Malathion (Ovide) is an organophosphate that when used topically over the scalp or pubic hair results in clearance of head and pubic lice in individuals with a lice infestation.

Malathion (Ovide) Uses:

• Head lice infection:

  • It is indicated for the topical treatment of head lice and their ova (Pediculus humanus capitis) of the scalp hair

• Off Label Use of Malathion in Adults:

  • It may be used for lice infesting the pubic hair (Pediculosis pubis).

Malathion (Ovide) Dose in Adults:

Malathion (Ovide) Dose in the Head lice (Pediculus humanus capitis):

• Topical:
  • A sufficient amount of the lotion should be applied to cover and thoroughly moisten dry hair and scalp.
  • The hair should then be allowed to dry naturally and shampoo after 8 to 12 hours.
  • If required, repeat the application in 7 to 9 days.
  • Further treatment is generally not required.

Malathion (Ovide) Dose in the Pubic lice (Pediculosis pubis) (following treatment failure of pediculicides) (off-label):

• Adults:

  • Apply topically to the affected area.
  • Wash off after 8 to12 hours.

Malathion (Ovide) Dose in Childrens:

Malathion (Ovide) Dose in the Head lice:

• Children 2 to 5 years: Limited data available:

Note: It is only used for head lice that is resistant to permethrin/pyrethrins or previously failed courses:

• • Apply a sufficient amount topically to cover and moisten the dry hair and scalp. Leave the lotion over the hair for 8 to 12 hours.
  • It is typically applied overnight and rinse with a non-medicated shampoo in the morning.
  • A maximum dose of about 60 mL (2 fl oz) was used in clinical trials.

Note: In a blinded, comparative trial with permethrin in older children, a shorter application time of 20 minutes was shown effective (AAP [Devore 2015]; Meinking 2004). Further treatment is generally not necessary.

• Children ≥6 years and Adolescents:

  • Apply a sufficient amount topically to dry hair and scalp to cover and moisten the hair thoroughly.
  • Leave on for 8 to 12 hours. It is best to apply the lotion typically overnight.
  • Rinse hair and the scalp with a nonmedicated shampoo.
  • If live lice are observed 7 to 9 days after application, reapply the lotion.
  • During clinical trials, a maximum dose of about 60 mL (2 fl oz) was used.

Malathion (Ovide) dose in the Pubic lice (Pediculosis pubis) resistant to permethrin/pyrethrins or previously failed courses:

• Adolescents:

  • Apply the lotion topically to the affected area.
  • Wash off after 8 to12 hours.

Pregnancy Risk Factor B

• Negative events have not been reported in animal reproduction studies.

Use during breastfeeding:

• It is unknown if the 0.5% malathion lotion formulation is absorbed into breast milk.
• It should be used cautiously by breastfeeding mothers and breast-feeding moms.

Dose in Kidney Disease:

There are no dosage adjustments provided in the manufacturer’s labeling.

Dose in Liver disease:

There are no dosage adjustments provided in the manufacturer’s labeling.

Side effects of Malathion (Ovide):

• Dermatologic:

  • Skin irritation (including scalp irritation)
  • Stinging of the skin

• Ophthalmic:

  • Conjunctivitis (following contact with eyes)

• Miscellaneous:

  • Burn (chemical; including second-degree burns)

Contraindications to Malathion (Ovide):

• Allergy to malathion, or any other component of the formulation
• Use in infants and neonates

Warnings and precautions

• Dermatologic effects

  • Some patients may experience temporary skin irritation and may need to discontinue the medication temporarily.
  • Use can also cause chemical burns including second-degree burns and stinging sensations.

Monitoring Parameters:

Monitor for clearance of lice infestation in the whole family members.

How to administer Malathion (Ovide)?

Topical lotion.

• It is intended for external use only. Application over mucous membranes and contact with eyes should be avoided.
• The lotion is applied to dried hair and rubbed gently until the scalp is moistened. The neck and back of the head should not be spared and special attention should be paid to these areas.
• Allow the hair to dry without using a  towel or a hairdryer, do not cover the hair under dried. After 8 to 12 hours, wash hair with a nonmedicated shampoo followed by rinsing it using a fine-toothed comb to remove the dead lice and their eggs.
• Other family members should be evaluated too and treated. hands should be washed after applying the lotion.
• Applying the drug may not be effective if it does not include washing, drying all clothes, hats, bedding, and towels that have been recently worn or used by the patient.
• Wash all hair accessories, combs, and brushes in hot soapy water.

Mechanism of action of Malathion (Ovide):

It is an organophosphate that acts by inhibiting the cholinesterase activity in head lice and their ova resulting in a pediculicide activity.

International Brand Names of Malathion:

• Ovide
• A-Lices
• A-Lices 1%
• Aftir Gel
• Derbac-M
• Lice Care
• Lice Clean
• Lice Rid
• Malation
• Malthionex
• Olicide
• Organoderm
• Piojisar M
• Prioderm
• Quellada-M
• Radikal

Malathion Brand Names in Pakistan:

No Brands Available in Pakistan.