II. Indications

  1. Resistant Head Lice

III. Contraindications

  1. Infants

IV. Mechanism

V. Precautions

  1. Flammable - keep away from flame or heat source (e.g. hair dryer)
  2. Keep lotion away from eyes
  3. Not recommended for infants

VI. Medications

  1. Malathion 0.5% in Isopropanol 78% (Ovide Lotion)

VII. Dosing: Head Lice (adults and children age >6 years)

  1. Apply lotion to dry hair until hair and scalp is wet and allow hair to air dry
  2. Wash hair after 8 to 12 hours
  3. Remove nits with fine-tooth comb
  4. Re-treat in 7 to 9 days (if needed)
  5. Do NOT blow dry hair (flammable)

VIII. Adverse Effects

  1. Stinging and irritation secondary to Alcohol base
  2. Considered safe for topical use in children and adults (but avoid in infants)
    1. Little if any systemic absorption at this dose

IX. Safety

  1. Pregnancy Category B
  2. Unknown Safety in Lactation

X. Efficacy

  1. Highly pediculicidal (kills lice)
  2. Highly ovicidal (kills eggs)
  3. Offers residual protection by binding hair
  4. Resistance has been reported

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Related Studies

Cost: Medications

malathion (on 7/20/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
MALATHION 0.5% LOTION Generic $3.71 per ml

Ontology: Malathion (C0024547)

Definition (NCI) A synthetic phosphorous compound and cholinesterase inhibitor that is strictly used as a topical pediculicide. Malathion exerts its action on the nervous system of the lice by irreversibly inhibiting the activity of cholinesterase, thereby allowing acetylcholine to accumulate at cholinergic synapses and enhancing cholinergic receptor stimulation. This eventually leads to the head lice's death.
Definition (MSH) A wide spectrum aliphatic organophosphate insecticide widely used for both domestic and commercial agricultural purposes.
Concepts Hazardous or Poisonous Substance (T131) , Organophosphorus Compound (T115) , Pharmacologic Substance (T121)
MSH D008294
SnomedCT 333071000, 87205003
LNC LP16826-7, MTHU009774
English Carbafos, Carbofos, Carbophos, Karbofos, Malathion, Butanedioic acid, ((dimethoxyphosphinothioyl)thio)-, diethyl ester, Succinic Acid, mercapto-, Diethyl Ester, S-ester with O,O-Dimethylphosphorodithioate, Butanedioic Acid,((dimethoxyphosphinothioyl)thio)-, Diethyl Ester, malathion (medication), pediculicides malathion, MALATHION, Malathion [Chemical/Ingredient], carbophos, carbofos, malathion, Maldison, Malathion product, Malathion (substance), Malathion product (product), Malathion product (substance)
Swedish Malation
Czech malathion
Finnish Malationi
Russian MALATION, МАЛАТИОН
Spanish malatión (producto), malatión, producto (producto), malatión, producto, Malatión, Malathion, malatión (sustancia), malatión
Italian Karbofos, Carbophos, Carbofos, Malathion
Polish Malation
Japanese マラチオン, マラソン(薬物)
Portuguese Malathion, Malation
French Malathion
German Carbofos, Malathion

Ontology: Ovide (C0876117)

Concepts Pharmacologic Substance (T121) , Organophosphorus Compound (T115)
English Ovide, ovide