• Indications
  1. Lice (second-line treatment)
  • Contraindications
  1. Avoid under age 4 years old
  • Mechanism
  1. Neurotoxic to lice
  • Medications
  1. Topical Suspension 0.9%
  • 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)
  • 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]
  • Safety
  1. Pregnancy Category B
  2. Unknown safety in Lactation
  • Resources
  1. Spinosad topical suspension (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=8e87bd3b-db25-4e97-bf57-96c875f67ce1