Permisol Max Lotion

Introduction

Permisol Max Lotion 5%+10% is a combination topical treatment used primarily for managing scabies and associated pruritic conditions. Permethrin is an insecticide that targets mites, while Crotamiton provides anti-inflammatory relief. This combination enhances the efficacy of scabies treatment by addressing both the infestation and the symptoms.

Uses

This combination is used for:

Scabies: An infestation of the skin by the mite Sarcoptes scabiei, which causes severe itching and rash. Permethrin kills the mites, while Crotamiton alleviates itching and inflammation.
Pruritic Conditions: Conditions characterized by itching where the combination helps relieve symptoms and manage irritation.

The combination is used when scabies treatment requires both antiparasitic and symptomatic relief, particularly in cases resistant to other treatments or when other options are contraindicated.

Brand Name	Permisol Max
Type	Lotion
Weight	5%+10%
Generic	Permethrin + Crotamiton
Manufacturer	ACI Limited
Available in	English বাংলা

Mechanism of Action

Permethrin acts as an insecticide by disrupting the nervous system of the mites, leading to their death. Crotamiton works by reducing inflammation and itching through its anti-inflammatory properties. Together, they effectively target the mites and alleviate the symptoms associated with scabies.

How Long Does It Take to Work?

The combination treatment can show improvement in symptoms within a few days. Relief from itching and irritation may begin shortly after application, though it can take 1-2 weeks for complete resolution of symptoms. For scabies, the treatment's effectiveness depends on completing the full course and following application instructions closely.

Absorption

Both Permethrin and Crotamiton are applied topically and have minimal systemic absorption. Permethrin acts locally on the mites, and Crotamiton provides symptomatic relief at the application site. Minimal systemic absorption helps limit the risk of systemic side effects.

Route of Elimination

Permethrin is primarily metabolized in the liver and excreted in the urine, while Crotamiton also has minimal systemic absorption with primary action localized to the skin. Any systemic absorption of Crotamiton is processed by the liver and excreted through the kidneys.

Dosage

Adult: Permethrin & Crotamiton lotion is suitable for adults, children of 2 months of age and above, and the elderly. It is for external use only and should not be applied to broken skin, mucous membranes or near the eyes. Permethrin & Crotamiton lotion should be applied to skin which is clean, dry and cool. It should not be used immediately after a hot bath. Permethrin & Crotamiton lotion is intended for a single application over the whole body. Permethrin & Crotamiton lotion should be left on for at least 8 hours. Reapply the lotion to the hands if they are washed within 8 hours of treatment. The whole body should be washed thoroughly 8-12 hours after application. Adults & children over 2 years: Apply the lotion over the whole body but not the head and face. Pay particular attention to the areas between fingers and toes, under nails, wrists, armpits, external genitalia, breasts and buttocks.

The elderly: Apply the lotion over the whole body including the neck, face, ears and scalp. Pay particular attention to the areas between fingers and toes, under nails, wrists, armpits, external genitalia, breasts and buttocks. Avoid the area close to the eyes.

Children under 2 years: Children under 2 years should only be treated under medical supervision. Apply the lotion over the whole body including the neck, face, ears and scalp. Pay particular attention to the areas between fingers and toes, under nails, wrists, armpits, palms of hands and soles of feet, external genitals and buttocks. Avoid the area around the mouth where the lotion could be licked off and the area around the eyes

The dosage is as follows:

For Scabies: Apply the combination treatment to the entire body from the neck down, including under the nails and between the fingers and toes. The treatment is typically applied once daily for 1-2 days, with a possible second course if needed.
For Pruritic Conditions: Apply to the affected areas as directed by a healthcare provider. The duration and frequency of application depend on the severity of the symptoms.

Follow the specific instructions provided by a healthcare provider or on the product label for optimal results.

Administration

Apply the combination treatment topically to clean, dry skin. Ensure that the medication covers all affected areas, including less obvious sites such as under the nails. Avoid contact with eyes, mouth, and mucous membranes. Wash hands thoroughly after application.

Side Effects

Common side effects may include:

Skin irritation or redness at the application site.
Dryness or peeling of the skin.

Severe reactions are rare but may include severe allergic responses or dermatitis. If severe side effects occur, discontinue use and seek medical advice.

Toxicity

Toxicity is rare due to minimal systemic absorption. However, excessive use or ingestion can lead to symptoms such as nausea, vomiting, and dizziness. Immediate medical attention should be sought in case of suspected overdose or severe reactions.

Precautions

Precautions include:

Apply the medication only to affected areas and avoid use on broken or severely inflamed skin.
Monitor for skin irritation or allergic reactions and discontinue use if these occur.
Avoid contact with sensitive areas such as the eyes and mucous membranes.

Consult a healthcare provider before use if there is a history of skin sensitivities or allergies.

Interaction

Interactions are unlikely due to the topical nature of the medication. However, avoid using other topical treatments simultaneously unless advised by a healthcare provider. Discuss any concurrent medications with a healthcare provider to prevent potential interactions.

Disease Interaction

Use with caution in:

Patients with pre-existing skin conditions or hypersensitivity to topical treatments.
Individuals with a history of severe dermatitis or eczema, as they may be more prone to irritation.

Adjustments to treatment may be required based on the patient’s overall condition.

Drug Interaction

The combination is generally free of significant drug interactions due to its topical application. Nonetheless, consult with a healthcare provider regarding any concurrent systemic or topical treatments to avoid potential interactions.

Food Interactions

There are no significant food interactions with Permisol Max Lotion 5%+10%. The medication is applied topically and does not affect or interact with dietary intake.

Pregnancy Use

During pregnancy, Permisol Max Lotion 5%+10% should be used only if clearly needed and as directed by a healthcare provider. While Permethrin is generally considered safe during pregnancy, its use should be evaluated in the context of potential risks and benefits. Consult a healthcare provider for personalized advice.

Lactation Use

The combination can be used during lactation, but it is important to avoid applying it directly to the breast area. The minimal systemic absorption of the medication suggests it is unlikely to affect the nursing infant. Consult a healthcare provider for guidance on use while breastfeeding.

Acute Overdose

Acute overdose is unlikely due to the topical application, but ingestion or excessive application may cause gastrointestinal upset or other symptoms. Seek immediate medical attention if an overdose is suspected. Treatment focuses on symptomatic relief.

Contraindication

Permisol Max Lotion 5%+10% is contraindicated in:

Individuals with known hypersensitivity to either Permethrin, Crotamiton, or any component of the formulation.
Patients with severe skin conditions or open lesions where topical application might exacerbate irritation.

Ensure contraindications are reviewed before initiating treatment.

Use Direction

Apply as directed by a healthcare provider. Ensure the medication covers the entire affected area and follow the prescribed frequency and duration of application. Do not exceed the recommended dose or duration of use.

Storage Conditions

Store at room temperature, away from direct sunlight and moisture. Keep the medication out of reach of children to prevent accidental ingestion. Proper storage preserves the efficacy of the product.

Volume of Distribution

The volume of distribution for Permethrin and Crotamiton is not well-defined due to their topical application and minimal systemic absorption. The primary action occurs at the site of application.

Half Life

The half-life of Permethrin and Crotamiton in systemic circulation is not well-documented due to their limited systemic absorption. The primary effects are localized to the application site.

Clearance

Permethrin is primarily metabolized in the liver and excreted through the kidneys, while Crotamiton is also minimally absorbed systemically and primarily acts at the site of application. Any minor systemic absorption is processed by the liver and excreted in the urine.

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