Monosol

Indications

Monosulfiram is applied to the skin to treat scabies, an itchy skin infestation caused by tiny mites that burrow into the skin. It is available as a solution (which is diluted before use) and as a medicated soap, which is also used to help prevent scabies and keep the skin clean during and after treatment.

How It Works

Monosulfiram is a sulfur-containing compound that is toxic to scabies mites and their eggs. When applied over the whole body, it kills the mites living in the skin, which allows the rash and itching to settle over the following weeks.

Dosage and Administration

Use exactly as directed on the label or by your doctor. The solution is usually diluted with water before use (commonly 1 part solution to 2 or 3 parts water for adults, and more dilute for children). After a bath, dry the skin and apply the diluted solution to the whole body from the neck down, including between fingers and toes, under the nails, the armpits and the genital area. Let it dry and leave it on as directed, then repeat on the following days if the label says so. The soap is used daily for bathing. All family members and close contacts should be treated at the same time, even without symptoms. For babies and young children, use only on medical advice.

Interactions

Monosulfiram is related to Disulfiram. If alcohol is drunk during treatment and for at least 48 hours afterwards, it can cause an unpleasant reaction with flushing, fast heartbeat, headache, nausea and vomiting. Avoid alcohol and alcohol-containing medicines. Use with Metronidazole may also cause reactions. Do not apply other skin products to the same area at the same time.

Contraindications

Do not use if you are allergic to monosulfiram, disulfiram or any ingredient of the product. Do not apply to broken, raw or badly infected skin unless a doctor advises it.

Side Effects

Possible side effects include:

• Skin irritation, burning, stinging or redness
• Itchy rash or allergic skin reaction (contact dermatitis)
• Flushing or other reactions if alcohol is consumed

Itching may continue for 2 to 4 weeks after successful treatment; this does not always mean the treatment failed.

Stop using it and get urgent medical help if you develop a widespread rash, blistering, swelling of the face, lips or throat, difficulty breathing, or severe flushing with fast heartbeat and vomiting.

Pregnancy and Lactation

There is limited information on safety in pregnancy and breastfeeding. Use only if a doctor advises it; other scabies treatments may be preferred. If breastfeeding, wash it off the breasts before feeding.

Precautions and Warnings

For external use only. Keep away from the eyes, mouth and other mucous membranes; if it gets in the eyes, rinse well with water. The solution may contain alcohol and be flammable, so keep it away from flames. Wash clothes, towels and bedding used in the last few days in hot water and dry in the sun. See a doctor if the rash becomes infected or does not improve.

Overdose

Using too much on the skin may increase irritation. If it is swallowed, contact a doctor or poison centre straight away, especially if alcohol has also been taken.

Therapeutic Class

Topical scabicide (anti-parasitic skin preparation).

Storage

Store below 30°C in a dry place, away from light, heat and flames, and out of the reach of children. Keep the bottle tightly closed.