Scabies
This lotion is indicated for the treatment of scabies and pruritus.
Permethrin is a pyrethroid pediculocide and scabicide. It causes paralysis and death of the pest by inhibiting sodium ion influx through nerve cell membrane channels delaying repolarisation.
Crotamiton has scabicidal and antipruritic action against Sarcoptes scabei. It is an effective pediculocide as well.
Adult: Permethrin & Crotamiton lotion is suitable for adults, children of 2 months of age and above, and the elderly. It is for external use only and should not be applied to broken skin, mucous membranes or near the eyes. Permethrin & Crotamiton lotion should be applied to skin which is clean, dry and cool. It should not be used immediately after a hot bath. Permethrin & Crotamiton lotion is intended for a single application over the whole body. Permethrin & Crotamiton lotion should be left on for at least 8 hours. Reapply the lotion to the hands if they are washed within 8 hours of treatment. The whole body should be washed thoroughly 8-12 hours after application. Adults & children over 2 years: Apply the lotion over the whole body but not the head and face. Pay particular attention to the areas between fingers and toes, under nails, wrists, armpits, external genitalia, breasts and buttocks.
The elderly: Apply the lotion over the whole body including the neck, face, ears and scalp. Pay particular attention to the areas between fingers and toes, under nails, wrists, armpits, external genitalia, breasts and buttocks. Avoid the area close to the eyes.
Children under 2 years: Children under 2 years should only be treated under medical supervision. Apply the lotion over the whole body including the neck, face, ears and scalp. Pay particular attention to the areas between fingers and toes, under nails, wrists, armpits, palms of hands and soles of feet, external genitals and buttocks. Avoid the area around the mouth where the lotion could be licked off and the area around the eyes
Lotion should be applied to clean, dry skin. If the body is hot due to warm bath or any other reason, skin should be allowed to cool. It should be applied to the whole body excluding head. The whole body should be washed thoroughly 8-12 hours after treatment. On the next day cloths and bed sheets should be cleaned with warm water. The lotion should be applied if lotion is washed out by water. Other members of the family should use this lotion as preventive in the same way due to its highly contagious effects. The lotion should not be applied to the vicinity of mouth and areas close to eyes.
The treatment of eczematous-like reactions with corticosteroids should be withheld prior to treatment with permethrin, as there is a risk of exacerbating the scabies infestation by reducing the immune response to the mite. The likelihood of interactions between the two treatments leading to potentiated adverse reactions or reduced efficacy is, however small.
Combination of permethrin 5% and crotamiton 10% is contra-indicated in patients with known hypersensitivity to permethrin or crotamiton.
Occasional reports of burning or stinging sensation which passes quickly. This is usually mild and occurs more frequently in patients with severe scabies. Transient signs and symptoms of skin irritation including rash or itching, erythema, edema and eczema. These are generally considered to be part of the natural history of scabies.
There is no experience to judge the safety of permethrin & crotamiton in pregnancy, therefore it is not recommended during pregnancy, especially in the first three months. It is not known whether the active substance passes into breast milk. Nursing mothers should avoid applying it in the area of the nipples.
This lotion should be kept out of the reach of children. This lotion is for external use only. Nursing staff who routinely apply this lotion may wish to wear gloves to avoid any possible irritation to the hand. Avoid contact with the eyes. The lotion can cause eye irritation. If lotion goes to the eyes, rinse with water immediately.
Local Antipruritic, Parasiticidal preparations
There are no reports of overdosage of permethrin & crotamiton. Excessive application to the skin might result in local adverse reactions. In the event of accidental ingestion by a child, gastric lavage should be considered if within 2 hours of ingestion. Treatment of hypersensitivity reactions should be symptomatic.
Store in a cool place (do not store above 25° C & do not freeze) and protected from light.