Monosulfiram: Brands, Price & Uses in Bangladesh

Monosulfiram is a topical scabicide (thiocarbamate derivative) indicated for the treatment of scabies caused by the mite Sarcoptes scabiei.

• Established use: Treatment of scabies in adults and children, applied as a whole-body topical preparation (solution or medicated soap), as part of standard scabies management protocols.
• Adjunct measures: Monosulfiram therapy is most effective when combined with simultaneous treatment of close contacts and household members, and thorough washing of bedding and clothing, to prevent reinfestation.
• Not established: Monosulfiram is not established or recommended for the treatment of head lice (pediculosis) or other non-scabies skin infestations; it should not be used for indications outside topical scabies treatment.

Adult Dose

Monosulfiram is applied topically as a soap or lotion to the entire body surface from the neck down (including areas not visibly affected, since mites can be present in apparently normal skin), typically once daily for 2-3 consecutive days as directed by the treatment protocol, then washed off after the recommended contact time. A course may be repeated after about one week if live mites persist.

Pediatric Dose

Used in children under medical supervision with the same whole-body application principle; concentration/duration of contact may be adjusted downward in young children and infants to reduce systemic absorption. See Use in Special Populations.

Administration Notes

• For external/topical use only; not for oral or mucosal use.
• Apply to the entire body surface from the neck down, not just visibly affected areas.
• Avoid contact with the eyes, mucous membranes, and open or broken skin.
• Treat all close contacts and household members simultaneously, and wash bedding and clothing, per standard scabies management protocols, to prevent reinfestation.
• Strictly avoid alcohol consumption (oral, and topical/cosmetic alcohol-containing products applied to skin) during treatment with Monosulfiram and for several days afterward. See Interactions.

• Local skin irritation, erythema (redness), or a rash at the site of application
• Dizziness, headache, or fatigue (particularly if systemic absorption occurs)
• Disulfiram-like reaction (flushing, tachycardia, nausea, hypotension) if alcohol is consumed during treatment — see Interactions
• Rarely, severe hypersensitivity skin reactions have been reported with Monosulfiram use