ERALYCE 5% CREAM 30G

Indications

Approved Uses

Scabies (infestation with Sarcoptes scabiei).

Off-Label Uses

Pediculosis pubis (crab lice) (off-label use of permethrin products in some settings).

Dosage & Administration

Dosing by Condition

Scabies: apply permethrin 5% cream once to the whole body (neck down; include scalp/hairline in infants/young children/elderly as needed), leave 8-14 hours, then wash off; repeat once after 7-14 days if symptoms persist or live mites are seen. (Head lice dosing applies to permethrin 1% products, not this 5% cream.)

Initial Dose

Single application of 5% cream to entire body surface from neck down for scabies

Maintenance Dose

Single application; repeat only if live mites are detected after 7-14 days

Maximum Dose

Apply a thin layer to cover the entire body surface as directed (neck down; include scalp/face only if indicated); typical adult amount is up to ~30 g per application; usually 1 application, may repeat once after 7-14 days.

Children's Dosage

Approved for children aged 2 months and older for scabies: apply 5% cream to entire body including scalp, hairline, neck, and face (avoiding eyes and mouth); same single-application regimen as adults

Dose Adjustment Notes

No dose adjustment is required in renal or hepatic impairment due to minimal systemic absorption; for infants/young children/elderly, include scalp/hairline/temples/forehead in application when treating scabies.

How to Take

For scabies: apply permethrin 5% cream to clean, dry, cool skin in a thin layer and massage thoroughly over the entire body from the neck down to the soles (include between fingers/toes and under nails; in infants/young children/elderly also apply to scalp/hairline/temples/forehead as needed); leave on 8-14 hours, then wash off; put on clean clothes and launder clothing/bedding used in the previous 2-3 days; treat close contacts simultaneously.

Side Effects

Common Side Effects

Application-site burning/stinging, pruritus, erythema, rash, tingling or numbness.

Side Effect Frequency

Most adverse effects are local and common: application-site burning/stinging/tingling, pruritus, and erythema; pruritus is also frequently due to scabies itself and may persist post-treatment. Less common/uncommon: rash, edema, numbness, and allergic contact dermatitis.

Safety & Warnings

Contraindications

Contraindication: hypersensitivity to permethrin, pyrethrins/pyrethroids, or any component; avoid application to eyes and mucous membranes (warning/precaution, not a formal contraindication).

Warnings & Precautions

External use only; avoid eyes/mucous membranes; do not apply to severely broken/inflamed skin unless advised; itching may persist for weeks after successful treatment; treat close contacts and decontaminate clothing/bedding; wash hands after application.

Age Restriction

Use in adults and children ≥2 months; not recommended in infants <2 months.

Driving Warning

Safe

Drug Interactions

Food Interaction

None (not applicable for topical permethrin).

Special Populations

Children

Approved for children aged 2 months and older for scabies: apply 5% cream to entire body including scalp, hairline, neck, and face (avoiding eyes and mouth); same single-application regimen as adults

Elderly

Standard adult dosing; ensure adequate assistance with application to all body areas

Kidney Impairment

No adjustment needed.

Liver Impairment

No adjustment needed.

Storage & Patient Advice

Stopping the Medicine

No tapering required; stop after completing the recommended regimen (typically one application, repeat once after 7-14 days if needed).

Overdose

Topical overuse may cause local irritation/burning-wash off with water; accidental ingestion requires urgent medical/poison center contact and supportive care.

Patient Counseling

For scabies: Apply permethrin 5% cream in a thin layer to clean, dry skin over the entire body from the neck down (include between fingers/toes, under nails, wrists, axillae, groin, buttocks, soles; in infants/elderly/immunocompromised also apply to scalp/face avoiding eyes/mouth). Leave on 8-14 hours (overnight), then wash off completely and put on clean clothes. Itching can persist for 2-4 weeks after successful treatment. Treat all household members/close physical contacts at the same time. Decontaminate by washing recently worn clothing, towels, and bedding in hot water and drying on high heat (or seal unwashables for several days). Repeat a second application in 7-14 days if symptoms persist or if live mites/new burrows are seen. Avoid eyes/mucosa; do not apply to severely irritated/broken skin unless directed by a clinician.

Monitoring Requirements

No routine monitoring; reassess for live mites or lice after 7-14 days

Pharmacology

Mechanism of Action

Disrupts parasite neuronal voltage-gated sodium channels, causing delayed repolarization/prolonged depolarization leading to paralysis and death of mites/lice.

Onset of Action

Mites are killed within hours after application; clinical improvement in pruritus may begin within a few days, but itching can persist for 2-4 weeks after successful treatment.

Duration of Effect

Mite-killing effect occurs after a single application; residual activity on the skin persists for several days (up to about 1-2 weeks), while symptomatic itching may persist for 2-4 weeks despite eradication.

Bioavailability

Minimal systemic absorption; typically ≤2% of the applied dose is absorbed through intact skin.

Excretion

Excreted mainly in urine as inactive metabolites (including conjugated metabolites such as glucuronides); minor fecal excretion may occur.

Product Information

Available Dosage Forms

Cream (this product).

Composition per Dose

Each gram of cream: 50 mg permethrin (5% w/w)

Generic Availability

Yes

Skin Condition

Parasitic

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