Nix Dermal Cream

Common Name

permethrin 5%

How does this medication work? What will it do for me?

Permethrin 5% belongs to a group of medications called synthetic pyrethroids, which are insecticides. Permethrin 5% works by paralyzing mites that cause scabies, killing them and their eggs. This product should get rid of scabies infestation after one application. However, skin itching may take up to 2 weeks to disappear after treatment.

A second application may be needed 7 to 10 days after the first treatment if you still see live scabies mites or new lesions on your skin.

Your doctor or pharmacist may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor or pharmacist.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor or pharmacist has not recommended it.

What form(s) does this medication come in?

Each g of off-white, vanishing dermal cream contains permethrin 50 mg (5%). Nonmedicinal ingredients: butylated hydroxytoluene, carbomer 934P, coconut oil, glycerin, glyceryl monostearate, isopropyl myristate, lanolin alcohols, mineral oil, polyoxyethylene cetyl ethers, purified water, and sodium hydroxide. Formaldehyde 1 mg (0.1%) added as preservative.

How should I use this medication?

For adults and children 12 years of age and older, the usual amount of cream needed per treatment is 30 g. For children 5 to 12 years of age, the usual amount of cream needed per treatment is 15 g, and for children 2 to 4 years of age is 7.5 g. If the head, neck, scalp, and outer ears require treatment, more cream may be needed to cover these areas.

For children 2 to 23 months of age, this medication should only be used when recommended by a doctor. The usual amount of cream needed per treatment is 3.25 g to 7.5 g.

To use the cream, massage the cream into the skin covering the entire area from the neck to the soles of the feet. Pay extra attention to the areas between the fingers and toes, underneath the fingernails and toenails, wrists, armpits, genital area, and buttocks. For infants 2 to 23 months of age, the cream should also be applied to the face, neck, scalp, outer ears, temples, and forehead (avoid the mouth area).

Be aware that the cream will disappear as it is absorbed into the skin, and it is not necessary to coat the skin in a visible layer. If you wash your hands within 8 hours of applying the cream, reapply the cream to the hands. After applying the cream, put on clean clothes and leave the cream on for 12 to 14 hours Then wash the cream off in the bath or shower, and put on a new set of clean clothes.

Most people do not need a second application. However, if live scabies mites or new lesions are seen on the skin 7 to 10 days after the first application, repent the process again.

Since scabies are spread through contact, family members and sexual partner(s) should be examined for scabies infestation. If they are infested, they should speak to their doctor or pharmacist immediately about using this product.

To prevent reinfestation, all clothing, bedding and towels used by an infested person 2 days before treatment should be machine-washed with hot water, and dried in the dryer on the hot cycle for at least 20 minutes, or dry-cleaned. Mattresses used by an infested person should not be used for 48 hours, and toilet seats and combs should be disinfected.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions and other medications. If your doctor or pharmacist has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor or pharmacist.

It is important that this medication be used exactly as recommended by your doctor or pharmacist.

Store this medication at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Permethrin 5% should not be used by anyone who is allergic or sensitive to permethrin, any synthetic pyrethroid or pyrethrins, ragweed, chrysanthemums, or to any of the ingredients of the medication.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is used in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• itching
• mild burning or stinging
• redness, numbness, tingling, or rash

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Accidental swallowing: Consult your doctor or a poison control centre immediately.

Eye irritation: If this product gets into your eyes, rinse with water immediately.

Symptoms: Symptoms of scabies infestation include itching, redness, and swelling. This product may temporarily make these symptoms worse. You may be itchy for weeks following treatment because eggs and fecal pellets might still be left behind in your skin. This does not mean you need to repeat the treatment. Only repeat the treatment if you see live mites or new lesions on your skin. If itching continues for more than 4 weeks, talk to your doctor or pharmacist.

Pregnancy: This product should only be used during pregnancy if the benefits outweigh the risks. Talk to your doctor or pharmacist before using this product.

Breast-feeding: It is not known if permethrin passes into the breast milk. If you are a breast-feeding mother and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of this medication has not been established for children less 2 two months old. Also talk to your doctor or pharmacist before using this product on a child that is under 2 years old.

What other drugs could interact with this medication?

There may be an interaction between permethrin 5% and any of the following:

• corticosteroids (e.g., hydrocortisone, betamethasone)

If you are using any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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