Ivermectin (Topical)
Brand names: Sklice
Drug class:
Antineoplastic Agents
Usage of Ivermectin (Topical)
Pediculosis
Topical treatment of pediculosis capitis (head lice infestation) in adults and children ≥6 months of age.
AAP and others usually recommend topical treatment with OTC preparation of permethrin 1% or pyrethrins with piperonyl butoxide for initial treatment; other topical pediculicides (e.g., malathion 0.5%, Benzyl Alcohol 5%, spinosad 0.9%) recommended if OTC preparations ineffective or permethrin or pyrethrin resistance suspected. Oral ivermectin recommended as an alternative for infestations not responding to or resistant to topical agents.
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How to use Ivermectin (Topical)
General
Measures to Avoid Reinfestation and Transmission of Lice
Administration
Topical Administration
Apply topically to scalp and hair as 0.5% lotion.
For external use only. Do not administer orally or intravaginally; do not apply topically to eyes.
Apply to dry scalp and hair in amount sufficient to thoroughly coat hair and scalp. Leave lotion on hair and scalp for 10 minutes, then thoroughly rinse off with warm (not hot) water. Minimize exposing other areas of skin by performing rinse at a sink (rather than in shower or bath).
Avoid contact with eyes. If contact with eyes occurs, immediately flush with water.
Available in single-use tube; discard any unused portion.
Supervise pediatric patients during lotion application; an adult should apply and rinse the lotion for the child. (See Inadvertent Ingestion in Pediatric Patients under Cautions.)
Wash hands after applying the lotion.
Dosage
Pediatric Patients
Pediculosis Pediculosis Capitis (Head Lice Infestation) TopicalInfants and children ≥6 months of age: Manufacturer recommends single application.
Apply to dry hair and scalp in an amount sufficient to completely coat hair and scalp. After 10 minutes, thoroughly rinse lotion off with water. (See Administration under Dosage and Administration.)
Adults
Pediculosis Pediculosis Capitis (Head Lice Infestation) TopicalManufacturer recommends single application.
Apply to dry hair and scalp in an amount sufficient to completely coat hair and scalp. After 10 minutes, thoroughly rinse lotion off with water. (See Administration under Dosage and Administration.)
Prescribing Limits
Pediatric Patients
Pediculosis Pediculosis Capitis (Head Lice Infestation) TopicalInfants and children ≥6 months of age: Do not exceed single tube of lotion (120 mL).
Adults
Pediculosis Pediculosis Capitis (Head Lice Infestation) TopicalDo not exceed single tube of lotion (120 mL).
Special Populations
No special population dosage recommendations.
Warnings
Contraindications
Warnings/Precautions
Inadvertent Ingestion in Pediatric Patients
To prevent ingestion in pediatric patients, use only under direct supervision of an adult. (See Pediatric Use under Cautions.)
Specific Populations
PregnancyCategory C.
LactationNot known whether distributed into milk after topical application. Use with caution in nursing women.
Pediatric UseSafety and efficacy not established in infants <6 months of age; greater skin surface area to body mass ratio and potentially immature skin barrier in this age group may increase systemic absorption and toxicity. Use only in infants and children ≥6 months of age.
Keep out of the reach of children; use only under direct supervision of an adult.
Geriatric UseInsufficient experience in adults ≥65 years of age to determine whether geriatric patients respond differently than younger adults.
Common Adverse Effects
Conjunctivitis, ocular hyperemia, eye irritation, dandruff, dry skin, burning skin sensation.
What other drugs will affect Ivermectin (Topical)
No formal drug interaction studies to date.
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