permethrin (Rx, OTC)

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Brand and Other Names:Nix, Elimite, more...Acticin

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

cream

  • 5%

liquid

  • 1%

lotion

  • 1%
more...

Scabies

Cream: Apply from head to toe, leave on for 8-14 hr, rinse; may reapply in 7 days if live mites reappear

Single application usually curative

Head Lice & Nits (Eggs)

Lotion/cream rinse/liquid: apply to washed hair, leave on 10 min, rinse and comb out nits and eggs; may repeat in 7 days if lice or nits still present

Single application usually curative.

Dosage Forms & Strengths

cream

  • 5%

liquid

  • 1%

lotion

  • 1%
more...

Scabies & Head Lice

<2 months

  • Safety & efficacy not established

>2 months

  • Scabies: Apply cream from head to toe; leave on for 8-14 hr, rinse; may reapply in 7 days if live mites reappear; single application usually curative
  • Head Lice & Nits (Eggs): Apply lotion/cream/liquid to washed hair, leave on 10 min, rinse and comb out nits and eggs; may repeat in 7 days if lice or nits still present; single application usually curative
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Adverse Effects

1-10%

Mild and transient burning and stinging (10%)

Pruritus (7%)

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Warnings

Contraindications

Hypersensitivity

< 2 months of age (OTC)

Cautions

May exacerbates itching, swelling, and redness temporarily

For external use only

Avoid contact with eyes

May cause difficulty breathing or asthmatic attack in patients with ragweed allergies

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Pregnancy & Lactation

Pregnancy Category: B

Lactation: Not known if distributed in breast milk; may temporarily withhold the drug while the mother is nursing

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

more...
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Pharmacology

Mechanism of Action

Like natural pyrethrins, permethrin acts as a neurotoxin by depolarizing nerve cell membranes of parasites

The drug disrupts sodium ion influx through cell membrane channels by which membrane repolarization is regulated

Delayed repolarization results in paralysis of nerves in the exoskeletal respiratory muscles of parasite leading to death

Pharmacokinetics

Absorbed: Small amounts (< 2%)

Metabolism: Rapidly metabolized by ester hydrolysis to inactive metabolites

Excretion: Urine

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Formulary

FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

Adding plans allows you to:

  • View the formulary and any restrictions for each plan.
  • Manage and view all your plans together – even plans in different states.
  • Compare formulary status to other drugs in the same class.
  • Access your plan list on any device – mobile or desktop.

The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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