Brand Name(s):

  • Natroba®

WHY is this medicine prescribed?

Spinosad suspension is used to treat head lice (small insects that attach themselves to the skin) in adults and children 4 years of age and older. Spinosad is in a class of medications called pediculicides. It works by killing the lice.

HOW should this medicine be used?

Topical spinosad comes as a suspension (liquid) to apply to the scalp and hair. It is usually applied to the scalp and hair in one or sometimes two treatments. If live lice are seen one week after the first treatment then a second treatment of spinosad suspension should be applied. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use spinosad suspension exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Your hair length will determine how much suspension to use for each treatment. If you have long hair or thick, medium length hair, you may need to use the entire bottle. Be sure to use enough suspension to cover all of your scalp area and hair.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient. Read these instructions carefully.

Spinosad suspension should only be used on the hair and scalp. Avoid getting spinosad suspension in your eyes, mouth, or vagina.

If spinosad suspension gets in your eyes, flush them with water right away. If your eyes are still irritated after flushing with water, call your doctor or get medical help right away.

To use the suspension, follow these steps:

  • Shake the suspension well right before each use to mix the medication evenly.
  • Use a towel to cover your face and eyes. Be sure to keep your eyes closed during this treatment. You may need to have an adult help you apply the suspension.
  • Apply spinosad suspension to dry hair and scalp area. Be sure to use enough suspension to cover the entire scalp area first and then apply outwards towards the ends of the hair to cover all of the hair on your head.
  • Keep the suspension on your hair and scalp for 10 minutes after you finish applying the suspension. You should use a timer or clock to track the time.
  • After 10 minutes, rinse the suspension from your scalp and hair with warm water in a sink. You should not use a shower or bathtub to rinse the suspension away because you do not want to get the suspension over the rest of your body.
  • You and anyone who helped you apply the suspension should wash your hands carefully after the application and rinsing steps.
  • You may shampoo your hair after rinsing the suspension from your scalp and hair.
  • A lice comb may also be used to remove the dead lice and nits (empty egg shells) after this treatment. You may also need to have an adult help you to do this.
  • If you see live lice on your head one week after treatment, repeat this entire process.

After using spinosad suspension, sanitize all the clothing, underwear, pajamas, hats, sheets, pillowcases, and towels you have used recently. These items should be washed in very hot water or dry-cleaned. You should also wash combs, brushes, hairs clips and other personal care items in hot water.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before using spinosad suspension,

  • tell your doctor and pharmacist if you are allergic to spinosad, any other medications, or any of the ingredients in spinosad suspension. Ask your pharmacist for a list of the ingredients.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.
  • tell your doctor if you have or have ever had skin conditions or sensitivities.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using spinosad suspension, call your doctor.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What SIDE EFFECTS can this medicine cause?

Spinosad suspension may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • redness of the scalp area

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

  • irritation of the scalp area

Spinosad suspension may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( Web Site ) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website ( Web Site) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. Web Site

What should I do in case of OVERDOSE?

If someone swallows spinosad suspension, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What OTHER INFORMATION should I know?

Keep all appointments with your doctor.

Do not let anyone else use your medication. Your prescription is probably not refillable. If you feel you need additional treatment, call your doctor.

Lice are generally spread by close head-to-head contact or from items that come in contact with your head. Do not share combs, brushes, towels, pillows, hats, scarves, or hair accessories. Be sure to check everyone in your immediate family for head lice if another family member is being treated for lice.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

AHFS® Consumer Medication Information. © Copyright, The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: November 15, 2016.