Tuesday, November 8, 2016

Head Lice : Medications and Administration

Drugs
Recommended Therapy
Note1
FIRST LINE
Children
> 2 months

Adults
Permethrin 1% w/v Lotion1
[2 x 30ml bottle]
·         Apply for at least 10 minutes on dried hair
·         Rinse completely
·         Re-apply after 7-10 days1,3,6

·         First line therapy6
·         Category : B
·         Kills live lice but not unhatched eggs
·         Permethrin may continue to kill newly hatched lice for several days after treatment.
·         A second treatment often is necessary on day 9 to kill any newly hatched lice before they can produce new eggs3

Pregnancy and
Lactation
·         Animal studies showed no evidence of impairment or harm to fetus
·         No sufficient information on breast milk excretio. However unlikely to cause any harm to infant
·         Consider witholding therapy or temporary discontinuation of nurisng

SECOND LINE / NOT AVAILABLE
Children > 50 kg

Adults
Gamma Benzene Hexachloride
(Lindane) 0.1% lotion1
·           Apply sufficient amount onto clean, dry hair
·           Allow to remain for 4 minutes
·           Rinse off thoroughly with warm water
·         Second line
·         Category : B
·         Not available at our facility
·         Due to risk for neurologic adverse events1
·         Use restricted to treatment failure or not tolerating other medications

Children
> 6 months7

Adults
Malathion Shampoo 1%1
·         Apply shampoo on wet hair and work up lather
·         Leave for 15 minutes and rinse, then comb
·         Repeat if necessary after 7 - 9 days
·         Category : C+
·         Not available at our facility

1.       Formulari Ubatan KKM (November 2016)
2.       Pindaan / Tambahan Kepada Formulari Ubat KKM bil 2/2016
3.       Centres of Disease Control and Prevention (CDC)
4.       www.uptodate.com
5.       BNF for Children (September 2015-2016)
6.       Pediculosis and Scabies: A Treatment Update. Am Fam Physician. 2012 Sep 15;86(6):535-541.
7.       A-lices Scalp & Body Hygiene Shampoo Consumer Medicine Information



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