FDA-filed SPL labeling · retrieved through openFDA

Permethrin Topical

Permethrin topical is an antiparasitic medication used to treat scabies and lice infestations.

Brand names ElimiteNixActicinNix Cream Rinselice treatment +8 more
Drug class Pyrethroid
Rx/OTC Form 1 Route Topical
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 15 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveJan 24, 2024
Clinical labels in scope 15
AvailabilityRx/OTC
Earliest approval/marketing year 1986
FDA-listed product records 33
Boxed warningNone found in compared labels
How we combine label and product data →
No current FDA shortage listed · checked Sep 21, 2026
Permethrin Topical at a glance The quick version — the full detail is in the Patient Information Guide below.
💊
HelloPharmacist Editorial Team Bottom Line
Permethrin topical is a well-established treatment for scabies (Elimite 5% cream) and head lice (various creme rinse products). It works by paralyzing and killing the parasites on contact and is applied directly to the skin or hair. Most side effects are mild and temporary, but stop use and seek help if you have breathing trouble, eye irritation, or worsening skin reactions.

📖 Permethrin Topical: Patient Information Guide

A plain-language walkthrough of Permethrin Topical — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for

Permethrin topical is an antiparasitic used across several products to treat two main types of parasitic infestations:

  • Elimite (permethrin) 5% cream: Treats scabies, a skin infestation caused by the mite Sarcoptes scabiei
  • Good Neighbor Pharmacy Lice Treatment, Good Sense Lice Killing Creme Rinse, Health Mart Lice Treatment, Kakshal Permethrin, and Leader Lice Treatment: Treat head lice infestations
⚙️How it works

Permethrin belongs to a class of drugs called pyrethroids — synthetic compounds that mimic naturally occurring insect-killing substances. It targets the nerve cell membranes of parasites, specifically blocking the sodium channels that nerves rely on to send and reset signals. Without that reset, the parasite's nerves fire uncontrollably, causing paralysis and death of the lice, mites, or other pests.

Very little permethrin is absorbed through human skin — studies with Elimite 5% cream suggest that 2% or less of the applied amount enters the body. Whatever is absorbed is quickly broken down by the body into inactive byproducts and eliminated mainly through urine.

💊How it's taken

Permethrin topical products are applied to the skin or hair — never swallowed. Elimite 5% cream is applied to the whole body surface and rinsed off after a period of time directed by your prescriber. Lice creme rinse products are applied to clean, towel-dried hair, left on for exactly 10 minutes, then rinsed thoroughly with warm water.

  • A second lice treatment application may be needed if live lice are still present 7 or more days after the first treatment
  • Do not leave the lice creme rinse on longer than 10 minutes
  • Always follow the specific directions on your product label or from your prescriber
🤒Side effects — in detail

Most side effects with permethrin topical are mild and happen right at the application site.

  • Burning and stinging after application (reported in about 1 in 10 patients with Elimite cream)
  • Itching (pruritus) — may occur at various times after application
  • Redness (erythema)
  • Numbness or tingling of the skin
  • Skin rash
  • Headache, dizziness, fever
  • Stomach pain, diarrhea, nausea, or vomiting

Stop use and get medical help if you develop trouble breathing, eye irritation that persists after flushing, or skin irritation or infection that continues or worsens.

⚠️Warnings & precautions
  • For external use only — never swallow; if ingested, call Poison Control (1-800-222-1222) immediately
  • Do not use on children under 2 months of age
  • Keep away from the eyes, and out of the nose, ears, mouth, and vagina
  • Do not treat lice in the eyebrows or eyelashes yourself — see a doctor
  • If you have a ragweed allergy, use with caution — permethrin may trigger breathing difficulty or an asthma attack
  • If breathing difficulty or eye irritation develops, stop use and seek medical attention right away
  • Excessive use of the topical product may cause increased irritation and redness
  • Keep out of reach of children
🔀What it interacts with

The FDA label for permethrin topical does not identify specific drug or food interactions. However, for lice creme rinse products, one important product-related caution applies:

  • Conditioner-containing shampoos: Do not wash hair with a shampoo that contains conditioner, and do not use a conditioner alone before applying the lice creme rinse — conditioner can reduce the product's effectiveness

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

📋Before taking it
  • Do not use if you are allergic to permethrin, any synthetic pyrethroid or pyrethrin — Elimite is contraindicated in these patients
  • Ragweed allergy: ask a doctor before use, as permethrin may cause breathing difficulty or trigger an asthmatic episode
  • Children under 2 months of age: do not use
  • Pregnant or breastfeeding: ask a health professional before use
  • Do not apply to the eyebrows or eyelashes area if treating lice there — consult a doctor instead
🚑If you take too much

No cases of accidental ingestion of Elimite 5% cream have been reported. If someone swallows any permethrin product, contact Poison Control at 1-800-222-1222 or seek emergency medical care immediately. Using too much of the product on the skin may cause increased irritation and redness at the application site.

📡Pharmacodynamics — effects in the body

Permethrin kills a broad range of parasites — including lice, mites, ticks, and fleas — by disrupting their nerve function. It interferes with sodium channels in nerve cell membranes, preventing the normal electrical reset that nerves need after firing. This leads to prolonged nerve excitation, paralysis, and death of the pest. Because human nerve cells are structured differently and very little permethrin is absorbed through the skin, the drug has a favorable safety profile when used as directed.

🔬Pharmacokinetics — how your body processes it

Permethrin is applied to the skin and is minimally absorbed — studies with Elimite 5% cream suggest that 2% or less of the applied dose enters the body. Once absorbed, it is rapidly broken down through a process called ester hydrolysis into inactive metabolites (breakdown products). These inactive byproducts are cleared from the body mainly through urine.

📦How to store it

Store at 20º to 25ºC (68º to 77ºF) .

📄 Written from Permethrin Topical’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

🩺 Pharmacist Counseling Corner

Quick, plain-English answers to the questions patients ask most about Permethrin Topical — the kind of thing our pharmacy team would talk through with you at the counter.

What is permethrin cream actually used for?
It depends on the specific product. Elimite 5% cream is prescribed to treat scabies — a skin infestation caused by tiny mites that burrow under the skin and cause intense itching. Other permethrin products like Good Sense Lice Killing Creme Rinse and similar lice treatment creme rinses are used to kill head lice. Both types work by paralyzing and killing the parasites on contact.
How do I use the lice creme rinse correctly?
Start by washing your hair with a regular shampoo — but skip the conditioner, since it can make the treatment less effective. Towel dry your hair so it's damp but not dripping, then shake the bottle and saturate your hair and scalp completely, starting behind the ears and at the back of your neck. Leave it on for exactly 10 minutes — no longer — then rinse with warm water. After rinsing, use the nit comb provided to carefully remove any remaining eggs. If you still see live lice 7 or more days after the first treatment, you may need a second application.
Will it burn or itch when I apply it? What side effects should I expect?
Some burning and stinging right after you apply it is common, especially with the 5% cream for scabies — about 1 in 10 people notice this. Itching, redness, or mild tingling can also happen. These are usually mild and go away on their own. Stop using it and call your doctor if the irritation keeps getting worse, if you notice signs of a skin infection, or if you have any trouble breathing.
Is there anything I should watch out for that means I need to call a doctor?
Yes — stop using the product and get medical help right away if you have trouble breathing or an asthma attack, especially if you're allergic to ragweed. Also see a doctor if eye irritation doesn't clear up after flushing your eyes with lots of water, or if your skin irritation gets worse or looks infected. And if anyone swallows any of the product, call Poison Control immediately at 1-800-222-1222.
Can I use this on my baby or while I'm pregnant?
Do not use permethrin topical products on infants under 2 months of age. If you're pregnant or breastfeeding, you should talk to a health professional before using any permethrin product — the label recommends checking in first rather than using it on your own. Your doctor can help you weigh the benefit against any potential concern.
Is one treatment enough, or will I need to do it again?
For the lice creme rinse products, one treatment is the starting point. Check the affected person's head daily after treatment. If you still see live lice 7 or more days after the first application, a second treatment is recommended. For Elimite scabies cream, follow your prescriber's instructions — they'll let you know if a repeat treatment is needed based on how you respond.
Is Permethrin Topical available over the counter?
Both — Permethrin Topical is sold both over the counter and by prescription, according to its FDA labeling. Lower strengths or certain forms are often available without a prescription, while higher strengths or specialized forms still require one. Ask your pharmacist which version is right for you.
When was Permethrin Topical first available?
Permethrin Topical has been available in the United States since at least 1986, based on FDA approval history (Drugs@FDA) and product marketing records.
Who makes Permethrin Topical?
Permethrin Topical is supplied by 21 manufacturers listed in the FDA NDC Directory, including Bryant Ranch Prepack, Insight Pharmaceuticals LLC, Actavis Pharma, Inc..

💬 Answers drafted from Permethrin Topical’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 Keep exploring

💊 How Permethrin Topical comes

Permethrin Topical is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Topical cream, ointment or gel

On the skin
Brands Elimite Good Neighbor Pharmacy Lice Treatment Good Sense Lice Killing Creme Rinse Health Mart Lice Treatment Kakshal Permethrin Leader Lice Treatment Lice Treatment Nix Nix Lice Killing Creme Rinse Sunmark Lice Treatment Topcare lice killing creme rinse
How this form is used
What it may be used for
  • Elimite (permethrin) 5% cream is used to treat scabies (infestation with Sarcoptes scabiei mites)
  • Good Neighbor Pharmacy Lice Treatment, Good Sense Lice Killing Creme Rinse, Health Mart Lice Treatment, Kakshal Permethrin, and Leader Lice Treatment are used to treat head lice infestations
Important instructions
  • Good Sense Lice Killing Creme Rinse: wash hair with shampoo (no conditioner), towel dry, then saturate hair and scalp with the creme rinse, starting behind the ears and at the back of the neck
  • Good Sense Lice Killing Creme Rinse: leave the product on hair for 10 minutes — no longer — then rinse with warm water
  • Good Sense Lice Killing Creme Rinse: if live lice are still seen 7 or more days after the first treatment, a second treatment should be given
  • Keep all products out of eyes; if contact occurs, flush immediately with large amounts of water
Available strengths 4 strengths
33 FDA-listed product records

📊 Permethrin Topical across the U.S. market

How Permethrin Topical appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

1
Dose forms
21
Manufacturers
12
Brand names
33
FDA-listed product records
1986
First marketed
Bryant Ranch Prepack9%
Insight Pharmaceuticals LLC9%
Actavis Pharma, Inc.6%
A-S Medication Solutions6%
Aurobindo Pharma Limited6%
Strategic Sourcing Services LLC6%
Other makers58%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

📈 How widely Permethrin Topical is used

A general measure of how commonly Permethrin Topical is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

Think of this as a proxy for how widely Permethrin Topical is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

217,112
Medicaid prescriptions filled (Q1–Q4 2025)
$5.5M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

How commonly is Permethrin Topical prescribed? Of the 1,596 medications we measure, Permethrin Topical ranks #379 by Medicaid prescriptions — more than 76% of them.

Where Permethrin Topical ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5

Utilization by Permethrin Topical product

Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

The 50 mg/mL topical cream is the most-dispensed Permethrin Topical product — about 100% of these Medicaid prescriptions.

permethrin 50 MG/ML Topical Cream Most dispensed

216,325 Medicaid prescriptions (Q1–Q4 2025) 100% of Permethrin Topical prescriptions shown $5.5M gross reimbursement (before rebates) ≈ $25 per prescription (gross)

Summed across the 5 of 15 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 106387

permethrin 10 MG/ML Medicated Shampoo

787 Medicaid prescriptions (Q1–Q4 2025) <1% of Permethrin Topical prescriptions shown $12,673 gross reimbursement (before rebates) ≈ $16 per prescription (gross)

Summed across the 2 of 17 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 250387

Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Permethrin Topical, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 7 of 32 listed Permethrin Topical NDCs with Medicaid activity.

🔍 Compare Permethrin Topical products

A representative set of FDA-listed product records for Permethrin Topical — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Showing 33 of 33 products — FDA National Drug Code Directory. See every product, package size and price: browse all 33 Permethrin Topical NDCs →

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Permethrin Topical RxCUI 33199 3 dose forms · 2 strengths
  1. Dose form (SCDF) Medicated Shampoo RxCUI 377506 In current FDA listings
    Clinical drug / strength (SCD) 10 MG/ML RxCUI 250387
  2. Dose form (SCDF) Topical Cream RxCUI 377789 In current FDA listings
    Clinical drug / strength (SCD) 50 MG/ML RxCUI 106387
  3. Dose form (SCDF) Topical Lotion RxCUI 377788 In current FDA listings

Look up RxCUI 33199 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

🏷️ Sold under these brand names

Elimite Nix Acticin Nix Cream Rinse lice treatment good neighbor pharmacy lice treatment good sense lice killing creme rinse health mart lice treatment Kakshal Permethrin leader lice treatment Nix Lice Killing Creme Rinse sunmark lice treatment Topcare lice killing creme rinse

🏭 Manufacturers & labelers

Bryant Ranch Prepack 3 Insight Pharmaceuticals LLC 3 Actavis Pharma, Inc. 2 A-S Medication Solutions 2 Aurobindo Pharma Limited 2 Strategic Sourcing Services LLC 2 Dr. Reddy's Laboratories, Inc. 2 RPK Pharmaceuticals, Inc. 2 Padagis Israel Pharmaceuticals Ltd 2 Northstar Rx LLC 2 Walgreen Company 1 Topco Associates LLC 1 Rite Aid Corporation 1 NuCare Pharmaceuticals,Inc. 1 Northstar RxLLC 1 L. Perrigo Company 1 Kakshal 1 Geodis Logistics LLC 1 CVS Pharmacy 1 Cardinal Health 110, LLC. dba Leader 1 Amerisource Bergen 1

RxNorm drug class

Permethrin Topical belongs to the Pyrethroid class.

Pharmacologic class Pyrethroid
Drug family (ATC) Pyrethrines, incl. synthetic compounds

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

🔬 Where this comes from

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Jan 24, 2024
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Permethrin Topical.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Permethrin Topical after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
15
NDC products indexed
33
Distinct labelers/manufacturers represented
21
Linked representative label
Aurobindo Pharma Limited
Linked label effective
Jan 24, 2024
Composite sections available
15
Linked SPL Set ID
443c0446-ccba-4f52-83ed-4c3163f35807
Linked SPL Document ID
443c0446-ccba-4f52-83ed-4c3163f35807
Open the linked representative label on DailyMed ↗

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 15 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Aurobindo Pharma Limited is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.