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.
Key points to consider when prescribing oral ivermectin for scabies include:
- The importance of combination treatment with a topical scabicide for crusted scabies
- The need for careful consideration in patients with certain health conditions or taking specific medications
- The potential for treatment failure with a single dose of topical scabicide or oral ivermectin alone
- The recommendation to avoid lindane due to risks of neurotoxicity 1
It's crucial to follow the prescribed treatment regimen and to take measures to prevent reinfestation, such as washing and drying clothing and bedding on high heat. Additionally, treating close contacts simultaneously is essential due to the contagious nature of scabies. While oral ivermectin is effective, it's not suitable for everyone, such as pregnant women or children under a certain weight, highlighting the need for individualized treatment plans based on the patient's specific situation and medical history.
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.