Permethrin

These indications are based on manufacturer information for both originator and generic products. For product specific indications, please refer to product specific manufacturer information

South African indications:

• Infestations caused by Sarcoptes scabiei (scabies)

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients

Cautions

• Breastfeeding
• Contact with eyes
• Flammable

Forms avail. in SA and covered in this monograph: lot

Dosages below include:

• South African Standard Treatment Guideline indications and dosages

Infections caused by Sarcoptes scabiei

Specific doses based on individual indications

Please note that the dosages below should be used in combination with regional guidelines, taking into account local antibiotic sensitivities

South African Standard Treatment Guideline indications and dosages

Scabies
- If benzyl benzoate is unsuccessful

• Topical (lot): Apply undiluted to the whole body from neck to feet and leave on overnight (8–12hrs); Wash off the following morning
  (STG, PHC 2020)

Head lice

• Topical (lot): Apply to towel-dried or dry hair and comb into hair repeatedly with a normal comb until scalp is covered completely (for up to 1hr); Repeat every 5 days; Treatment duration: 3 weeks
  (STG, PHC 2020)

Paed. forms avail. in SA and covered in this monograph: lot

Paed. dosages below include:

• South African Standard Treatment Guideline indications and dosages

Infections caused by Sarcoptes scabiei

Specific doses based on individual indications

Please note that the dosages below should be used in combination with regional guidelines, taking into account local antibiotic sensitivities

South African Standard Treatment Guideline indications and dosages

Scabies
Head lice

• See adult dosage
  (STG, PHC 2020)

Pregnancy

• Safe; no evidence of risk in studies
• Reproduction studies have been performed in mice, rats and rabbits (200 - 400 mg/kg/day orally) and have revealed no evidence of impaired fertility or harm to the foetus due to permethrin. There are however, only very limited data on the use of permethrin in pregnant women. Because animal studies are not always predictive of the human response. Treatment should be considered during pregnancy only if clearly needed

Breastfeeding

• Caution
• Studies following oral administration of permethrin in cattle have indicated that very low concentrations of permethrin are excreted in milk. However, it is not known whether permethrin is excreted in human milk. Whilst it is unlikely that the concentrations of permethrin in the milk will present any risk to the infant, consideration should be given to withholding treatment during nursing or temporarily discontinuing nursing

Renal Impairment

• No dose adjustment recommended

Hepatic Impairment

• No dose adjustment recommended

Elderly

• No dose adjustment recommended

Porphyria Information

• Probably not porphyrinogenic (PNP)

Drugs in Sport

• Permitted - No warnings

Skin and Subcutaneous Tissue Disorders

• Skin burning
• Pruritus
• Skin stinging
• Skin redness

Corticosteroids

None routine

The principal physiological action in susceptible parasites exposed to permethrin is induction of electrochemical abnormalities across the membranes of excitable cells, leading to sensory hyper-excitability, inco-ordination and prostration. 

Permethrin is available in several formulations. Please note the list below gives examples of products which are available and is not necessarily comprehensive. The listing of a product does not constitute endorsement of the product by EMGuidance; likewise, failure to list a product does not imply that EMGuidance disapproves of the product. This information is put together on the basis of the National Government's Medicines Price Registry at the time of publication

Lotion (per g) 50mg

• Skabi-Rid (TomarMed)