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Ivermectin Lotion (Sklice) for Head Lice



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Am Fam Physician. 2014 Jun 15;89(12):984-986.

Ivermectin 0.5% lotion (Sklice) is a prescription ovicidal pediculicide labeled for the topical treatment of head lice in patients six months and older.1

Drug Dosage Dose form Cost of full course*

Ivermectin 0.5% lotion (Sklice)

A single 4-oz (117-g) tube

Lotion (each gram of lotion contains 5 mg of ivermectin)

$280


*—Estimated retail price of one full course of treatment based on information obtained at http://www.goodrx.com (accessed April 24, 2014).

Drug Dosage Dose form Cost of full course*

Ivermectin 0.5% lotion (Sklice)

A single 4-oz (117-g) tube

Lotion (each gram of lotion contains 5 mg of ivermectin)

$280


*—Estimated retail price of one full course of treatment based on information obtained at http://www.goodrx.com (accessed April 24, 2014).

SAFETY

There have been no reports of serious adverse reactions with the use of topical ivermectin in a limited number of patients (i.e., fewer than 400).1,2 Ivermectin 0.5% lotion does not have the neurotoxicity concerns of lindane or the flammability concerns of malathion (Ovide).2,3 The safety of the lotion has not been established in patients younger than six months, and use in this age group is not recommended because of the potential risk of increased systemic absorption and ivermectin toxicity.1 Topical ivermectin is classified as a U.S. Food and Drug Administration pregnancy category C drug, and its excretion in breast milk has not been studied.1

TOLERABILITY

Topical ivermectin is well tolerated. The most common adverse effects are rare and include ocular irritation (0.5%) and burning sensation of the skin (0.3%).2 To date, no studies have compared the acceptability of topical ivermectin with other pediculicides.

Address correspondence to Jessica Early, MD, at jearly@challiance.org. Reprints are not available from the authors.

Author disclosure: No relevant financial affiliations.

REFERENCES

1. SKLICE (ivermectin) lotion. DailyMed. http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=4c5557cd-c4cf-11df-851a-0800200c9a66. Accessed September 7, 2013.

2. Pariser DM, Meinking TL, Bell M, Ryan WG. Topical 0.5% ivermectin lotion for treatment of head lice. N Engl J Med. 2012;367(18):1687–1693.

3. Nolan K, Kamrath J, Levitt J. Lindane toxicity: a comprehensive review of the medical literature. Pediatr Dermatol. 2012;29(2):141–146.

4. Pio MY, Osayande A. Spinosad (Natroba) for head lice. Am Fam Physician. 2013;87(12):874–876.

5. Meinking TL, Villar ME, Vicaria M, et al. The clinical trials supporting benzyl alcohol lotion 5% (Ulesfia): a safe and effective topical treatment for head lice (pediculosis humanus capitis). Pediatr Dermatol. 2010;27(1):19–24.

STEPS new drug reviews cover Safety, Tolerability, Effectiveness, Price, and Simplicity. Each independent review is provided by authors who have no financial association with the drug manufacturer.

The series coordinator for AFP is Allen F. Shaughnessy, PharmD, Tufts University Family Medicine Residency Program at Cambridge Health Alliance, Malden, Mass.

A collection of STEPS published in AFP is available at http://www.aafp.org/afp/steps.



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