ivermectin topical

Medically Reviewed on 1/5/2023

Generic Name: ivermectin topical

Brand Names: Sklice, Soolantra

Drug Class: Acne Agents, Topical; Scabicidal Agents; Pediculicides, Topical

What is ivermectin topical, and what is it used for?

Ivermectin topical is a medication used to treat head lice infestation, and inflammatory lesions caused by a skin condition known as rosacea. Ivermectin topical is available as a cream to apply on rosacea lesions and as a lotion for application on the scalp and hair for head lice. Ivermectin is an antiworm (anthelmintic) medication that kills head lice, but its mechanism of action in the treatment of rosacea lesions is not known.

Ivermectin is derived from the fermentation of a type of soil dwelling bacteria (actinomycetes), known as Streptomyces avermitilis. Ivermectin binds to the nerve and muscle cell membranes of head lice and increases their permeability to chloride ions, leading to paralysis and death of the parasites. Ivermectin topical solution kills lice as well as lice eggs (nits), and usually a single treatment can clear head lice infestation.

Warnings

  • Do not use ivermectin topical if you are hypersensitive to any of the components in the formulation.
  • Ivermectin topical is not meant for oral, ophthalmic, or intravaginal use.
  • Ivermectin topical solution should be used only for scalp and scalp hair.
  • Children should be administered ivermectin topical solution for head lice treatment only under direct adult supervision to prevent ingestion.
  • Do not use ivermectin topical solution on children below 6 months of age. The risk of systemic absorption and toxicity is higher because of the immature skin barrier and higher surface area to body mass ratio.
  • Ivermectin topical cream is not meant for use in children.

What are the side effects of ivermectin topical?

Common side effects of ivermectin topical include:

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

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What are the dosages of ivermectin topical?

Topical Lotion

  • 0.5% (Sklice)

Topical Cream

  • 1% (Soolantra)

Adult:

Lice

Sklice only

  • Pediculicide indicated for topical treatment of head lice infestation
  • Apply lotion to dry hair in amount sufficient (up to one 4-oz tube) to thoroughly coat the hair and scalp; leave lotion on hair for 10 minutes, and then rinse with water
  • For single use only, do not re-treat

Rosacea

Soolantra only

  • Indicated for inflammatory lesions caused by rosacea
  • Apply small amount of 1% cream to affected area(s) once daily
  • Use a pea-size amount for each area of the face (forehead, chin, nose, each cheek) that is affected
  • Spread as a thin layer, avoiding the eyes and lips

Pediatric:

Lice

Sklice only

Pediculicide indicated for topical treatment of head lice infestation

Children below 6 months:

  • Safety and efficacy not established

Children 6 months and above:

  • Apply lotion to dry hair in amount sufficient (up to one 4-oz tube) to thoroughly coat the hair and scalp; leave lotion on hair for 10 minutes, and then rinse with water
  • For single use only, do not re-treat

Overdose

  • Ivermectin topical is unlikely to result in overdose or toxicity if used appropriately. Accidental or intentional overdose by topical exposure, ingestion, inhalation or injection can cause rash, hives, contact dermatitis, edema, headache, dizziness, nausea, vomiting, diarrhea, abdominal pain, shortness of breath, weakness, tingling and numbness, seizure, and impairment of balance, coordination and speech.
  • Overdose is treated with symptomatic and supportive care that may include intravenous fluids, electrolytes and respiratory support, if required. Undigested drug in the gastrointestinal tract may be eliminated with induced vomiting, gastric lavage and administration of purgatives.

What drugs interact with ivermectin topical?

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

  • Ivermectin topical has no listed severe, serious, moderate, or mild interactions with other drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

Pregnancy and breastfeeding

  • Systemic absorption from topical ivermectin is far lower than from oral use of the drug, however, there are no adequate and well-controlled studies on the safety of topical ivermectin in pregnant women.
  • Ivermectin topical should be used during pregnancy only if potential benefits to the mother outweigh the possible risks to the fetus.
  • The presence of ivermectin in breastmilk after topical application has not been studied, although systemic absorption from topical use is expected to be low.
  • Decision to breastfeed must be made after considering the maternal benefits from the treatment and the risks to the nursing infant from exposure to the drug or from the mother’s underlying condition.
  • Nursing mothers should take care to avoid exposure to the drug in the breast area to prevent oral ingestion by the breastfed infant.

What else should I know about ivermectin topical?

  • Use ivermectin topical exactly as directed.
  • Ivermectin topical is for external use only. Avoid contact with eyes and lips. Wash hands thoroughly after use.
  • Check with your healthcare provider before using ivermectin topical if you have any skin conditions or sensitivities.
  • Ivermectin topical solution for lice treatment is for single use only. Do not use it again without checking with your healthcare provider.
  • Store safely out of reach of children.
  • In case of overdose, seek medical help immediately or contact Poison Control.

Summary

Ivermectin topical is a medication used to treat head lice infestation, and inflammatory lesions caused by a skin condition known as rosacea. Ivermectin topical is available as a cream to apply on rosacea lesions and as a lotion for application on the scalp and hair for head lice. Common side effects of ivermectin topical include skin burning sensation, skin irritation, dry skin (xeroderma), dandruff, eye irritation, red eye (ocular hyperemia), inflammation of conjunctiva (conjunctivitis), and skin inflammation.

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Medically Reviewed on 1/5/2023
References
https://www.rxlist.com/consumer_sklice_soolantra_ivermectin_topical/drugs-condition.htm

https://reference.medscape.com/drug/sklice-soolantra-ivermectin-topical-999720

https://www.uptodate.com/contents/ivermectin-topical-drug-information

https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/206255lbl.pdf

https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/202736s003lbl.pdf

https://www.aafp.org/pubs/afp/issues/2014/0615/p984.html