(per meth' rin)

Brand Name(s): Elimite^®, Nix^®; also available generically

WHY is this medicine prescribed?

Permethrin is used to treat scabies ('mites that attach themselves to the skin) in adults and children 2 months of age and older. Over-the-counter permethrin is used to treat lice (small insects that attach themselves to the skin on the head) in adults and children 2 months of age and older. Permethrin is in a class of medications called scabicides and pediculicides. It works by killing lice and mites.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Permethrin comes as a cream to apply to the skin. Over-the-counter permethrin comes as a lotion to apply to the scalp and hair. Permethrin cream is usually applied to the skin in one treatment, but occasionally a second treatment is necessary. Permethrin lotion is usually applied to the skin in one or two treatments, but occasionally three treatments are necessary. If live mites are seen two weeks (14 days) after the first treatment with permethrin cream, then a second treatment should be applied. If live lice are seen one week after the first treatment with over-the-counter permethrin lotion, then a second treatment should be applied. Follow the directions on your prescription label or the package label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use permethrin exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Permethrin should only be used on the skin or hair and scalp. Avoid getting permethrin in your eyes, nose, ears, mouth, or vagina. Do not use permethrin on your eyebrows or eyelashes.

If permethrin gets in your eyes, flush them with water right away. If your eyes are still irritated after flushing with water, call your doctor or get medical help right away.

To use permethrin cream, follow these steps:

1. Apply a thin layer of cream all over your skin from your neck down to your toes (including the soles of your feet). Be careful to apply cream in all skins folds, such as between your toes and fingers or around your waist or buttocks.
2. For treatment of babies or adults over 65 years of age, the cream should also be applied to the scalp or hairline, temples, and forehead.
3. You may need to use all of the cream in the tube to cover your body.
4. Leave the cream on your skin for 8-14 hours.
5. After 8-14 hours have passed, wash off the cream by bathing or showering.
6. Your skin may be itchy after treatment with permethrin cream. This does not mean your treatment did not work. If you see live mites 14 days or more after treatment, then you will need to repeat the treatment process.

To use the lotion, follow these steps:

1. Wash your hair with shampoo and rinse with water. Do not use a conditioner or a shampoo that contains a conditioner because your treatment will not work as well.
2. Dry your hair with a towel until just damp.
3. Shake permethrin lotion well right before use to mix the medication evenly.
4. Use a towel to cover your face and eyes. Be sure to keep your eyes closed during this treatment. You may need to have an adult help you apply the lotion.
5. Apply permethrin lotion to your hair and scalp area. Begin to apply the lotion behind your ears and at the back of your neck and then cover all of the hair on your head and scalp.
6. Keep the lotion on your hair and scalp for 10 minutes after you finish applying permethrin lotion. You should use a timer or clock to track the time.
7. Rinse your hair and scalp with warm water in a sink. You should not use a shower or bathtub to rinse the lotion away because you do not want to get the lotion over the rest of your body.
8. Dry your hair with a towel and comb out tangles.
9. You and anyone who helped you apply the lotion should wash your hands carefully after the application and rinsing steps.
10. A lice comb may also be used to remove the dead lice and nits (empty egg shells) after this treatment. You may also need to have an adult help you to do this.
11. If you see live lice on your head 7 days or more after treatment, repeat this entire process.

After using permethrin, sanitize all the clothing, underwear, pajamas, hats, sheets, pillowcases, and towels you have used recently. These items should be washed in very hot water or dry-cleaned. You should also wash combs, brushes, hairs clips and other personal care items in hot water.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

What SPECIAL PRECAUTIONS should I follow?

Before using permethrin,

• tell your doctor and pharmacist if you are allergic to permethrin, pyrethrins (A-200, Licide, Pronto, RID), ragweed, any other medications, or any of the ingredients in permethrin cream or lotion. Ask your pharmacist for a list of the ingredients.

• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.

• tell your doctor if you have or have ever had skin conditions or sensitivities.

• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using permethrin, call your doctor.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What SIDE EFFECTS can this medicine cause?

Permethrin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• itching of skin or scalp area
• redness of skin or scalp area
• numbness or tingling of the skin
• rash

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

• trouble breathing
• continued irritation of the skin or scalp area
• infected or pus filled areas of the skin or scalp area

Permethrin may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

What should I do in case of OVERDOSE?

If someone swallows permethrin, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What OTHER INFORMATION should I know?

Do not let anyone else use your permethrin cream. Your prescription for permethrin cream is probably not refillable. If you feel you need additional treatment, call your doctor.

Ask your pharmacist any questions you have about permethrin lotion.

Lice are generally spread by close head-to-head contact or from items that come in contact with your head. Do not share combs, brushes, towels, pillows, hats, helmets, headphones, scarves, or hair accessories. Be sure to check everyone in your immediate family for head lice if another family member is being treated for lice.

If you have scabies, tell your doctor if you have a sexual partner. This person should also be treated.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™. © Copyright, 2024. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: January 15, 2018.