Usual Adult Dose for Scabies

Apply 30 mL of lotion as a thin layer over all skin from the neck down; wash off in 8 to 12 hours.

Maximum Dose: Larger adults may require up to 60 mL.

Comments: Use only once; do not re-treat.

Use: Treatment of scabies (infestations of Sarcoptes scabei) and their ova in patients who cannot tolerate or who have failed treatment with other approved therapies.

Usual Adult Dose for Lice

Apply 30 mL of shampoo directly to dry hair without adding water and give special attention to the fine hairs along the neck; after 4 minutes, add small quantities of water to hair until a good lather forms then immediately rinse all the lather away.

Maximum Dose: Up to 60 mL may be needed for long and dense hair.

Comments:

• Avoid unnecessary contact of lather with other body surfaces.
• Use only once; do not re-treat.

Usual Geriatric Dose for Lice

Use with caution.

Usual Geriatric Dose for Scabies

Use with caution.

Usual Pediatric Dose for Lice

• Premature Infants: Contraindicated.
• Infants and Children: Use with caution.

Usual Pediatric Dose for Scabies

• Premature Infants: Contraindicated.
• Infants and Children: Use with caution.

Renal Dose Adjustments

Data not available.

Liver Dose Adjustments

Data not available.

Precautions

US BOXED WARNINGS:

• APPROPRIATE USE: This drug is contraindicated in premature infants and individuals with known uncontrolled seizure disorders. Only use this drug in patients who cannot tolerate or have failed first-line treatment with safer medications for the treatment of scabies (lotion) or lice (shampoo). Instruct patients on the proper use of this drug (e.g., amount to apply, how long to leave it on, avoiding retreatment). Inform patients that itching occurs after the successful killing of scabies/lice and is not necessarily an indication for retreatment with this drug.
• NEUROLOGIC TOXICITY: Seizures and deaths have been reported following use of this drug with repeat or prolonged application, and also following a single application in rare cases. Use this drug with caution in infants, children, the elderly, and individuals with other skin conditions (e.g., atopic dermatitis, psoriasis) and in those who weigh less than 110 pounds (50 kg) as they may be at risk of serious neurotoxicity.

Dialysis

Data not available.

Other Comments

Administration Advice:

• Consult the manufacturer product information for step-by-step instructions on applying the lotion to the skin and the shampoo to the hair/scalp.
• Advise caregivers to wear gloves less permeable to this drug (e.g., nitrile, latex with neoprene, sheer vinyl), and thoroughly clean hands after application; natural latex gloves are more permeable and should not be used.

• This drug does not prevent infestation or re-infestation; it should not be used to ward off a possible infestation.

• Avoid contact with the eyes when applying this drug; if contact occurs, immediately flush eyes with water and consult a healthcare provider if irritation or sensitization occurs.
• Unless specifically directed by your healthcare provider, do not use this drug if you have open wounds, cuts, or sores.
• You may still itch after using this drug; do not use more of this drug to treat the itching. Consult your healthcare provider for other treatments that can be used to soothe the itching.