Spinosad

Class: Scabicides and Pediculicides
Chemical Name: (2R,3aS,5aR,5bS,9S,13S,14R,16aS,16bR)-2-[(6-Deoxy-2,3,4-tri-O-methyl-α-l-mannopyranosyl)oxy]-13-[[(2R,5S,6R)-5-(dimethylamino)tetrahydro-6-methyl-2H-pyran-2-yl]oxy]-9-ethyl-14methyl-2,3,3a,5a,5b,6,9,10,11,12,13,14,16a,16b-tetradecahydro-11H-as-indaceno[3,2-d]oxacyclododecin-7,15-dione
Molecular Formula: C₈₃H₁₃₂N₂O₂₀C₄₁H₆₅NO₁₀C₄₂H₆₇NO₁₀
CAS Number: 168316-95-8
Brands: Natroba

Medically reviewed by Drugs.com on Jan 24, 2022. Written by ASHP.

Introduction

Pediculicide.

Uses for Spinosad

Pediculosis

Topical treatment of pediculosis capitis (head lice infestation) in adults and children ≥4 years of age.

AAP usually recommends topical permethrin 1% or topical pyrethrins with piperonyl butoxide for initial treatment; some clinicians suggest spinosad 0.9% suspension may be an alternative, especially for permethrin-resistant pediculosis capitis.

Spinosad Dosage and Administration

General

Measures to Avoid Reinfestation and Transmission

• To avoid reinfestation or transmission of lice, most experts recommend that clothing, hats, bed linen, and towels that were worn or used by the infested individual during the 2 days prior to treatment be decontaminated (machine-washed in hot water and dried in a hot dryer).

• Items that cannot be laundered can be dry-cleaned or sealed in a plastic bag for 2 weeks.

• Decontaminate combs, brushes, and hair clips used by the infested individual by soaking in hot water (>54°C) for 5–10 minutes.

• Thoroughly vacuum car seats, upholstered furniture, and floors of rooms inhabited by infested individual. Fumigation of living areas is not necessary.

• Evaluate other family members and close contacts of the infested individual and treat if lice infestation is present. Some clinicians suggest treating family members who share a bed with the infested individual, even if no live lice are found on this family member. Ideally, treat all infested household members and close contacts at the same time.

• Use of fine-toothed or nit comb to remove any remaining nits (eggs) or nit shells from the hair is not necessary following application of spinosad. Some clinicians do not consider nit removal necessary since only live lice can be transmitted, but recommend it for aesthetic reasons and to decrease diagnostic confusion and unnecessary retreatment. Other clinicians recommend removal of nits (especially those within 1 cm of the scalp) to decrease risk of reinfestation since no pediculicide is 100% ovicidal and potentially viable nits may remain on the hair after treatment. Although many schools will not allow children with nits to attend, AAP and other experts consider these no-nit policies excessive.

Administration

Topical Administration

Apply topically to scalp and scalp hair as a 0.9% suspension.

For external use only. Do not administer orally or intravaginally; do not apply topically to eyes.