Nix Ultra Removal (mineral oil/dimethicone/permethrin)

No dosing information is available for this tab.

Permethrin 5% cream or 1% lotion (cream rinse) is applied topically.

The drug is for external use only and should not be administered orally.

Contact with the eyes should be avoided during application of permethrin 5% cream or permethrin 1% lotion (cream rinse) since ocular irritation may occur. Patients using permethrin also should be advised to avoid contact with mucous membranes such as inside the nose, mouth, or vagina.

The cream rinse should be shaken before using.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

Moderate Interaction: Assess the risk to the patient and take action as needed.

Oil-Based Vaginal Products/Etonogestrel-Ethinyl Estradiol

SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.

MECHANISM OF ACTION: The use of Eluryng or Nuvaring (etonogestrel-ethinyl estradiol vaginal ring) with oil-based vaginal products has been associated with ring breakage.(1,2)

CLINICAL EFFECTS: Concurrent use of Eluryng or Nuvaring (etonogestrel-ethinyl estradiol vaginal ring with oil-based vaginal products has been associated with ring breakage. Contraceptive efficacy is not believed to be affected. Vaginal injury including pain, discomfort, and bleeding has been reported in association with ring breakage.(1,2)

PREDISPOSING FACTORS: None determined.

PATIENT MANAGEMENT: If the contraceptive ring breaks but stays in the vagina, ring effectiveness should not be affected. If a broken ring slips out or is removed, it should not be reinserted. Instead, it should be discarded and replaced with a new ring.(1,2)

DISCUSSION: A single-dose of an oil-based vaginal miconazole nitrate capsule (1200 mg) increased etonogestrel levels by 17% and ethinyl estradiol levels by 16%.(1) These changes in serum levels are not expected to affect efficacy.(3)

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

• Bronchospastic pulmonary disease

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

Rare or Very Rare

• Eczema
• Head sensation disturbance
• Paresthesia
• Pruritus of skin
• Skin inflammation
• Skin irritation
• Skin rash
• Stinging of skin

No enhanced messaging available.

No enhanced messaging available.

Reproduction studies in mice, rats, and rabbits using oral permethrin dosages of 200-400 mg/kg daily did not impair fertility or cause harm to the fetus. There are no adequate and controlled studies to date using topical permethrin in pregnant women, and the drug should be used during pregnancy only when clearly needed. The CDC and some clinicians consider permethrin 5% a drug of choice for the treatment pediculosis or scabies in pregnant or lactating women. Pregnant women should be advised to consult their clinician before self-medicating with topical permethrin.

It is not known whether permethrin is distributed into human milk. Because many drugs are distributed in milk and because of the tumorigenic potential of permethrin in animal studies, a decision should be made whether to discontinue nursing temporarily or to withhold the drug while the mother is nursing, taking into account the importance of the drug to the woman. Nursing mothers should be advised to consult their clinician before self-medicating with topical permethrin.

No enhanced messaging available.