From the Guidelines
Yes, there is an oral medication available for treating scabies, specifically ivermectin, which can be prescribed as a pill. According to the 2015 guidelines for treating sexually transmitted diseases, including scabies, oral ivermectin is recommended for the treatment of crusted scabies, particularly in combination with a topical scabicide 1. The dosage for oral ivermectin is 200 ug/kg on days 1,2,8,9, and 15, with additional doses on days 22 and 29 potentially required for severe cases 1.
When considering treatment options for scabies, it's crucial to weigh the benefits and risks of each medication. Ivermectin is an effective option, especially for cases where topical treatments are not feasible or for widespread infestations. However, it's essential to note that topical treatments like permethrin cream are often the first-line therapy for many scabies cases.
Key points to consider when prescribing oral ivermectin for scabies include:
- The importance of simultaneous treatment of all household members and close contacts to prevent reinfestation
- The need to wash bedding and clothing in hot water to eliminate any surviving mites
- Potential side effects such as headache, dizziness, or mild skin rash
- The necessity of informing the doctor about any other medications being taken to avoid potential interactions
In the context of real-life clinical medicine, prioritizing the patient's morbidity, mortality, and quality of life is paramount. Therefore, the use of oral ivermectin as a treatment for scabies, particularly in cases where topical treatments are not suitable, is a viable and effective option, as supported by the guidelines 1.
From the Research
Availability of Oral Medication for Scabies
- There is evidence to suggest that oral ivermectin is an effective treatment for scabies, as reported in studies 2, 3, 4.
- Ivermectin has been shown to be safe and effective in treating scabies in both healthy individuals and those with HIV infection 3, 4.
- A single dose of ivermectin (200 micrograms per kilogram of body weight) has been found to be curative in many cases of scabies, although repeated doses may be required in some cases, particularly in HIV-related scabies 3, 4.
Comparison with Topical Treatments
- A study comparing the efficacy of oral ivermectin with topical permethrin found that twice application of permethrin with a 1-week interval was superior to a single dose of ivermectin 5.
- However, oral ivermectin has been found to be effective in treating scabies, especially in cases where topical treatments are not well tolerated or are ineffective 2, 3, 4.
Alternative Oral Treatments
- In cases where oral ivermectin is not available, oral albendazole may be used as an alternative treatment for moderate crusted scabies, in combination with topical permethrin and salicylic acid 6.
- Albendazole has been found to be effective in treating crusted scabies, with a clinical and microscopic cure achieved in a reported case 6.