Headlice - Antibiotic Prescribing

Doses are oral and for adults unless otherwise stated. Visit the Health Products Regulatory Authority (HPRA) website for detailed drug information (summary of product characteristics and patient information leaflets). Dosing details, contraindications and drug interactions can also be found in the Irish Medicines Formulary (IMF) or other reference sources such as British National Formulary (BNF) / BNF for children (BNFC). See guidance on dosing in children for quick reference dosage/weight guide. Refer to drug interactions table for detailed drug interactions for all antimicrobials. Note extensive drug interactions for clarithromycin, fluoroquinolones, azole antifungals and rifampicin. Many antibiotics increase the risk of bleeding with anticoagulants.

Note additional warnings for clarithromycin and fluoroquinolones

Comments from Expert Advisory Committee

Treatment recommended for persons with active infection, i.e. live lice.  Need to rotate insecticide used.  All members of the affected household should be treated simultaneously.  Isopropyl myristate should be first treatment choice considering UK cure rates below:

  • Isopropyl myristate - 82%
  • Dimethicone 4% -  70%
  • Malathion 0.5%  - 33 %  Permethrin  -13 % (Permethrin (Lyclear Dermal Creme) is used for crab lice and scabies)


Wet Combing has shown cure rates of 57%.  One session every 4 days for at least 2 weeks, continued until no lice are seen for 3 consecutive sessions. This is recommended in all cases, in addition to when treatments below are used.

  • Isopropyl myristate (Full Marks Solution™) 


  • Dimethicone 4% (Hedrin™) Hedrin  - Apply for 15 minutes to dry hair.


  • Permethrin (Lyclear Dermal Rinse)


  • Malathion (Derbac) preparation (availability can be limited )

NB : second treatment is required 7 days after each initial treatment .

We recommend patients use the website developed by HSE/ICGP/IPU partnership www.undertheweather.ie for tips on how to get better from common infections without using antibiotics, what you can do for yourself or a loved one and when to seek help.

Reviewed June 2016