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Crotamiton: Drug information

Crotamiton: Drug information
(For additional information see "Crotamiton: Patient drug information" and see "Crotamiton: Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • Crotan
Pharmacologic Category
  • Scabicidal Agent
Dosing: Adult

Note: Eurax cream and lotion have been discontinued in the US for >1 year.

Pruritus

Pruritus: Topical: Massage into affected areas until medication is completely absorbed; repeat as necessary

Scabies

Scabies: Topical: Apply a thin layer and massage drug onto skin of the entire body from the neck to the toes (with special attention to skin folds, creases, and interdigital spaces). Repeat application in 24 hours. May re-treat if new lesions appear or itching persists more than 2 to 4 weeks after initial treatment (CDC 2018).

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in manufacturer's labeling.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in manufacturer's labeling.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Crotamiton: Pediatric drug information")

Note: Eurax cream and lotion have been discontinued in the United States for >1 year.

Scabies

Scabies (alternative agent): Limited data available; recommended regimens variable:

AAP recommendations: Infants, Children, and Adolescents: Topical: Apply a thin layer onto skin of entire body from neck to toes overnight for 3 consecutive nights (days 1 through 3) and again on day 8 (Bradley 2022; Red Book [AAP 2021]). Shorter durations of 2 consecutive nights have also been reported (Amer 1992; Bernigaud 2020; Diiorio 2020).

5-day regimen:

Infants ≥2 months and Children <2 years: Topical: Apply a thin layer onto skin of entire body from neck to toes once daily for 5 consecutive days without bathing or washing cream off until 24 hours after last application (Cubela 1978; Hay 2012; Konstantinov 1979).

Children ≥2 years and Adolescents: Topical: Apply a thin layer onto skin of entire body from neck to toes once or twice daily for 5 consecutive days (Goldust 2014; Hay 2012; Pourhasan 2013).

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Adverse Reactions

The following adverse drug reactions are derived from product labeling unless otherwise specified.

Postmarketing:

Dermatologic: Dermal ulcer (anogenital) (Handa 2022), dermatitis, purpuric rash (anogenital) (Handa 2022), skin necrosis (anogenital) (Handa 2022), skin rash

Hypersensitivity: Hypersensitivity reaction

Contraindications

Hypersensitivity to crotamiton or any component of the formulation; patients who manifest a primary irritation response to topical medications

Warnings/Precautions

Other warnings/precautions:

• Appropriate use: For external use only; avoid contact with face, eyes, mucous membranes, and urethral meatus. Do not apply to acutely inflamed, raw, or weeping skin. Discontinue use if severe irritation or sensitization occurs.

Warnings: Additional Pediatric Considerations

Some dosage forms may contain propylene glycol; in neonates large amounts of propylene glycol delivered orally, intravenously (eg, >3,000 mg/day), or topically have been associated with potentially fatal toxicities which can include metabolic acidosis, seizures, renal failure, and CNS depression; toxicities have also been reported in children and adults including hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP 1997; Shehab 2009).

Product Availability

Eurax cream and lotion have been discontinued in the US for >1 year.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Lotion, External:

Crotan: 10% (60 g, 237 g, 454 g) [contains benzyl alcohol, cetyl alcohol, propylene glycol]

Generic Equivalent Available: US

No

Pricing: US

Lotion (Crotan External)

10% (per gram): $8.10

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Administration: Adult

Topical: For external use only; avoid eyes and mucous membranes. Shake lotion well before using. Take a bath or shower prior to application. Apply from neck down to toes. Trim fingernails and apply under nails (can use toothbrush, which should be disposed of after use). Take a cleansing bath 48 hours after the final application. Contaminated clothing and bed linens should be washed on hot cycle or dry-cleaned and all clothing and bedding should be changed the day after application.

Administration: Pediatric

Topical: For external use only; avoid eyes and mucous membranes. Shake lotion well before using. Take a bath or shower prior to application and towel dry skin; apply a thin layer and gently massage drug onto skin of the entire body from the neck to the toes (with special attention to skin folds, creases, and interdigital spaces); also apply under fingernails after trimming nails short (can use toothbrush to apply under nails; dispose of toothbrush after use). Because scabies can affect the head, scalp, and neck in infants and young children, apply to scalp, neck, and body of this age group (Diiorio 2020; Red Book [AAP 2021]). Take a cleansing bath 24 to 48 hours after the final application (Diiorio 2020; manufacturer's labeling). Contaminated clothing and bed linens should be washed on a hot cycle or dry-cleaned and all clothing and bedding should be changed the day after treatment is completed.

Use: Labeled Indications

Treatment of scabies (Sarcoptes scabiei) and symptomatic treatment of pruritus

Medication Safety Issues
Sound-alike/look-alike issues:

Eurax may be confused with Efudex, Eulexin, Evoxac, Serax, Urex

International issues:

Eurax [US, Canada, and multiple international markets] may be confused with Urex brand name for furosemide [Australia, China, Turkey] and methenamine [US, Canada]

Metabolism/Transport Effects

None known.

Drug Interactions

There are no known significant interactions.

Pregnancy Considerations

Animal reproduction studies have not been conducted; use during pregnancy only if clearly needed.

Breastfeeding Considerations

It is not known if crotamiton is excreted in breast milk.

Mechanism of Action

Crotamiton has scabicidal activity against Sarcoptes scabiei; mechanism of action unknown. Antipruritic effects mediated by inhibition of histamine, serotonin, and PAR-2 (Sekine 2012).

Pharmacokinetics (Adult Data Unless Noted)

Absorption: Amount of systemic absorption following topical use has not been determined

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Eurax;
  • (AT) Austria: Eurax;
  • (AU) Australia: Eurax;
  • (BD) Bangladesh: Crodex | Cronix | Crotam | Curex;
  • (BE) Belgium: Eurax;
  • (BF) Burkina Faso: Prurex;
  • (CH) Switzerland: Eurax;
  • (CL) Chile: Clamox | Eurax | Medinal | Sundar;
  • (CN) China: You li fu;
  • (CO) Colombia: Cropiton | Eurax | Liroderm | Pielic | Prusyn;
  • (DE) Germany: Crotamitex | Eraxil;
  • (DO) Dominican Republic: Eurax;
  • (EG) Egypt: Crotamitex | Eurax;
  • (ET) Ethiopia: Eurax;
  • (FR) France: Eurax;
  • (GB) United Kingdom: Boots derma care itch relief | Eurax;
  • (GR) Greece: Eurax;
  • (HK) Hong Kong: A Bite | Crotaderm | Crotamiton stada | Croton | Eurax | Eurosin | Euroton | Mecroton | Pruderm | Scabex;
  • (ID) Indonesia: Crotaderm | Eurax;
  • (IE) Ireland: Eurax;
  • (IL) Israel: Eurax | Scabicin;
  • (IN) India: Crotin | Crotorax;
  • (IQ) Iraq: Aswatamiton | Crotamin | Euraxdain | Huarax;
  • (IT) Italy: Eurax;
  • (JO) Jordan: Eurax;
  • (JP) Japan: Eurax;
  • (KE) Kenya: Cromiton | Eurax;
  • (KR) Korea, Republic of: Prurex | Uracin;
  • (KW) Kuwait: Eurax;
  • (LB) Lebanon: Eurax;
  • (LU) Luxembourg: Eurax;
  • (MA) Morocco: Eurax;
  • (MX) Mexico: Acomexol | Eurax;
  • (MY) Malaysia: A Bite | Crotocort | Crotorax | Eurax | Moz-Bite | Pritarax | Scabex | Scabicide;
  • (NG) Nigeria: Eurax;
  • (NO) Norway: Eurax;
  • (NZ) New Zealand: Eurax | Itch Soothe;
  • (PE) Peru: Eurax;
  • (PH) Philippines: Eurax | Scabirax;
  • (PK) Pakistan: Crotan | Eurax | Scratnil;
  • (PR) Puerto Rico: Crotan | Eurax;
  • (PT) Portugal: Eurax;
  • (QA) Qatar: Eurax;
  • (SA) Saudi Arabia: Crotaphil | Eurax;
  • (SE) Sweden: Eurax;
  • (SG) Singapore: Anti itch cream | Eurax | Moz-Bite | Scabex;
  • (SI) Slovenia: Eurax;
  • (TH) Thailand: Eurax;
  • (TN) Tunisia: Eurax | Prurex;
  • (TR) Turkey: Dermiton;
  • (TW) Taiwan: Croxa | Dowsoft | Eurax | Ulex;
  • (UG) Uganda: Eurax;
  • (VE) Venezuela, Bolivarian Republic of: Crotanol;
  • (ZA) South Africa: Eurax;
  • (ZM) Zambia: Eurax
  1. Amer M, el-Gharib I. Permethrin versus crotamiton and lindane in the treatment of scabies. Int J Dermatol. 1992;31(5):357-358. doi:10.1111/j.1365-4362.1992.tb03958.x [PubMed 1375206]
  2. American Academy of Pediatrics (AAP). In: Kimberlin DW, Barnett ED, Lynfield R, Sawyer MH, eds. Red Book: 2021 Report of the Committee on Infectious Diseases. 32nd ed. American Academy of Pediatrics; 2021.
  3. American Academy of Pediatrics Committee on Drugs. "Inactive" ingredients in pharmaceutical products: update (subject review). Pediatrics. 1997;99(2):268-278. [PubMed 9024461]
  4. Bernigaud C, Fischer K, Chosidow O. The management of scabies in the 21st century: past, advances and potentials. Acta Derm Venereol. 2020;100(9):adv00112. doi:10.2340/00015555-3468 [PubMed 32207535]
  5. Bradley JS, Nelson JD, Kimberlin DK, et al, eds. Nelson's Pocket Book of Pediatric Antimicrobial Therapy. 28th ed. American Academy of Pediatrics; 2022.
  6. Centers for Disease Control and Prevention (CDC). Parasites—Scabies. CDC website. http://www.cdc.gov/parasites/scabies/treatment.html. Published October 31, 2018. Accessed February 24, 2021.
  7. Crotan (crotamiton) [prescribing information]. Charleston, SC: Marnell Pharmaceuticals LLC; received December 2021.
  8. Cubela V, Yawalkar SJ. Clinical experience with crotamiton cream and lotion in treatment of infants with scabies. Br J Clin Pract. 1978;32(8):229-231. [PubMed 728333]
  9. Diiorio DA, Humphrey SR. Arthropod bites and infestations. In: Kliegman RM, St. Geme J, eds. Nelson Textbook of Pediatrics. 21st ed. Saunders Elsevier; 2020:chap. 688.
  10. Eurax (crotamiton) [prescribing information]. Jacksonville, FL: Ranbaxy; September 2012.
  11. Goldust M, Rezaee E, Raghifar R. Comparison of oral ivermectin versus crotamiton 10% cream in the treatment of scabies. Cutan Ocul Toxicol. 2014;33(4):333-336. [PubMed 23431958]
  12. Handa T, Kamiya T, Kan Y, et al. Anogenital skin necrosis with fibrin thrombosis induced by crotamiton. Contact Dermatitis. 2022;86(3):221-223. doi:10.1111/cod.14001 [PubMed 34729785]
  13. Hay RJ, Steer AC, Engelman D, Walton S. Scabies in the developing world--its prevalence, complications, and management. Clin Microbiol Infect. 2012;18(4):313-323. [PubMed 22429456]
  14. Konstantinov D, Stanoeva L, Yawalkar SJ. Crotamiton cream and lotion in the treatment of infants and young children with scabies. J Int Med Res. 1979;7(5):443-448. [PubMed 499647]
  15. Pourhasan A, Goldust M, Rezaee E. Treatment of scabies, permethrin 5% cream vs. crotamiton 10% cream. Ann Parasitol. 2013;59(3):143-147. [PubMed 24881286]
  16. Sekine R, Satoh T, Takaoka A, Saeki K, Yokozeki H. Anti pruritic effects of topical crotamiton, capsaicin, and a corticosteroid on pruritogen-induced scratching behavior. Exp Dermatol. 2012;21(3):201-204. [PubMed 22379965]
  17. Shehab N, Lewis CL, Streetman DD, Donn SM. Exposure to the pharmaceutical excipients benzyl alcohol and propylene glycol among critically ill neonates. Pediatr Crit Care Med. 2009;10(2):256-259. [PubMed 19188870]
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