Elimite (permethrin) 5% cream is a topical prescription medication specifically formulated to treat scabies infestations. As a synthetic pyrethroid, it offers targeted neurotoxic action against Sarcoptes scabiei mites and their eggs, providing clinically validated eradication. This formulation is recognized in dermatological guidelines as a first-line scabicide due to its efficacy and favorable safety profile. Proper application under medical supervision ensures optimal therapeutic outcomes while minimizing risk of recurrence or resistance.

Features

• Contains 5% permethrin as the active pharmaceutical ingredient
• Topical cream formulation for direct cutaneous application
• Single-use tube sizes (typically 60g) sufficient for full-body coverage
• Prescription-only status ensuring medical oversight
• Stable emulsion base for uniform drug distribution
• Minimal systemic absorption with localized action
• Manufactured under cGMP compliance standards

Benefits

• Achieves complete eradication of scabies mites and eggs with single application in most cases
• Provides rapid relief from intense itching typically within 24-72 hours
• Minimizes risk of secondary bacterial infections from scratching
• Prevents household and community transmission when used correctly
• Offers convenient single-application protocol (with possible repeat dose)
• Reduces psychological distress associated with parasitic infestations

Common use

Elimite is primarily indicated for the treatment of scabies infestations caused by the mite Sarcoptes scabiei var. hominis. It may also be used off-label for resistant cases of pediculosis (lice infestations) under dermatological guidance. The medication is suitable for adults and children aged 2 months and older, with special consideration required for elderly patients or those with compromised skin barrier function.

Dosage and direction

Apply a thin layer of cream to clean, dry skin from the neck down, covering all body surfaces including intertriginous areas, finger webs, wrists, axillae, buttocks, and genitalia. Pay particular attention to areas with visible burrows or rash. Avoid application to face, eyes, nostrils, and mouth unless specifically directed for facial involvement. Leave on for 8-14 hours before thorough washing with soap and water. Most cases require only one treatment; a second application 7-14 days later may be recommended if new burrows appear. Clothing, bedding, and towels should be washed in hot water or sealed in plastic bags for 72 hours post-treatment.

Precautions

• Perform patch testing in patients with known sensitivity to pyrethroids or chrysanthemums
• Use with caution in patients with asthma or respiratory conditions due to potential aerosol exposure
• Avoid concurrent use with other topical medications unless directed by physician
• Do not apply to acutely inflamed or broken skin unless medically advised
• Pregnancy Category B: Use only if clearly needed after risk-benefit assessment
• Lactation: Permethrin is excreted in milk; exercise caution during breastfeeding
• Keep away from heat sources and open flames during application period

Contraindications

• Known hypersensitivity to permethrin, other pyrethroids, or any component of the formulation
• History of allergic contact dermatitis to synthetic pyrethroid compounds
• Concurrent use with other neurotoxic agents without medical supervision
• Application to neonates under 2 months of age (safety not established)

Possible side effects

Common (≥1%):

• Temporary burning, stinging, or tingling at application site
• Mild erythema or edema
• Pruritus (may persist temporarily post-eradication)
• Skin dryness or mild scaling

Less common (<1%):

• Allergic contact dermatitis
• Skin rash or urticaria
• Numbness or paresthesia
• Headache or dizziness
• Transient respiratory irritation if inhaled during application

Rare:

• Severe hypersensitivity reactions
• Worsening of existing skin conditions
• Systemic effects (with improper use or excessive application)

Drug interaction

No clinically significant pharmacokinetic interactions with systemically administered drugs have been documented. Potential interactions may occur with:

• Other topical scabicides or pediculicides (risk of cumulative toxicity)
• Topical corticosteroids (may enhance systemic absorption)
• Drugs that lower seizure threshold (theoretical risk with significant absorption)
• Hepatic enzyme inducers/ inhibitors (minimal concern due to low systemic levels)

Missed dose

As Elimite is typically administered as a single application, the concept of “missed dose” does not apply in conventional terms. If the application is washed off prematurely (before 8 hours), reapply immediately and maintain on skin for full 8-14 hour duration. If complete application was omitted, apply as soon as remembered unless close to time for repeat treatment.

Overdose

Excessive application may lead to increased systemic absorption. Symptoms may include:

• CNS effects: dizziness, headache, fatigue
• Gastrointestinal distress: nausea, abdominal pain
• Paresthesia or numbness
• Respiratory discomfort
• In severe cases: muscle tremors or seizures

Treatment involves immediate washing of skin, supportive care, and symptomatic management. There is no specific antidote; dialysis is not effective due to high protein binding.

Storage

Store at controlled room temperature (20-25°C/68-77°F). Do not freeze. Keep tube tightly closed when not in use. Protect from excessive heat and direct sunlight. Discard any unused product 30 days after opening. Keep out of reach of children and pets.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Elimite is a prescription medication requiring proper diagnosis and supervision by a qualified healthcare provider. Individual results may vary based on compliance, application technique, and specific clinical circumstances. Always follow your healthcare provider’s instructions regarding use, dosage, and precautions.

Reviews

Clinical studies demonstrate 85-95% cure rates with single application of permethrin 5% cream. Dermatological guidelines consistently rank permethrin as first-line therapy due to superior efficacy compared to crotamiton and benzyl benzoate. Patient satisfaction surveys indicate high acceptability despite temporary cutaneous sensations. Post-marketing surveillance confirms the established safety profile when used as directed. Resistance, while documented in some populations, remains relatively uncommon compared to other scabicides.