Permethrin cream 5%
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Cream containing 5% permethrin.
Drugs List
Therapeutic Indications
Uses
Pubic lice
Scabies
Dosage
Owing to variations in body types, sizes, a precise recommendation of dosage is not possible.
In cases where the head, neck, scalp and ears are treated (primarily children and elderly), the dosage may be increased to ensure total body coverage.
Permethrin cream is a vanishing cream, when rubbed into the skin it will disappear, therefore there is no need to continue to apply cream to the skin until it remains detectable on the surface.
Adults
Treatment of scabies
Apply up to a 30g tube in one single application to the entire body, including neck, palms and soles (exclude the head and face unless scabies efflorescences are in this area), ensuring the areas between the fingers and toes (including under the nails of the fingers and toes), wrists, elbows, armpits, external genitalia and the buttocks are included. Use on clean, dry, cool skin, allowing skin to cool down after a bath before applying.
Elderly patients should include the face, ears and scalp, taking caution in the areas of skin around the eyes.
More cream may be required depending on body size but no more than 60g in total should be used in one single application.
Wash the entire body 8 to 12 hours after application. If hands are washed before this time, reapply the cream to them.
A second application may be required not less than 7 days after the initial application if there are no signs of the original lesions healing or if there are signs of new lesions.
Treatment of crab lice
Apply up to a 30g tube to cover the pubic region, peri-anal, inner thighs down to the knees and any hair that grows up from the pubic area to the chest/stomach.
Apply to facial hair (beards/moustaches) if affected, avoiding eyes. Facial hair including eyelashes should be checked for live lice and eggs. If live lice are found in the eyelashes, these should be removed using tweezers as cream may cause eye irritation.
Leave on for 24 hours before washing off.
Children
Dose may vary according to brand.
Older children should be supervised by an adult when applying to ensure thorough treatment is administered. Children between 2 months and 2 years should be treated under medical supervision.
Treatment of scabies
Apply to the entire body including the palms, soles, face, neck, scalp, and ears.
Children over 12 years:
(See Dosage; Adults)
Children aged 6 to 12 years:
Apply up to 15g (1/2 of a 30g tube) in one single application.
Children aged 2 months to 5 years:
Apply up to 7.5g (1/4 of a 30g tube) in one single application. Avoid areas around the mouth where the child may lick the cream.
Contraindications
Children under 2 months
Precautions and Warnings
Children under 2 years
Breastfeeding
Pregnancy
Not all available brands are licensed for all indications
Some formulations contain cetostearyl alcohol
Some formulations contain lanolin
Avoid application to broken skin
Avoid contact with eyes
Avoid contact with mucous membranes
Avoid contact with the mouth
Breastfeeding: Wash product off breasts prior to breastfeeding infant
For topical use only
If accidental contact with the eyes occurs, rinse thoroughly with water
If required, re-apply provided 7 days have elapsed since last application
Scabies - re-apply treatment to hands after washing
Contact doctor immediately with any signs of hypersensitivity reactions
Male & female: May damage latex condoms and diaphragms
Advise patient residue on clothing/bedding may cause fire hazard
Fire hazard: Keep away from naked flames and potential sources of ignition
Supervise children under 12
The treatment of eczematous-like reactions with corticosteroids should be withheld prior to treatment with permethrin cream as there is a risk of exacerbating the scabies infestation by reducing the immune response to the mite.
Pregnancy and Lactation
Pregnancy
Use permethrin with caution during pregnancy.
The manufacturer advises caution when using permethrin during pregnancy. The amount of permethrin absorbed systemically is minimal. Some may cross the placental barrier. Negative mutagenicity tests and very low mammalian toxicity show there is minimal risk for the foetus. At the time of writing there is limited human data available. Risks are unknown.
Lactation
Use permethrin with caution in breastfeeding.
The manufacturer notes that it is not known if permethrin passes into human breast milk. Only a small amount is absorbed systemically after treatment and only a very small percentage may pass into the breast milk and it is unlikely that the concentrations of permethrin in the milk will present any risk to the infant. Studies following oral administration of permethrin in cattle have indicated that very low concentrations are excreted in the breast milk.
Side Effects
Burning sensation (local)
Contact dermatitis
Dry skin
Dyspnoea
Eczema
Erythema
Erythematous rash
Excoriation
Folliculitis
Headache
Hypopigmentation
Irritation (localised)
Local burning
Nausea
Oedema
Paraesthesia
Pruritus
Rash
Sensation of tingling
Stinging
Urticaria
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: February 2020
Reference Sources
Summary of Product Characteristics: Lyclear Dermal Cream. Omega Pharma Ltd. Revised August 2018.
Summary of Product Characteristics: Permethrin 5% w/w Cream. Sandoz Limited. Revised September 2019.
Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
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