NDC 51672-4211 Ivermectin

Ivermectin

NDC Product Code 51672-4211

NDC CODE: 51672-4211

Proprietary Name: Ivermectin What is the Proprietary Name?
The proprietary name also known as the trade name is the name of the product chosen by the medication labeler for marketing purposes.

Non-Proprietary Name: Ivermectin What is the Non-Proprietary Name?
The non-proprietary name is sometimes called the generic name. The generic name usually includes the active ingredient(s) of the product.

Drug Use Information

Drug Use Information
The drug use information is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate. This information is not individual medical advice and does not substitute for the advice of a health care professional. Always ask a health care professional for complete information about this product and your specific health needs.

  • This medication is used to treat certain parasitic roundworm infections. Curing parasitic infections helps to improve your quality of life. In people with weakened defense (immune) systems, curing roundworm infections can reduce the risk of developing a severe or life-threatening infection. Ivermectin belongs to a class of drugs known as antihelmintics. It works by paralyzing and killing parasites.

NDC Code Structure

  • 51672 - Taro Pharmaceuticals U.s.a., Inc.

NDC 51672-4211-8

Package Description: 1 TUBE in 1 CARTON > 117 g in 1 TUBE

NDC Product Information

Ivermectin with NDC 51672-4211 is a a human prescription drug product labeled by Taro Pharmaceuticals U.s.a., Inc.. The generic name of Ivermectin is ivermectin. The product's dosage form is lotion and is administered via topical form.

Labeler Name: Taro Pharmaceuticals U.s.a., Inc.

Dosage Form: Lotion - An emulsion, liquid1 dosage form. This dosage form is generally for external application to the skin.2

Product Type: Human Prescription Drug What kind of product is this?
Indicates the type of product, such as Human Prescription Drug or Human Over the Counter Drug. This data element matches the “Document Type” field of the Structured Product Listing.

Ivermectin Active Ingredient(s)

What is the Active Ingredient(s) List?
This is the active ingredient list. Each ingredient name is the preferred term of the UNII code submitted.

  • IVERMECTIN 5 mg/g

Inactive Ingredient(s)

About the Inactive Ingredient(s)
The inactive ingredients are all the component of a medicinal product OTHER than the active ingredient(s). The acronym "UNII" stands for “Unique Ingredient Identifier” and is used to identify each inactive ingredient present in a product.

  • BUTYLATED HYDROXYANISOLE (UNII: REK4960K2U)
  • CASTOR OIL (UNII: D5340Y2I9G)
  • CETYL ALCOHOL (UNII: 936JST6JCN)
  • ANHYDROUS CITRIC ACID (UNII: XF417D3PSL)
  • CYCLOMETHICONE (UNII: NMQ347994Z)
  • GLYCERIN (UNII: PDC6A3C0OX)
  • IMIDUREA (UNII: M629807ATL)
  • LANOLIN ALCOHOLS (UNII: 884C3FA9HE)
  • METHYLPARABEN (UNII: A2I8C7HI9T)
  • OLEYL ALCOHOL (UNII: 172F2WN8DV)
  • OLIVE OIL (UNII: 6UYK2W1W1E)
  • PROPYLENE GLYCOL (UNII: 6DC9Q167V3)
  • PROPYLPARABEN (UNII: Z8IX2SC1OH)
  • WATER (UNII: 059QF0KO0R)
  • SHEA BUTTER (UNII: K49155WL9Y)
  • ANHYDROUS TRISODIUM CITRATE (UNII: RS7A450LGA)
  • SORBITAN TRISTEARATE (UNII: 6LUM696811)
  • STEARYL ALCOHOL (UNII: 2KR89I4H1Y)

Administration Route(s)

What are the Administration Route(s)?
The translation of the route code submitted by the firm, indicating route of administration.

  • Topical - Administration to a particular spot on the outer surface of the body. The E2B term TRANSMAMMARY is a subset of the term TOPICAL.
  • Topical - Administration to a particular spot on the outer surface of the body. The E2B term TRANSMAMMARY is a subset of the term TOPICAL.

Pharmacological Class(es)

What is a Pharmacological Class?
These are the reported pharmacological class categories corresponding to the SubstanceNames listed above.

  • Antiparasitic - [EPC] (Established Pharmacologic Class)
  • Pediculicide - [EPC] (Established Pharmacologic Class)

Product Labeler Information

What is the Labeler Name?
Name of Company corresponding to the labeler code segment of the Product NDC.

Labeler Name: Taro Pharmaceuticals U.s.a., Inc.
Labeler Code: 51672
FDA Application Number: ANDA210720 What is the FDA Application Number?
This corresponds to the NDA, ANDA, or BLA number reported by the labeler for products which have the corresponding Marketing Category designated. If the designated Marketing Category is OTC Monograph Final or OTC Monograph Not Final, then the Application number will be the CFR citation corresponding to the appropriate Monograph (e.g. “part 341”). For unapproved drugs, this field will be null.

Marketing Category: ANDA - A product marketed under an approved Abbreviated New Drug Application. What is the Marketing Category?
Product types are broken down into several potential Marketing Categories, such as NDA/ANDA/BLA, OTC Monograph, or Unapproved Drug. One and only one Marketing Category may be chosen for a product, not all marketing categories are available to all product types. Currently, only final marketed product categories are included. The complete list of codes and translations can be found at www.fda.gov/edrls under Structured Product Labeling Resources.

Start Marketing Date: 05-06-2020 What is the Start Marketing Date?
This is the date that the labeler indicates was the start of its marketing of the drug product.

Listing Expiration Date: 12-31-2021 What is the Listing Expiration Date?
This is the date when the listing record will expire if not updated or certified by the product labeler.

Exclude Flag: N What is the NDC Exclude Flag?
This field indicates whether the product has been removed/excluded from the NDC Directory for failure to respond to FDA’s requests for correction to deficient or non-compliant submissions. Values = ‘Y’ or ‘N’.

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Ivermectin Product Labeling Information

The product labeling information includes all published material associated to a drug. Product labeling documents include information like generic names, active ingredients, ingredient strength dosage, routes of administration, appearance, usage, warnings, inactive ingredients, etc.

Product Labeling Index

1.1 Indication

Ivermectin Lotion is indicated for the topical treatment of head lice infestations in patients 6 months of age and older.

1.2 Adjunctive Measures

  • Ivermectin Lotion should be used in the context of an overall lice management program:Wash (in hot water) or dry-clean all recently worn clothing, hats, used bedding and towels.Wash personal care items such as combs, brushes and hair clips in hot water.A fine-tooth comb or special nit comb may be used to remove dead lice and nits.

2 Dosage And Administration

For topical use only. Ivermectin Lotion is not for oral, ophthalmic, or intravaginal use.Apply Ivermectin Lotion to dry hair in an amount sufficient (up to 1 tube) to thoroughly coat the hair and scalp.Leave Ivermectin Lotion on the hair and scalp for 10 minutes, and then rinse off with water. It is recommended to wait 24 hours before applying shampoo to hair and scalp.The tube is intended for single use; discard any unused portion. Avoid contact with eyes.

3 Dosage Forms And Strengths

Lotion: 0.5%; each gram of lotion contains 5 mg of ivermectin. Ivermectin Lotion is an off-white to tan lotion.

4 Contraindications

None.

5.1 Ingestion In Pediatric Patients

In order to prevent ingestion, Ivermectin Lotion should only be administered to pediatric patients under the direct supervision of an adult.

6.1 Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.The data described below reflect exposure to a single 10 minute treatment of Ivermectin Lotion in 379 patients, ages 6 months and older, in placebo-controlled trials. Of these subjects, 47 subjects were age 6 months to 4 years, 179 subjects were age 4 to 12 years, 56 subjects were age 12 to 16 years and 97 subjects were age 16 or older. Adverse reactions, reported in less than 1% of subjects treated with Ivermectin Lotion, include conjunctivitis, ocular hyperemia, eye irritation, dandruff, dry skin, and skin burning sensation.

Other

Risk SummaryThere are no studies with the use of Ivermectin Lotion in pregnant women. Epidemiologic studies with the use of oral ivermectin during pregnancy are insufficient to inform a drug-associated risk of adverse developmental outcomes, because either the timing of administration during gestation was not accurately ascertained or the administration occurred only during the second trimester (see Data). However, systemic exposure from topical use of ivermectin is much lower than that from oral use [see Clinical Pharmacology (12.3)]. In animal reproduction studies, ivermectin induced adverse developmental outcomes when orally administered to pregnant mice, rats and rabbits during the period of organogenesis only at or near doses that were maternally toxic to the pregnant females [see Data].The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defects, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.

Data

Human DataFour published epidemiology studies, all performed in rural Africa to treat soil-transmitted helminths, evaluated pregnancy outcomes in a total of 744 women exposed to oral ivermectin in various stages of pregnancy. In the largest of these studies, 397 women in their second trimester of pregnancy were treated open-label with single doses of oral ivermectin, or ivermectin plus albendazole, for soil-transmitted helminths and compared with a pregnant, non-treated population. No differences in pregnancy outcomes were observed between treated and untreated populations. These studies cannot definitively establish or exclude the absence of any drug-associated risk during pregnancy, because either the timing of administration during gestation was not accurately ascertained or the administration occurred only during the second trimester.

Animal DataNo comparisons of animal exposure with human exposure are made due to the low systemic exposure noted in the clinical pharmacokinetic study [see Clinical Pharmacology (12.3)].Systemic embryofetal development studies were conducted in mice, rats and rabbits. Oral doses of ivermectin at 0.1 mg/kg/day, 0.2 mg/kg/day, 0.4 mg/kg/day, 0.8 mg/kg/day, and 1.6 mg/kg/day were administered during the period of organogenesis to pregnant female mice. Maternal death occurred at 0.4 mg/kg/day and above. Cleft palate occurred in the fetuses from the 0.4 mg/kg/day, 0.8 mg/kg/day, and 1.6 mg/kg/day groups. Exencephaly was seen in the fetuses from the 0.8 mg/kg group. Oral doses of ivermectin at 2.5 mg/kg/day, 5 mg/kg/day, and 10 mg/kg/day were administered during the period of organogenesis to pregnant female rats. Maternal death and pre-implantation loss occurred at 10 mg/kg/day. Cleft palate and wavy ribs were seen in fetuses from the 10 mg/kg/day group. Oral doses of ivermectin at 1.5 mg/kg/day, 3 mg/kg/day, and 6 mg/kg/day were administered during the period of organogenesis to pregnant female rabbits. Maternal toxicity and abortion occurred at 6 mg/kg/day. Cleft palate and clubbed forepaws occurred in the fetuses from the 3 mg/kg and 6 mg/kg groups. These teratogenic effects were found only at or near doses that were maternally toxic to the pregnant female. Therefore, ivermectin does not appear to be selectively fetotoxic to the developing fetus.

Risk SummaryThere is information available on the presence of ivermectin in human milk in 4 lactating women after a single 150 mcg/kg oral dose of ivermectin. However, there is insufficient information from this study to determine the effects of ivermectin on the breastfed infant or the effects of ivermectin on milk production.Topical ivermectin systemic exposure is much lower than that for oral ivermectin [see Clinical Pharmacology (12.3)]. Furthermore, the amount of ivermectin present in human milk after topical application of ivermectin to lactating women has not been studied.The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for Ivermectin Lotion and any potential adverse effects on the breastfed infant from Ivermectin Lotion or from the underlying maternal condition.

Clinical ConsiderationsAdvise a lactating woman to avoid accidental transfer of Ivermectin Lotion to breast area where the infant might directly ingest the drug.

Manufactured by: Taro Pharmaceutical Industries Ltd.Haifa Bay, Israel, 2624761Dist. by: Taro Pharmaceuticals U.S.A., Inc.Hawthorne, NY 10532Issued: December, 2019 21180-1219-0 809

8.4 Pediatric Use

The safety and effectiveness of Ivermectin Lotion have been established for pediatric patients 6 months of age and older [see Clinical Pharmacology (12.3) and Clinical Studies (14)].The safety of Ivermectin Lotion has not been established in pediatric patients below the age of 6 months. Ivermectin Lotion is not recommended in pediatric patients under 6 months of age because of the potential increased systemic absorption due to a high ratio of skin surface area to body mass and the potential for an immature skin barrier and risk of ivermectin toxicity.

8.5 Geriatric Use

Clinical studies of Ivermectin Lotion did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients.

10 Overdosage

In accidental or significant exposure to unknown quantities of veterinary formulations of ivermectin in humans, either by ingestion, inhalation, injection, or exposure to body surfaces, the following adverse effects have been reported most frequently: rash, edema, headache, dizziness, asthenia, nausea, vomiting, and diarrhea. Other adverse effects that have been reported include: seizure, ataxia, dyspnea, abdominal pain, paresthesia, urticaria, and contact dermatitis.In case of accidental poisoning, supportive therapy, if indicated, should include parenteral fluids and electrolytes, respiratory support (oxygen and mechanical ventilation if necessary) and pressor agents if clinically significant hypotension is present. Induction of emesis and/or gastric lavage as soon as possible, followed by purgatives and other routine anti-poison measures, may be indicated if needed to prevent absorption of ingested material.

11 Description

Ivermectin Lotion, for topical administration, is an off-white/tan lotion containing 0.5% ivermectin.Ivermectin, the active ingredient, is a pediculicide, derived from the fermentation of a soil dwelling actinomycete, Streptomyces avermitilis.Ivermectin is a mixture containing at least 90% 5-O-demethyl-22,23-dihydroavermectin A1a and less than 10% 5-O-demethyl-25-de(1-methylpropyl)-22,23-dihydro25-(1-methylethyl) avermectin A1a, generally referred to as 22,23-dihydroavermectin B1a and B1b, or H2B1a and H2B1b, respectively. The respective empirical formulas are C48H74O14 and C47H72O14, with molecular weights of 875.10 and 861.07, respectively. The structural formulas are:Component H2B1a: R = CH2CH3 Component H2B1b: R = CH3Ivermectin Lotion contains the following inactive ingredients: butylated hydroxyanisole, castor oil, cetyl alcohol, citric acid anhydrous, crodalan AWS, cyclomethicone, glycerin, imidurea, lanolin alcohols, methylparaben, oleyl alcohol, olive oil, propylene glycol, propylparaben, purified water, shea butter, sodium citrate anhydrous, sorbitan tristearate and stearyl alcohol.

12.1 Mechanism Of Action

Ivermectin, a member of the avermectin class, causes death of parasites, primarily through binding selectively and with high affinity to glutamate-gated chloride channels, which occur in invertebrate nerve and muscle cells. This leads to an increase in the permeability of the cell membrane to chloride ions with hyperpolarization of the nerve or muscle cell, resulting in paralysis and death of the parasite. Compounds of this class may also interact with other ligand-gated chloride channels, such as those gated by the neurotransmitter gamma-aminobutyric acid (GABA). The selective activity of compounds of this class is attributable to the fact that some mammals do not have glutamate-gated chloride channels, the avermectins have a low affinity for mammalian ligand-gated chloride channels, and ivermectin does not readily cross the blood-brain barrier in humans.

12.2 Pharmacodynamics

The pharmacodynamics of Ivermectin Lotion are unknown.

12.3 Pharmacokinetics

The absorption of ivermectin from Ivermectin Lotion was evaluated in a clinical study in subjects aged from 6 months to 3 years. This study evaluated pharmacokinetics in 20 lice infested subjects, and 13 of these subjects weighed 15 kg or less (overall weight range 8.5 to 23.9 kg). All enrolled subjects received a single treatment with Ivermectin Lotion. The systemic ivermectin exposure was evaluated using an assay with a lower limit of quantitation of 0.05 ng/mL. The mean (± standard deviation) plasma maximum concentration (Cmax) and area under the concentration-time curve from 0 to time of last measurable concentration (AUC0-tlast) were 0.24 ± 0.23 ng/mL and 6.7 ± 11.2 hr∙ng/mL, respectively. These levels are much lower than those observed following oral administration of 165 mcg/kg dose of ivermectin.

13.1 Carcinogenesis, Mutagenesis, Impairment Of Fertility

Long-term studies in animals have not been performed to evaluate the carcinogenic potential of Ivermectin Lotion or ivermectin.Ivermectin was not genotoxic in vitro in the Ames test, the mouse lymphoma assay, or the unscheduled DNA synthesis assay in human fibroblasts.Ivermectin had no adverse effects on fertility in rats at repeated oral doses of up to 3.6 mg/kg/day.

14 Clinical Studies

Two identical multi-center, randomized, double-blind, vehicle-controlled studies were conducted in subjects 6 months of age and older with head lice infestation. All subjects received a single application of either Ivermectin Lotion or vehicle control with instructions not to use a nit comb. For the evaluation of efficacy, the youngest subject from each household was considered to be the index subject of the household (N=289). Other enrolled infested household members received the same treatment as the youngest subject and were evaluated for all safety parameters [see Adverse Reactions (6.1)]. The primary efficacy was assessed as the proportion of index subjects who were free of live lice at day 2 and through day 8 to the final evaluation 14 (+2) days following a single application. Subjects with live lice present at any time up to the final evaluation were considered treatment failures. Table 1 contains the proportion of subjects who were free of live lice in each of the two trials.Table 1: Proportion of Subjects Free of Live Lice 14 Days After TreatmentStudyVehicle% (n/N)Ivermectin Lotion% (n/N)Study 116.2% (12/74)76.1% (54/71)Study 218.9% (14/74)71.4% (50/70)

16 How Supplied/Storage And Handling

Ivermectin Lotion, 0.5% is supplied in a 4 oz (117 g) white laminate tube (NDC 51672-4211-8).

Storage And Handling

Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature]. Do not freeze.

17 Patient Counseling Information

  • "See FDA-approved patient labeling (Patient Information)".Inform the patient and caregiver of the following instructions:Use Ivermectin Lotion in the context of an overall lice management program.Apply Ivermectin Lotion to dry scalp and dry scalp hair.Wash hands after applying Ivermectin Lotion.Leave Ivermectin Lotion on the hair and scalp for 10 minutes, and then rinse off with water.For single use only; do not re-treat.It is recommended to wait 24 hours before applying shampoo to hair and scalp.Discard tube after use.Avoid contact with eyes.Do not swallow Ivermectin Lotion.Keep out of reach of children. Use on children should be under the direct supervision of an adult.Advise a lactating woman to avoid accidental transfer of Ivermectin Lotion directly to breast area where the infant might directly ingest the drug.

Spl Patient Package Insert

  • Patient Information Ivermectin (eye'' ver mek' tin) Lotion, 0.5%Important: For use on scalp hair and scalp only. Do not use Ivermectin Lotion in your eyes, mouth, or vagina.What is Ivermectin Lotion?Ivermectin Lotion is a prescription medicine for topical use on the hair and scalp only. Ivermectin Lotion is used to treat head lice in people 6 months of age and older. It is not known if Ivermectin Lotion is safe and effective for children under 6 months of age.Before you use Ivermectin Lotion, tell your healthcare provider about all of your medical conditions, including if you or your child:have any skin conditions or sensitivitiesare pregnant or plan to become pregnant. It is not known if Ivermectin Lotion can harm your unborn babyare breastfeeding or plan to breastfeed. Ivermectin has been found in breast milk when taken by mouth and may pass into breast milk after using Ivermectin Lotion. If you use Ivermectin Lotion and breastfeed your baby:avoid accidental transfer of Ivermectin Lotion to your breast to help prevent ingestion by your baby.talk to your healthcare provider about the best way to feed your baby during treatment with Ivermectin Lotion.How should I use Ivermectin Lotion?See the detailed "Instructions for Use" at the end of this leaflet.Use Ivermectin Lotion exactly as prescribed. Your healthcare provider will prescribe the treatment that is right for you.Use Ivermectin Lotion when your hair is dry.It is important to use enough Ivermectin Lotion to completely coat all of your hair and scalp. Leave Ivermectin Lotion on your hair and scalp for a full 10 minutes, and then rinse off with water.You need to completely cover all the scalp and hair with lotion.Children will need an adult to apply Ivermectin Lotion for them.It is recommended to wait 24 hours before applying shampoo to hair and scalp.Do not swallow Ivermectin Lotion. If swallowed, call your healthcare provider or go to the nearest emergency room right away.Do not get Ivermectin Lotion into your eyes. If Ivermectin Lotion gets in your eye, gently flush with water.Wash your hands after applying Ivermectin Lotion.When you complete your treatment with Ivermectin Lotion, do not use Ivermectin Lotion again without talking to your healthcare provider first.What are the possible side effects of Ivermectin Lotion?The most common side effects of Ivermectin Lotion include: eye redness or sorenesseye irritationdandruffdry skinburning sensation of the skinThese are not all the possible side effects of Ivermectin Lotion. For more information, ask your healthcare provider or pharmacist.Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. How should I store Ivermectin Lotion?Store Ivermectin Lotion at room temperature between 68°F to 77°F (20°C to 25°C).Do not freeze Ivermectin Lotion.Safely throw away any unused Ivermectin Lotion.Keep Ivermectin Lotion and all medicines out of reach of children.General information about the safe and effective use of Ivermectin Lotion.Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use Ivermectin Lotion for a condition for which it was not prescribed. Do not give Ivermectin Lotion to other people, even if they have the same symptoms you have. It may harm them. You can also ask your healthcare provider or pharmacist for information about Ivermectin Lotion that is written for health professionals.What are the ingredients in Ivermectin Lotion?Active: Ivermectin 0.5%Inactive ingredients: butylated hydroxyanisole, castor oil, cetyl alcohol, citric acid anhydrous, crodalan AWS, cyclomethicone, glycerin, imidurea, lanolin alcohols, methylparaben, oleyl alcohol, olive oil, propylene glycol, propylparaben, purified water, shea butter, sodium citrate anhydrous, sorbitan tristearate and stearyl alcohol.Manufactured by: Taro Pharmaceutical Industries Ltd., Haifa Bay, Israel, 2624761 Dist. by: Taro Pharmaceuticals U.S.A., Inc. Hawthorne, NY 10532 Issued: December, 2019 21180-1219-0 809

Instructions For Use

  • Before you use Ivermectin Lotion, it is important that you read the Patient Information and these Instructions for Use. Be sure that you read, understand, and follow these Instructions for Use so that you use Ivermectin Lotion the right way. Ask your healthcare provider or pharmacist if you have questions about the right way to use Ivermectin Lotion.Your hair and scalp must be dry before applying Ivermectin Lotion.Figure AUse the top of cap to break the tamper seal on the tube (see Figure A).Figure B      Figure CFigure DApply Ivermectin Lotion directly to dry hair and scalp (see Figure B).Completely cover your scalp and hair closest to the scalp first, and then apply outwards towards the ends of your hair (see Figure C).Rub Ivermectin Lotion throughout your hair (see Figure D).It is important to completely cover your entire head so that all lice and eggs are exposed to the lotion. Be sure that each hair is coated from the scalp to the tip.Use up to 1 entire tube (4 oz) to completely cover hair and scalp.Figure EFigure FAllow Ivermectin Lotion to stay on your hair and scalp for 10 minutes after it has been applied. Use a timer or clock. Start timing after you have completely covered your hair and scalp with Ivermectin Lotion (see Figure E).After 10 minutes, completely rinse Ivermectin Lotion from your hair and scalp using only water (see Figure F).You or anyone who helps you apply Ivermectin Lotion should wash their hands after application.It is recommended to wait 24 hours before applying shampoo to hair and scalp.Do not use Ivermectin Lotion again without talking to your healthcare provider first.How do I stop the spread of lice?To help prevent the spread of lice from one person to another, here are some steps you can take:Avoid direct head-to-head contact with anyone known to have live, crawling lice.Do not share combs, brushes, hats, scarves, bandannas, ribbons, barrettes, hair bands, towels, helmets, or other hair-related personal items with anyone else, whether they have lice or not.Avoid sleepovers and slumber parties during lice outbreaks. Lice can live in bedding, pillows, and carpets that have recently been used by someone with lice.After finishing treatment with lice medicine, check everyone in your family for lice after one week. Be sure to talk to your healthcare provider about treatments for those who have lice.Machine wash any bedding and clothing used by anyone having lice. Machine wash at high temperatures (150°F) and tumble in a hot dryer for 20 minutes.This Patient Information and Instructions for Use have been approved by the U.S. Food and Drug Administration. Issued: December 2019

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