Pedi: Children <6 mo (↑ risk of benzyl alcohol absorption).
Use Cautiously in:
Pedi: Children <4 yr (safety and effectiveness for treatment of scabies not established).
Adv. Reactions/Side Effects⬆⬇
EENT: ocular erythema
Local: erythema
Interactions⬆⬇
Drug-drug:
None reported.
Route/Dosage⬆⬇
Head Lice
(Adults and Children ≥6 mo): Apply amount necessary to wet scalp (up to 1 bottle), leave in place for 10 min, then rinse; may be repeated after 7 days if live lice are still seen.
Scabies
(Adults and Children ≥4 yr): Apply amount necessary to completely cover skin from the neck to the toes (including the soles of the feet). Allow suspension to absorb into skin and dry for 10 min before getting dressed.
Availability⬆⬇
Topical suspension: 0.9%
Assessment⬆⬇
Lice: Assess scalp for presence of lice and their ova (nits) prior to and 1 wk after application of spinosad.
Scabies: Assess skin for scabies prior to and following therapy.
Implementation⬆⬇
Topical For topical application only.
Patient/Family Teaching⬆⬇
Instruct patient to avoid swallowing suspension or getting suspension in eyes. If suspension gets in eyes, flush eyes thoroughly with water.
If patient is a child, instruct parents to notify school nurse or day care center so that classmates and playmates can be checked for lice or scabies.
Advise patient/parent that others residing in the home should be examined for lice or scabies.
Lice: Instruct patient/parent on correct application technique and not to change treatment without consulting health care professional. Use suspension in 1 or 2 treatments that are 1 wk apart. If live lice are seen 7 days after first application, repeat application. Shake bottle well. Cover face and eyes with a towel and keep eyes tightly closed. Use suspension only on dry scalp and dry hair. Completely cover scalp first; then apply outward toward ends of hair. Use enough suspension to coat completely every single louse. Leave it on scalp for a full 10 min. Continue to keep eyes covered to prevent dripping into eyes. Because all lice must be covered, help with application is advised. After 10 min, completely rinse suspension from hair and scalp with warm water. Wash hands after application. Hair may be shampooed any time after treatment.
Instruct patient/parent on methods of preventing reinfestation. All clothes, including outdoor apparel and household linens, should be machine-washed using very hot water and dried for at least 20 min in a hot dryer. Soak brushes and combs in hot (130° F), soapy water for 5–10 min. Remind patient that brushes and combs should not be shared. Shampoo wigs and hairpieces. Vacuum rugs and upholstered furniture. Wash toys in hot, soapy water. Items that cannot be washed should be sealed in a plastic bag for 2 wk.
Scabies: Instruct patient or parent to cover the body with the suspension from neck to soles of feet. If patient is bald, also apply to the scalp, hairline, temples, and forehead. Allow suspension to absorb into the skin and dry for 10 min before getting dressed. Leave on the skin for ≥6 hr before showering or bathing. One application is curative.
Instruct patient on methods of preventing reinfestation of scabies. All clothes, including outdoor apparel and household linens and towels, should be machine-washed using very hot water and dried for at least 20 min in a hot dryer. Dry-clean nonwashable clothes.
Advise female patient to notify health care professional if pregnancy is planned or suspected, or if breastfeeding. Women who are breastfeeding may choose to pump and discard breast milk for 8 hr after use to avoid infant ingestion.
