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Before Proceeding to the Medical Consultation Form please read
CONTRAINDICATIONS /PRECAUTIONS and  WARNINGS 
and accept the Waiver of Liability


In order for Medical Wellness Center Physicians to provide you with the best care you need  read and agree to Waiver of  Liability and you need to reply honesty to all questions and you need to understand any and all risks and side effects associated with Elimite Cream.


 To order Elimite Cream Prescription:
  1. First read about Elimite Cream and it's contraindications/precautions, and read and agree to the Waiver of Liability
  2. Next, accurately and truthfully complete and submit a medical consultation questionnaire
  3. Your medial consultation will be reviewed by one of our Physicians and if approved you will receive an Elimite prescription with 6 refills.  This physician evaluation is RISK-FREE.  If Elimite is not appropriate for you there is No charge.  The initial consultation fee for the physician evaluation is only $49.95. 
  4. If you you are experiencing an acute scabies outbreak and need a prescription within 24 hours, you can indicate this urgency and have your medical consultation reviewed and a prescription called in to a pharmacy of your choice within 24 hours.
CONTRAINDICATIONS/PRECAUTIONS:
There are NO known absolute contraindications to the use of Ellimite cream, but Elimite cream use has not been thoroughly evaluated  in a number of situations:
  • Elimite cream should ONLY be used in the TOPICAL treatment of Scabies.  It is not to be taken internally.
  • Anyone with a severely compromised immune system or advanced HIV disease should not use Elimite unless prescribed-by and under the direct supervision of their regular primary-care physician.    If you have any questions about your medical condition, consult your primary care physician before using Elimite cream.
  • Avoiding contact with the eyes; flushing eyes thoroughly with water if medication accidentally gets in eyes
  • Do not use if you are sensitive to veterinary insecticides containing permethrin will be sensitive to permethrin cream or lotion. In addition, patients sensitive to other synthetic pyrethroids, such as those found in household insecticides, {06} or sensitive to pyrethrins or chrysanthemums may be sensitive to this medication also. {01} {04}
  • Hypersensitivity to any ingredient of Elimite cream contraindicates usage: Active Ingredient: Each gram contains permethrin 50 mg (5%).

  • Inactive Ingredients: Butylated hydroxytoluene, carbomer 934 P, fractionated coconut oil, glycerin, glyceryl monostearate, isopropyl myristate, lanolin alcohols, mineral oil, polyoxyethylene cetyl ethers, purified water, and sodium hydroxide. Formaldehyde 1 mg (0.1%) is added as a preservative.
  • Absolutely no one under the age of 18 should use Elimite cream without direct physician supervision.  It is absolutely contraindicated in babies under 2 months of age.
  • Pregnant women and nursing mothers should NOT use Elimite cream, there are no adequate studies to guarantee safety, and whether the active ingredients may get into breast milk.
IMPORTANT WARNING:
Elimite cream is only prescribed by our service for ADULTS with NORMAL immune systems only! There are no adequate studies of Elimite during pregnancy or breast feeding, therefore Elimite Cream should not be used by pregnant women or nursing woman. 

Elimite cream should only be applied externally. Do not get in eyes.  If ingested by mistake call 911 immediately or your local poison center for emergency treatment.

IMPORTANT PRECAUTIONS - SIDE EFFECTS:

When using Elimite cream as directed, local skin reactions such as erythema (redness),edema (swelling) along with some discomfort, burning, itching are very common.  If you should develop a more severe local skin reaction, you should seek medical attentions. 

IMPORTANT PATIENT INFORMATION:

Elimite cream is a ONE time application only.  It takes up to 6 weeks for the symptoms of itching to go away even though the scabies mite is completely irradicated.   Do not repeat application

To alleviate itching and burning soak in cool water or apply wet washcloth to irritated areas.  You can also apply soothing over-the-counter Calamine lotion to relieve itching.   Also, you can use over-the-counter antihistamines to relieve the allergic symptoms caused by scabies.
 

  1. This medication is to be used as directed by a physician.  It is for external use only.  Eye contact should be avoided.
  2. Apply from head to toe avoiding eyes before bedtime and leave on for 8 -14 hours.
  3. Wash off in bath or shower
  4. Treat all family member/household members and close intimate contacts.  After infection symptoms do not occur for up to 30 days.
  5. Treat all bedding, clothes etc - wash and dry for 1 1/2 hours. 
  6. Any items that can not be washed place in plastic bag and leave for 2 weeks.  The eggs hatch in 10 days and the mite can not live away from human skin contact for more than 24 hours.

I DO NOT HAVE ANY OF THE ABOVE CONTRAINDICATIONS:
By accepting "I Agree" means that you have read the above contraindication, precautions and warnings and honestly acknowledge that you do not have any of the above contraindications to Elimite therapy. 
I agree, proceed to Waiver of LiabilityI disagree
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