II. Indications

  1. Lice (second-line treatment)

III. Contraindications

  1. Avoid under age 4 years old

IV. Mechanism

  1. Neurotoxic to lice

V. Medications

  1. Topical Suspension 0.9%

VI. Dosing

  1. Apply to dry hair, leave on for 10 minutes and rinse
  2. Single application is effective (but may repeat in 9-10 days if lice are still present)
  3. Expensive ($200-280 per bottle in 2019)

VII. Efficacy

  1. Lice eradication rate (85%) is twice that of Permethrin
  2. Best efficacy is with nit combing
  3. Stough (2009) Pediatrics 124(3): e389-95 [PubMed]

VIII. Safety

  1. Pregnancy Category B
  2. Unknown safety in Lactation

Images: Related links to external sites (from Bing)

Related Studies

Cost: Medications

natroba (on 4/20/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
NATROBA 0.9% TOPICAL SUSP $2.20 per ml