II. Mechanism
- Pyrethroid (Synthetic based on Pyrethrins)
- Neurotoxin
III. Indications
IV. Advantages
- Residual activity for over 2 weeks
V. Precautions
- Avoid in under age 2 months old
- Safe: Poorly absorbed
- Rapidly metabolized to inactive
VI. Pregnancy and Lactation
- Pregnancy Category B
-
Lactation safety is unknown
- Consider switching to formula while using Permethrin
VII. Preparations
- Permethrin 1% (Nix rinse supplied as 60 ml)
- Over the counter
- Permethrin 5% (Elimite supplied as 60 g cream)
- FDA indication only for Scabies
VIII. Dosing
-
Scabies treatment (Permethrin 5%)
- Apply Permethrin 5% cream from head to soles of feet
- Adults and children over age 5 years apply from neck down
- Consider forhead application in the elderly
- Avoid Mouth, nose and eyes
- Wash after 8-14 hours
- Repeat application in 1-2 weeks
- Apply Permethrin 5% cream from head to soles of feet
-
Lice treatment (Permethrin 1%)
- Apply to clean dry hair
- Saturate hair and scalp
- Wash after 10 minutes
- Consider overnight treatment
- Leave on overnight for 8-14 hours under shower cap
- Rinse hair in morning
- Repeat in one week
IX. Supply
- Adult: 60 grams per adult per treatment (120 g total)
- Child: 30 grams per child per treatment (60 g total)
X. Efficacy
- Resistance increasing to 1% Permethrin
- Lice Treatment may require 5% Permethrin
XI. Adverse Effects
- See Pyrethrin
- Mild transient burning, Paresthesias or Pruritus at the application site
- Local erythema may occur
XII. References
- Marco (2013) Crit Dec in Emerg Med 27(1): 2-7
- Mumcuoglo (1995) Med Vet Entomol, 9:427 [PubMed]
- Rupes (1995) Cent Eur J Public Health, 3:30 [PubMed]
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| permethrin (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| PERMETHRIN 5% CREAM | Generic | $0.83 per gram |
Ontology: Permethrin (C0070455)
| Definition (NCI) | A synthetic pyrethroid and neurotoxin. Permethrin affects the neuronal membrane by blocking the movement of sodium ions from outside to inside the neuronal cell membrane thereby disrupting the sodium channel current that regulates the polarization of the membrane. This leads to delayed repolarization and subsequent paralysis of the nervous system. Permethrin is used to eradicate parasites such as head lice, ticks and scabies from humans and animals. |
| Definition (MSH) | A pyrethroid insecticide commonly used in the treatment of LICE INFESTATIONS and SCABIES. |
| Concepts | Organic Chemical (T109) , Pharmacologic Substance (T121) , Hazardous or Poisonous Substance (T131) |
| MSH | D026023 |
| SnomedCT | 1887004, 410457007 |
| English | cyclopropanecarboxylic acid, 3-(2,2-dichloroethenyl)-2,2-dimethyl-, (3-phenoxyphenyl)methyl ester, permethrin (medication), scabicides permethrin, Permethrin [Chemical/Ingredient], PERMETHRIN, (+/-)-3-Phenoxybenzyl 3-(2,2-Dichlorovinyl)-2,2-Dimethylcyclopropanecarboxylate, Cyclopropanecarboxylic Acid, 3-(2,2-Dichloroethenyl)-2,2-Dimethyl-, (3-Phenoxyphenyl)Methyl Ester, M-Phenoxybenzyl (+/-)-3-(2,2-Dichlorovinyl)-2,2-Dimethylcyclopropanecarboxylate, (m-Phenoxybenzyl)-cis,trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropanecarboxylate, 3-Phenoxybenzyl-(+-)-cis,trans-2,2-dichlorovinyl-2,2-dimethyl-cyclopropylcarboxylic acid, ester, 3-Phenoxybenzyl-cis,trans-(1RS)-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropanecarboxylate, permethrin, Permethrin (product), Permethrin, Permethrin (substance) |
| Swedish | Permetrin |
| Czech | permethrin |
| Finnish | Permetriini |
| Russian | PERMETRIN, ПЕРМЕТРИН |
| Japanese | ペルメトリン |
| Polish | Permetryna |
| Spanish | permetrina (producto), permetrina, permetrina (sustancia), Permetrina |
| French | Perméthrine |
| German | Permethrin |
| Italian | Permetrina |
| Portuguese | Permetrina |
Ontology: Pyrethroids (C0597329)
| Definition (CSP) | active insecticidal constituents of pyrethrum (Chrysanthemum cinerariifolum) flowers. |
| Concepts | Hazardous or Poisonous Substance (T131) , Organic Chemical (T109) , Pharmacologic Substance (T121) |
| MSH | D011722 |
| SnomedCT | 311846002 |
| English | pyrethroid, Pyrethroids, pyrethroids, Pyrethroid insecticide, Pyrethroid insecticide (substance) |
| French | Pyréthrinoïdes, Pyréthroïdes |
| Spanish | piretroide, insecticida (sustancia), piretroide, insecticida |
Ontology: Elimite (C0720177)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D026023 |
| English | elimite, Elimite |
Ontology: BNIP3L gene (C1332435)
| Definition (NCI) | This gene is involved in the regulation of apoptosis and induces cell death. |
| Concepts | Gene or Genome (T028) |
| English | BCL2/ADENOVIRUS E1B 19-KD PROTEIN-INTERACTING PROTEIN 3-LIKE, NIX, BNIP3L, BCL2/adenovirus E1B 19kDa interacting protein 3-like, BNIP3a, Nix, BNIP3L gene, BCL2/Adenovirus E1B 19kd Interacting Protein 3-Like Gene, BNIP3L Gene |
