II. Indications
- Lice (second-line treatment)
III. Contraindications
- Avoid under age 4 years old
IV. Mechanism
- Neurotoxic to lice
V. Medications
- Topical Suspension 0.9%
VI. Dosing
- Apply to dry hair, leave on for 10 minutes and rinse
- Single application is effective (but may repeat in 9-10 days if lice are still present)
- Expensive ($200-280 per bottle in 2019)
VII. Efficacy
- Lice eradication rate (85%) is twice that of Permethrin
- Best efficacy is with nit combing
- Stough (2009) Pediatrics 124(3): e389-95 [PubMed]
VIII. Safety
- Pregnancy Category B
- Unknown safety in Lactation
IX. Resources
- Spinosad topical suspension (DailyMed)