The Basics
What is Permethrin?
Used to treat scabies and lice.
Brand names for Permethrin
Acticin, Nix Creme Rinse, Elimite
How Permethrin is classified
Anti-Infective Agents, Antiparasitic Agents, Insecticides
Permethrin During Pregnancy
Permethrin pregnancy category
Category BNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Permethrin while pregnant
About 2% of the topically applied dose is absorbed systemically.[7] Animal studies have not demonstrated fetal harm.[48] In a prospective study of 113 pregnant women who used permethrin shampoo (31 in their first trimester) did not have any indication of embryotoxicity.[49] In another study, 196 pregnant women who utilized 4% permethrin did not have adverse fetal outcomes.[8] Often considered the first line for topical treatment of parasitic infections, permethrin is safe to use during pregnancy
Taking Permethrin While Breastfeeding
What are recommendations for lactation if you're taking Permethrin?
Because less than 2% is absorbed after topical application, rapid metabolism to inactive metabolites and safe application directly on infants’ skin, topical permethrin products are acceptable in nursing mothers.[1][2] Extensive exposure, such as from agricultural use or malaria control might have long-term health concerns because residues can be found in breastmilk.[3] Only water-miscible cream, gel or liquid products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[4]
Maternal / infant drug levels
Because less than 2% is absorbed after topical application, rapid metabolism to inactive metabolites and safe application directly on infants’ skin, topical permethrin products are acceptable in nursing mothers.[1][2] Extensive exposure, such as from agricultural use or malaria control might have long-term health concerns because residues can be found in breastmilk.[3] Only water-miscible cream, gel or liquid products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[4]
Possible effects of Permethrin on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Permethrin
Pyrethrins.
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Porto I. Antiparasitic drugs and lactation: focus on anthelmintics, scabicides, and pediculicides. J Hum Lact. 2003;19:421-5. PMID: 14620457
2. Leachman SA, Reed BR. The use of dermatologic drugs in pregnancy and lactation. Dermatol Clin. 2006;24:167-97. PMID: 16677965
3. Bouwman H, Kylin H. Malaria control insecticide residues in breast milk: the need to consider infant health risks. Environ Health Perspect. 2009;117:1477-80. PMID: 20019894
4. Noti A, Grob K, Biedermann M et al. Exposure of babies to C(15)-C(45) mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 2003;38:317-25. PMID: 14623482
5. Zehringer M , Herrmann A. Analysis of polychlorinated biphenyls, pyrethroid insecticides and fragrances in human milk using a laminar cup liner in the GC injector. Eur Food Res Technol. 2001;212:247-51.
6. Sereda B, Bouwman H, Kylin H. Comparing water, bovine milk, and indoor residual spraying as possible sources of DDT and pyrethroid residues in breast milk. J Toxicol Environ Health A. 2009;72:842-51. PMID: 19557612
7. Bouwman H, Sereda B, Meinhardt HM. Simultaneous presence of DDT and pyrethroid residues in human breast milk from a malaria endemic area in South Africa. Environ Pollut. 2006;144:902-17. PMID: 16564119
8. Feo ML, Eljarrat E, Manaca MN et al. Pyrethroid use-malaria control and individual applications by households for other pests and home garden use. Environ Int. 2012;38:67-72. PMID: 21982035
9. Corcellas C, Feo ML, Torres JP et al. Pyrethroids in human breast milk: Occurrence and nursing daily intake estimation. Environ Int. 2012;47:17-22. PMID: 22717642
10. Ito S, Blajchman A, Stephenson M et al. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993;168:1393-9. PMID: 8498418
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
