the soles of the feet. Re-apply if the cream or lotion on hands is washed with soap and water within 8 hours during the treatment period. Leave on the skin for approx 8-14 hours before washing off thoroughly. Generally, a single application is curative; but may repeat treatment at least 7 days after initial application if original lesions have no signs of healing, if live mites are present, or new skin lesions appear. Alternatively, re-treatment may be needed 14 days after 1st therapy if living mites are present. Dosage and treatment recommendations may vary among individual products or between countries (refer to detailed product guideline).
Child: As 5% cream: 2 months to <1 year Up to 3.75 g; ≥1-5 years Up to 7.5 g; 6-12 years Up to 15 g; >12 years Same as adult dose. As 5% lotion: 2 months to 1 year Up to 1/8 of a 50 mL bottle; 2-5 years Up to 1/4 of a 50 mL bottle; 6-12 years Up to 1/2 of a 50 mL bottle; >12 years Same as adult dose. Apply thinly to the whole body including the neck, palms of hands and soles of feet; infants should also be treated on the scalp, hairline, temple, ears, forehead and face. Leave on the skin for approx 8-14 hours before washing off thoroughly. Generally, a single application is curative; but may repeat treatment at least 7 days after initial application if original lesions have no signs of healing, if live mites are present, or new skin lesions appear. Alternatively, re-treatment may be needed 14 days after 1st therapy if living mites are present. Dosage and treatment recommendations may vary among individual products or between countries (refer to detailed product guideline).
Elderly: As 5% cream: Same as adult dose. Additionally, apply a thin layer on the scalp, hairline, forehead, temple, ears or face.

Topical/Cutaneous
Pediculosis pubis
Adult: As 5% cream: Apply sufficient amount (up to 30 g) to cover the pubic and peri-anal area, inner thighs down to the knee, and any hair that grows from the pubic area up to the stomach or chest. Allow the cream to dry then wash off thoroughly after 12 hours or after leaving on overnight. Dosage and treatment recommendations may vary among individual products or between countries (refer to detailed product guideline).
Contraindications
Hypersensitivity to permethrin, other pyrethroids, or pyrethrin.
Special Precautions
Scabies therapy: Persistent pruritus may be experienced after treatment; this reaction is usually not a sign of treatment failure and not a cause for re-treatment. Children (≥2 months) and elderly. Pregnancy and lactation.
Adverse Reactions
Significant: Hypersensitivity reactions; may temporarily exacerbate symptoms, such as oedema, that accompany scabies (5% cream).
General disorders and administration site conditions: Application site reactions (e.g. transient burning, numbness, stinging or tingling sensation).
Nervous system disorders: Paraesthesia.
Skin and subcutaneous tissue disorders: Pruritus, erythema, dry skin, rash.
Patient Counseling Information
Avoid contact with eyes or mucous membranes, or the area around the mouth (in children). Scabies therapy: As 5% cream/lotion: Do not go on a warm/hot bath before treatment; allow the skin to cool down prior to application. Carefully treat areas between skin folds or creases (e.g. between fingers and toes, wrist or waist folds, armpits, cleft of buttocks).
Drug Interactions
Concomitant use with corticosteroids may increase the risk of exacerbating scabies infestation; hold corticosteroids before starting permethrin treatment.
Action
Description: Permethrin is a pyrethroid scabicide and pediculicide. It disrupts Na ion influx through the nerve cell membrane channels in parasites which causes delayed repolarisation and eventual paralysis and death of the pest.
Pharmacokinetics:
Absorption: Minimal systemic absorption (≤2%) after topical administration.
Metabolism: Rapidly metabolised in the liver via ester hydrolysis to form inactive metabolites.
Excretion: Via urine.
Chemical Structure

Chemical Structure Image
Permethrin

Source: National Center for Biotechnology Information. PubChem Database. Permethrin, CID=40326, https://pubchem.ncbi.nlm.nih.gov/compound/Permethrin (accessed on Jan. 22, 2020)

Storage
Cream: Store between 15-25°C. Do not freeze. Cream rinse: Store between 20-25°C. Lotion: Store below 30°C. Protect from light.
ATC Classification
P03AC04 - permethrin ; Belongs to the class of pyrethrines, including synthetic compounds used as ectoparasiticides.
References
A Scabs (Taisho Pharmaceutical [H.K.] Ltd). MIMS Hong Kong. http://www.mims.com/hongkong. Accessed 10/05/2021.

A-Lices Lotion (HOE Pharmaceuticals Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 14/06/2021.

Anon. Permethrin (Topical). AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 14/06/2021.

Anon. Permethrin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 10/05/2021.

Buckingham R (ed). Permethrin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 10/05/2021.

Glenper Cream 5% (Glenmark Pharmaceuticals Ltd.). MIMS Myanmar. http://www.mims.com/myanmar. Accessed 10/05/2021.

Joint Formulary Committee. Permethrin. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 10/05/2021.

Lyclear Creme Rinse (Omega Pharma Ltd.). MHRA. https://products.mhra.gov.uk. Accessed 10/05/2021.

Lyclear Dermal Cream (Omega Pharma Ltd). MHRA. https://products.mhra.gov.uk. Accessed 10/05/2021.

Nix Creme Rinse (Insight Pharmaceuticals LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 14/06/2021.

Permethrin 5% w/w Cream (Sandoz Limited). MHRA. https://products.mhra.gov.uk. Accessed 14/06/2021.

Permethrin Cream (Actavis Pharma, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 10/05/2021.

Permethrin Lotion 5% w/w (GlaxoSmithKline Consumer Healthcare [UK] Trading Limited). MHRA. https://products.mhra.gov.uk. Accessed 10/05/2021.

Disclaimer: This information is independently developed by MIMS based on Permethrin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 MIMS. All rights reserved. Powered by MIMS.com
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