The Medical Letter on Drugs and Therapeutics
Spinosad (Natroba) Topical Suspension for Head Lice
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The FDA has approved spinosad 0.9% suspension (Natroba – ParaPro) for topical treatment of head lice infestation in patients ≥4 years old. It is available only by prescription.

MECHANISM OF ACTION — Spinosad is a fermentation product of the soil actinomycete Saccharopolyspora spinosa. It causes neuronal excitation in insects, leading to paralysis and death. It is not ovicidal. Natroba contains an unspecified amount of benzyl alcohol, which is also pediculicidal.1

PHARMACOKINETICS — An unpublished study in 14 children with head lice summarized in the package insert found that application of spinosad 0.18% for 10 minutes did not produce detectable plasma levels of the drug. Plasma concentrations of benzyl alcohol were not determined.

DRUGS FOR HEAD LICEPyrethrins ... more      

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