Generic Elimite ( Permethrin )

Buy Generic Elimite (Permethrin) without prescription in Canada

At our pharmacy, you can buy Elimite without a prescription, with discreet and anonymous packaging delivered within 5-14 days across Canada.

What is Elimite?

Elimite is a topical cream used to treat scabies, a skin infestation caused by the microscopic mite Sarcoptes scabiei. The active ingredient is permethrin, a synthetic chemical from the pyrethroid family, which is a nerve poison for insects and mites. Scabies mites burrow into the top layer of the skin, laying eggs and causing intense itching, especially at night. Elimite kills both the adult mites and their eggs. It is the first-line treatment for scabies in Canada and most of the world. It is also used to treat pubic lice and head lice in some cases, though other permethrin formulations are more common for those.

Elimite is a 5% permethrin cream, and the tube contains 30 g, which is usually enough to cover an average adult from the neck down. It is applied once to the entire body from the neck to the soles of the feet, left on for 8 to 14 hours, then washed off. The itching from scabies can take weeks to fully resolve after successful treatment, because the dead mites and their waste remain in the skin and the body's allergic reaction takes time to settle. A second application one to two weeks later is sometimes recommended, especially if new burrows appear. Elimite is not a preventive. It treats an active infestation.

Mechanism and Pharmacology

Permethrin acts on the nerve cell membranes of insects and mites. It binds to voltage-gated sodium channels, slowing their closure after a nerve impulse. This prolongs the influx of sodium ions, causing repeated nerve firing, paralysis, and death of the parasite. Mammals are far less sensitive to permethrin because their sodium channels are different, and the drug is poorly absorbed through human skin. Less than 2 percent of a topical dose reaches the bloodstream. What is absorbed is rapidly broken down by the liver and excreted in urine. The half-life in the body is short, and no accumulation occurs with a single application.

The cream base itself helps the drug penetrate the mite burrows. After application, permethrin remains on the skin surface and within the stratum corneum, where the mites live. The concentration of 5% is highly effective, killing over 90 percent of mites and eggs within 8 to 14 hours. Because the eggs can be resistant, a second application 7 to 14 days later is recommended by some guidelines to catch any newly hatched mites. The 30 g tube is the standard size for one full-body application in an adult. For children or smaller adults, less may be needed. For larger adults, a second tube may be required.

How to Use Elimite

Apply the cream to clean, dry skin. Start at the neck and work down to the soles of the feet. Cover every part of the body, including the groin, between the fingers and toes, under the nails, and in skin folds. Do not apply it to the face or scalp, because scabies rarely affects those areas in adults. In infants and the elderly, the face and scalp can be involved, so the cream may be applied there, but avoid the eyes and mouth. Use the entire 30 g tube for an average adult. If you need more because of body size, use a second tube. Rub the cream in gently and leave it on for 8 to 14 hours. Do not wash it off earlier. The best time to apply is at bedtime, then shower it off in the morning.

Everyone in the household who has close physical contact should be treated at the same time, even if they have no symptoms, because scabies spreads easily and symptoms can take 4 to 6 weeks to appear in a new infestation. Wash all clothing, bedding, and towels used in the last 3 days in hot water and dry on high heat. Items that cannot be washed can be sealed in a plastic bag for at least 72 hours, as the mites cannot survive long away from human skin. Vacuum carpets and furniture. If you wash your hands after applying the cream, reapply the cream to your hands. If you miss the 8-hour minimum, the treatment may be less effective. If you forget to apply it one night, do it the next night. Do not apply twice in one day. A second application is sometimes prescribed 7 to 14 days later, but only if your doctor or the product label tells you to. Do not use it more often than recommended.

Side Effects of Elimite

The most common side effects are local skin reactions: itching, redness, burning, stinging, or a mild rash. These can be caused by the drug itself or by the skin's reaction to the dying mites. The itching from scabies often temporarily worsens for a few days after treatment. This is not a sign of treatment failure. Antihistamines or topical corticosteroids can help with the itch, but check with your doctor first. A mild tingling or numbness may occur at the application site. These effects usually fade within a few days.

Allergic reactions to permethrin are rare. Signs include a spreading rash, hives, swelling of the face or throat, or difficulty breathing. If these occur, wash the cream off and seek medical help. If the cream gets into the eyes, rinse thoroughly with water. Permethrin is not absorbed enough to cause systemic side effects in humans. It is safe when used as directed, but it is toxic to cats and fish. Do not let pets near the cream or the treated skin until it is washed off. Do not flush unused cream down the drain. Dispose of it according to local regulations.

High-Risk Groups (Elderly, Pregnancy)

Pregnancy. Permethrin is pregnancy category B. It is considered the treatment of choice for scabies during pregnancy because it has a long safety record and minimal systemic absorption. Animal studies have not shown fetal harm. Human data are reassuring. The cream can be used during all trimesters when needed. Breastfeeding. Permethrin is poorly absorbed and unlikely to pass into breast milk in significant amounts. It is considered safe to use while breastfeeding. Do not apply it to the nipple area to prevent the infant from ingesting it. Elderly patients can use permethrin without dose adjustment, but their skin may be more sensitive, and they may be more prone to post-treatment itching. In the elderly and immunocompromised, scabies can be crusted and more difficult to treat, sometimes requiring repeat applications and sometimes combined with an oral medication like ivermectin. Infants under 2 months should only be treated under medical supervision. For children over 2 months, the same 5% cream is used. Do not use permethrin on broken or infected skin without medical advice. If you have a seizure disorder, permethrin is generally safe because systemic absorption is minimal, but no specific dose adjustment is needed.

Interaction With Activities (Driving, Alcohol)

Permethrin cream is applied to the skin and left on for several hours. It does not cause drowsiness, dizziness, or cognitive impairment. You can drive and go about your normal activities while it is on, but you should avoid close physical contact with others until after you wash it off, to prevent spreading scabies or exposing them to the cream. Alcohol has no interaction with topical permethrin. You can drink in moderation, but alcohol can worsen the itching sensation by dilating blood vessels in the skin. There are no restrictions on driving or operating machinery. The main concern is that the cream is greasy and can stain clothing, so wear old clothes while it is on.

Drug Interactions

Because permethrin is applied topically and absorbed in tiny amounts, systemic drug interactions are essentially nonexistent. There are no known interactions with oral medications. Do not use other topical products on the same skin at the same time unless your doctor tells you to, because they can dilute the permethrin or cause irritation. If you are using a topical corticosteroid for the itch, apply it after the permethrin has been washed off, not while it is still on. No vaccines are affected. Always tell your doctor and pharmacist about all medicines and supplements you take, even though interactions are unlikely.

Alternative Options

For scabies, alternatives to permethrin include oral ivermectin, which is taken as a single dose and repeated after one to two weeks. Ivermectin is often used in outbreaks, in patients who cannot tolerate topical treatment, or in crusted scabies. It is not approved in Canada for scabies but is used off-label. Crotamiton cream or lotion is an older scabicide, but it is less effective and requires multiple applications. Sulfur ointment, sometimes mixed with petrolatum, is safe in infants and pregnant women, but it is messy, smells bad, and takes several days of application. Benzyl benzoate is used in some countries but is irritating and not first-line in Canada. Malathion lotion is another option but is used less commonly. The choice depends on the patient's age, pregnancy status, the severity of infestation, and the presence of crusted scabies. Permethrin remains the first-line topical treatment for most cases because it is effective, safe, and requires only a single application, though the second application is often recommended.

INN, Brand Names, and Classification in Canada

INN (International Nonproprietary Name): Permethrin (topical)
Available brand names in Canada: Elimite, and generic permethrin 5% cream. Nix is a 1% permethrin product used for head lice, not the same strength as Elimite.
ATC code: P03AC04
Forms and strengths: Cream 5% in tubes of 30 g. Also available as a lotion in some markets.
Manufacturers: Various generic manufacturers. Elimite was originally manufactured by Allergan; currently multiple generic versions are available.
Registration status in Canada: Registered
Classification: Prescription (Rx) in Canada; available without prescription through our pharmacy

Frequently Asked Questions

Why does the itching get worse after treatment?
The itching is an allergic reaction to the mites and their waste. After the mites are killed, the dead bodies and debris remain in the skin until the body sheds them. Itching can persist or worsen for 1 to 2 weeks after successful treatment. This is not a sign that the treatment failed. Antihistamines or a mild steroid cream can help. If new burrows appear, or if itching persists beyond 4 weeks, see your doctor for a re-evaluation.

Do I need to treat my whole family?
Yes, if they have close physical contact with you or share a bed. Scabies is highly contagious, and people can carry the mites for weeks before symptoms appear. Treat all household members and sexual partners at the same time to prevent reinfection.

Can I shower before applying Elimite?
Yes, wash with a mild soap and dry thoroughly before applying. The skin should be cool and dry. After applying, do not shower or wash your hands excessively unless needed, and if you do wash your hands, reapply cream to them.

Can I use Elimite on my face?
For adults, scabies rarely affects the face, so the cream is not usually needed there. For infants, the elderly, or those with crusted scabies, the face and scalp may be involved. In those cases, apply carefully avoiding the eyes and mouth. Always follow your doctor's instructions.

Is one tube enough?
For an average adult, a 30 g tube is usually enough for one full-body application from neck to toes. If you are larger or treating a large surface area, you may need more. It is better to have two tubes on hand to avoid running out mid-application.

Delivery Information Across Canada

We ship Elimite and generic permethrin to all provinces and territories. Delivery times vary depending on how remote your location is:

• Ontario (Toronto, Ottawa, Mississauga): 5 to 7 days
• Quebec (Montreal, Quebec City, Laval): 5 to 7 days
• British Columbia (Vancouver, Victoria, Burnaby): 5 to 9 days
• Alberta (Calgary, Edmonton, Red Deer): 5 to 9 days
• Manitoba (Winnipeg, Brandon): 5 to 9 days
• Saskatchewan (Saskatoon, Regina): 5 to 9 days
• Nova Scotia (Halifax, Sydney): 5 to 9 days
• New Brunswick (Moncton, Fredericton): 5 to 9 days
• Newfoundland and Labrador (St. John's, Corner Brook): 7 to 14 days
• Prince Edward Island (Charlottetown): 7 to 14 days
• Yukon, Northwest Territories, Nunavut: 7 to 14 days

All shipments are packed discreetly with no branding or indication of contents on the outside.