ivermectin topical (Sklice, Soolantra)
Classes: Scabicidal Agents; Pediculicides, Topical; Acne Agents, Topical
Dosing and uses of Sklice, Soolantra (ivermectin topical)
Adult dosage forms and strengths
topical lotion
- 0.5% (Sklice)
topical cream
- 1% (Soolantra)
Lice
Pediculicide indicated for topical treatment of head lice infestation
Sklice: Apply 0.5% 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 retreat
Administration instructions for lice
- For topical use only
- Avoid contact with eyes
- Use lotion in context of an overall lice management program including hot-water washing or dry-cleaning of all recently worn clothing and linens
- Wash personal care items (eg, combs, brushes, hair clips)
- A fine tooth comb or nit comb may be used to remove dead lice and nits
Rosacea
Indicated for inflammatory lesions caused by rosacea
Soolantra: Apply small amount of 1% cream to affected area(s) qDay
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 dosage forms and strengths
topical lotion
- 0.5% (Sklice)
Lice
Pediculicide indicated for topical treatment of head lice infestation
<6 months: Safety and efficacy not established
Sklice (≥6 months): Apply 0.5% 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 retreat
Administration instructions for lice
- For topical use only
- Avoid contact with eyes
- Use lotion in context of an overall lice management program including hot-water washing or dry-cleaning of all recently worn clothing and linens
- Wash personal care items (eg, combs, brushes, hair clips)
- A fine tooth comb or nit comb may be used to remove dead lice and nits
Sklice, Soolantra (ivermectin topical) adverse (side) effects
<1%
Conjunctivitis
Ocular hyperemia
Eye irritation
Dandruff
Dry skin
Skin burning sensation
Warnings
Contraindications
None
Cautions
To prevent ingestion, administer to children only with direct adult supervision
Not for oral, ophthalmic or intravaginal use
Pregnancy and lactation
Pregnancy category: C; no comparisons of animal exposure with human exposure are available with topical ivermectin because of low systemic absorption
Lactation: Following oral administration, ivermectin is excreted in human milk in low concentrations; excretion following topical administration has not been evaluated
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Sklice, Soolantra (ivermectin topical)
Mechanism of action
Pediculicide derived from fermentation of a soil dwelling actinomycete, Streptomyces avermitilis
Causes parasite death by selective, high-affinity binding to glutamate-gated chloride channels located in invertebrate nerve and muscle cells; this results in increased cell membrane permeability to chloride ions with hyperpolarization of the nerve or muscle cells, and ultimately parasite paralysis and death
The mechanism by which ivermectin topical treats rosacea lesions is unknown
Absorption
Plasma levels following topical administration are much lower than those observed following PO administration
Peak Plasma Concentration: 0.24 ng/mL (topical); 30.6-46.6 ng/mL (PO)
AUC: 6.7 hr•ng/mL
