Curex

Approved Indications:

• Scabies (Sarcoptes scabiei infestation):
  Used for the treatment of scabies by killing the mites and their eggs.
• Pruritus (itching) of various causes:
  Provides symptomatic relief of pruritus associated with:
• Allergic dermatitis
• Insect bites
• Neurogenic itch
• Atopic or contact dermatitis

Clinically Accepted Off-Label Uses:

• Pruritus in elderly or sensitive skin types: When corticosteroids or antihistamines are contraindicated.
• Adjunctive treatment in secondary scabies or lichen simplex: To manage persistent itch and reduce scratching.

Route of Administration: Topical (external use only)

For Scabies:

• Adults and children ≥3 years:
• Apply a thin layer of Crotamiton 10% cream or lotion to the entire skin surface (excluding face and scalp unless instructed).
• Reapply the same way after 24 hours.
• Take a cleansing bath 48 hours after the last application.
• Total of two applications.

For Pruritus:

• Apply to affected area 2 to 3 times daily, rubbing gently until absorbed.
• Continue until symptoms resolve or as advised by a physician.

Pediatrics:

• Children <3 years: Use only under physician supervision.
• Children ≥3 years: Same as adults, under supervision.

Elderly:

• No dose adjustment needed; monitor for skin sensitivity.

Renal/Hepatic Impairment:

• No dosage adjustment required due to minimal systemic absorption.

Cautions in Administration:

• Do not apply to broken, inflamed, or oozing skin.
• Avoid contact with eyes, mouth, mucous membranes, and genital areas.
• Do not use occlusive dressings.

Crotamiton exerts dual pharmacological effects—as a scabicide and antipruritic. Its precise mechanism of action is not fully elucidated, but it is believed to kill Sarcoptes scabiei mites through direct toxic action on their nervous system and metabolism. It may interfere with the parasite's enzymatic or cellular pathways, leading to death. As an antipruritic, it acts by inhibiting peripheral sensory nerves and possibly affecting central itch pathways without involving histamine receptors. This dual effect provides rapid relief from itching and controls mite infestation effectively.

• Absorption: Minimal percutaneous absorption under normal conditions.
• Distribution: Negligible systemic distribution; acts locally at the application site.
• Metabolism: Not systemically metabolized at therapeutic doses.
• Elimination: Not significantly excreted; no measurable urinary or fecal elimination.
• Onset of Action: Itch relief begins within 15–30 minutes after application.
• Half-life/Bioavailability: Not applicable due to topical, non-systemic action.

• Pregnancy:
  Crotamiton is classified as Pregnancy Category C. There are no well-controlled studies in pregnant women. Animal data are insufficient. Use only when the benefits outweigh potential risks.
• Lactation:
  Unknown whether crotamiton is excreted in human breast milk. Caution is advised. Avoid application to the nipple area and extensive body surface during breastfeeding.
• Recommendation:
  Use only if clearly necessary under medical supervision during pregnancy and lactation. Avoid on broken skin to reduce absorption.

• Primary Class: Topical Antiparasitic Agent
• Subclass: Scabicide and Non-Steroidal Antipruritic

• Known hypersensitivity to crotamiton or any component of the formulation.
• Application on acutely inflamed, broken, or weeping skin lesions.
• Ophthalmic, oral, or intravaginal use is strictly contraindicated.
• Use in infants <3 years without physician supervision.

• Avoid contact with eyes, mouth, and mucosal surfaces.
• Do not use occlusive bandages; increased absorption may occur.
• Discontinue if irritation, rash, or allergic reaction develops.
• Avoid applying to large or damaged skin areas, especially in children or elderly.
• Safety in long-term or repeated use has not been established.
• If symptoms persist or worsen, re-evaluation is necessary.

Common (Local Reactions):

• Burning or stinging sensation
• Skin dryness
• Mild irritation or redness

Less Common:

• Allergic contact dermatitis
• Itching or rash worsening after application

Rare but Serious:

• Hypersensitivity reactions (e.g., generalized rash, angioedema)
• Secondary bacterial infections from excessive scratching

Note: Reactions are usually mild and reversible upon discontinuation.

• No significant systemic interactions reported due to minimal absorption.
• Avoid concurrent topical corticosteroids over the same area, which may suppress local immune response.
• Occlusive dressings may increase absorption and risk of toxicity.
• No known interactions with food, beverages, or alcohol.

• CDC and WHO guidelines recognize crotamiton as a second-line agent for scabies when first-line agents like permethrin or oral ivermectin are unavailable, contraindicated, or not tolerated.
• Continued recognition for use in pregnancy or young children where permethrin use may be avoided.
• No major recent changes in dosing or labeling. Remains available in 10% cream and lotion forms globally.

• Temperature: Store at 20°C to 25°C (68°F to 77°F); brief storage between 15°C and 30°C permitted.
• Light & Humidity: Protect from light and moisture.
• Do not freeze. Keep tightly closed and away from children.
• Shelf life: As per manufacturer’s instructions; typically 24–36 months.
• Shake lotion gently before use if separation occurs.