Drug Uses

Elimite is used for the treatment of scabies.

How Taken

Massage the skin from the head to the soles of the feet with Elimite. 30 grams should be sufficient for an application. Wash the cream off after 8 to 14 hours. Do not apply to open cuts or wounds. This could cause too much medication to be absorbed by your body. Talk to your doctor before taking this medicine if you are breast-feeding. Elimite may pass into breast-milk.

Warnings/Precautions

Do not apply this medication to the eyes, nose, or mouth. Use water to wash it off immediately if this happens. You should avoid sexual contact with others until the infection has been cured.

Missed Dose

Elimite is applied only once so it is unlikely for you to miss a dose.

Possible Side Effects

Notify your doctor if any of the following side effects occur: itching, burning or stinging, tingling, numbness, redness, swelling, or rash.

Storage

Store at 15° to 25°C (59° to 77°F). Keep out of the reach of children.

Overdose

Excessive use of this medicine may result in increased irritation and erythema. Contact your doctor if you suspect an overdose.

More Information

To prevent reinfection, thoroughly wash all clothing, hats, bed clothes, bed linens, hair brushes, or combs that might have been previously infected.

Disclaimer

This drug information is for your information purposes only, it is not intended that this information covers all uses, directions, drug interactions, precautions, or adverse effects of your medication. This is only general information, and should not be relied on for any purpose. It should not be construed as containing specific instructions for any particular patient. We disclaim all responsibility for the accuracy and reliability of this information, and/or any consequences arising from the use of this information, including damage or adverse consequences to persons or property, however such damages or consequences arise. No warranty, either expressed or implied, is made in regards to this information.

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Q: What happens when I submit my Elimite order?
A: Your order is dispatched through our order system to a licensed physician who will review the information you have submitted and approve or decline your request of Elimite. When your order is approved, the physician will then write your prescription and our ordering system will ensure that it is sent to the pharmacy where it will be filled and shipped.


Treatment Options for Scabies
The most appropriate treatment will generally be a topical medication or cream containing
permethrin, lindane, or crotamiton. The following treatment considerations are provided for
informational purposes only.
• Topical medications - ensure thorough application of topical scabicides, including within
severe contractures and skin folds of patients.
o 5% permethrin cream (Elimite, Nix) is the medication most commonly used to
kill scabies mites. This medication is safe for use in children as young as two
months of age, pregnant and lactating women, and the elderly.
?? After bathing or showering, the cream should be applied over the entire
body, from the chin down to, and including, the soles of the feet. Include
the scalp, face and neck in children less than five years of age. It should
be left on for 8-14 hours and then rinsed off by bathing. It is best to apply
at bedtime and then wash off in the morning. The treatment should be
repeated in 1 week since treatments may not be ovicidal (i.e., kill the mite
eggs).
o Other options include:
- 1% lindane (Kwell) is rarely used because of its limited safety profile: do
not use lindane in persons who are less than 10 years of age, weigh less
than 50 kg, who are immunocompromised, pregnant or lactating, who
have a known seizure disorder, or who have extensively broken, denuded
or excoriated skin. In addition, scabies resistance to lindane has been
reported in some areas of the world, including parts of the United States.
It should be left on for 6-12 hours and then rinsed off by bathing. A
second application may be needed one week later.
- 10% crotamiton (Eurax) has a good safety profile, but is more difficult to
use and has a much lower cure rate. To use, wash thoroughly and scrub
away any loose scales, then apply a thin layer topically from neck to toes.
Gently massage into skin and leave on; a second application should be
applied after 24 hours; bathe 48 hours after the last application.
- Precipitated sulfur 6% in petrolatum is safe and effective in infants less
than two months of age and pregnant or lactating women. However,
sulfur is less acceptable to patients secondary to its odor and messy
application. It should be applied to the entire body (including the head
and neck in newborns) for 24 hours and then reapplied every 24 hours for
the next two days (i.e., a total of three applications). A bath should be
taken before each application and 24 hours after the last application.
- Ivermectin (Stromectin) is an antiparasitic drug taken orally. While not
approved by the FDA for the treatment of scabies, it has been found to be
effective and is especially useful for patients whose infestation is
refractory or who cannot tolerate topical therapy. Therefore, off-label use
of ivermectin for the treatment of scabies is a consideration. The dosage is
200 mcg/kg PO once; a repeat dose may be necessary if the patient is
infected with Norwegian scabies or in immunocompromised patients.
The safety of this medication in pregnancy and in children less than five years
of age has not been established
o Re-screen affected persons for continuing infestation after one, two, and four
weeks to ensure that treatment was successful.
• Patients with Norwegian scabies may need brushing and topical keratolytics (e.g.,
salicylic acid 3-6% cream) to remove scales.
• The nails of cases should be trimmed and should be cleaned under to remove any mites or
eggs that may be present from scratching. For those with nail involvement, nail
scrubbing with scabicide may be performed; removal of the nail using 40% urea cream or
by avulsion may be required for recalcitrant subungual scabies.
• Itching can last as long as several weeks after effective treatment. To combat this:
o Moisturize before and after showering;
o Avoid irritants such as too much soap and excessive sweating;
o Consider the use of oral or topical anti-itch medications in the antihistamine class,
such as diphenhydramine (Benadryl), as indicated. Other antihistamine
medications that could be considered include hydroxyzine (Atarax), cetirizine
(Zyrtec), loratidine (Claritin) and promethazine (Phenergan); and,
o Consider the use of appropriately potent topical corticosteroids. Oral steroids
may rarely be used. However, steroids should not be prescribed before the
completion of primary scabicide therapy.
• Occasionally, the rash area can become infected with bacteria. If this occurs, it may need
to be treated with an antibiotic ointment applied to the area, or oral antibiotics.
• Nodular scabies: 10% crotamiton cream (Eurax) may be used for treating scabies nodules
in children. The cream should be left on the nodules for 24 hours, washed off, and then
reapplied for an additional 24 hours. Persistent nodular scabies may need to be treated
with injections of steroids into the nodules or (rarely) with coal tar products applied to the
skin.
All family members and close contacts should be treated. If a child with scabies attends
daycare or a person is institutionalized (such as in a nursing home or prison), then staff in
contact with the person should be treated. It is necessary to treat everyone at the same time
to avoid re-infection.
Environmental controls and preventative measures must be implemented to ensure successful
treatment.

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