Monosulfiram solution is a parasiticidal agent effective against the burrowing mite Sarcoptes scabiei. It is indicated for both the treatment and prevention of scabies.

Monosulfiram is an ectoparasiticide that is used in the treatment and prevention of scabies by destroying the causative parasites on the skin.

Before application Monosulfiram Solution should be diluted with two to three parts of water. The patient's body should be liberally washed with soap and water and thoroughly dried. Apart from face and scalp, the entire body should be painted with the dilute solution, which is rubbed well in and left to dry. About ten minutes is allowed for the skin to dry naturally and the patient then dresses. Application is suitable for use in clinics dealing with children. In difficult cases this routine may be repeated successively for two or three days. These instructions are applicable to adults and children.

No clinically significant drug interactions have been reported and none are well established.

Contraindicated in individuals with known idiosyncratic hypersensitivity to Monosulfiram. The solution should not be used near an open flame. Due to its chemical similarity to disulfiram, alcohol should be avoided before and for at least 48 hours after application.

Adverse effects are uncommon even when applied undiluted. Rare cases of erythematous rash due to idiosyncratic reaction have been reported.

Pregnancy category has not been classified. The FDA has not assigned a specific category for this drug.

The solution contains alcohol and monosulfiram; ingestion may cause severe reactions such as flushing, dyspnoea, headache, dizziness, nausea, vomiting, drowsiness or sleep. Tachycardia and hypotension may occur, and myocardial ischaemia may be fatal. Management includes symptomatic treatment, oxygen therapy in severe dyspnoea, and blood pressure control. Additional supportive measures may include cardiac stimulants, intravenous iron, ascorbic acid, nicotinamide, adenine, and intravenous sodium thiosulphate.

Parasiticidal preparations

Store at room temperature (below 35°C). Do not store in a cold place as crystallization may occur; crystals can be redissolved by placing the bottle in warm water. The solution is flammable and should be kept away from open flames. Water is a suitable diluent for Monosulfiram.