ISOPROPYL MYRISTATE 50%
Place in Therapy
Place in Therapy
Isopropyl myristate (IPM) 50% in cyclomethicone 50% is a newer agent approved by Health Canada for the treatment of lice, and is available to be purchased over-the-counter.1 The Ontario Ministry of Health and Long-term Care’s Committee to Evaluate Drugs considers this agent to be comparable to first-line options in patients over the age of 2 years.2 Since IPM is a non-insecticide and there are no known mechanisms for development of resistance, it is also a great alternative to the traditional first-line agents should there be concerns over resistance or the use of insecticides in patients.3
Its use is supported by data citing cure rates of 82% and minor adverse effects (mild erythema and scalp pruritis).4 A systematic review from 2011 eludes that IPM may actually be more effective at eradicating lice compared to permethrin and pyrethrins.5 In addition, there are also no known contraindications for this agent, other than it is only approved for use in children over the age of 2 years.3 While there is no information about drug interactions and studies haven’t looked at pregnancy or lactating populations, since it’s a non-insecticide, it is unlikely that its use in special populations or concomitantly with other medications would be an issue.
Since it is not an ovicidal agent, it does require two applications administered 7-10 days apart. IPM costs roughly $13 for one bottle, and is covered by Non-insured Health Benefits (NHIB). 6-7
References:
1. Health Canada. Drugs and health products. 2013; http://webprod5.hc-sc.gc.ca/dpd-bdpp/dispatch-repartition.do?lang=eng
2. Ministry of Health and Long-term Care; Committee to Evaluate Drugs (CED). Isopropyl myristate. 2010 http://www.health.gov.on.ca/english/providers/program/drugs/ced/pdf/resultz.pdf
3. Miller, P. Patient Self-Care; Second Edition. Parasitic skin infections: lice and scabies. 2010;679-688
4. Kaul N, Palma K, Silagy S, Goodman J and Toole J. North American efficacy and safety of a novel pediculicide rinse, isopropyl myristate 50% (Resultz). Journal of Cutaneous Medicine and Surgery. 2007; (11)5: 161-167
5. Burgess I. Head lice. Clinical Evidence 2011;05:1703
6. Finlay J, MacDonald NE; Canadian Pediatric Society (CPS) Infectious Disease and Immunization Committee. Position statement: head lice infestations: a clinical update. Paediatr Child Health. 2008; 13(8):692-696
7. Rx Files. Over the Counter Products – Head Lice. 2010. 97
Isopropyl myristate (IPM) 50% in cyclomethicone 50% is a newer agent approved by Health Canada for the treatment of lice, and is available to be purchased over-the-counter.1 The Ontario Ministry of Health and Long-term Care’s Committee to Evaluate Drugs considers this agent to be comparable to first-line options in patients over the age of 2 years.2 Since IPM is a non-insecticide and there are no known mechanisms for development of resistance, it is also a great alternative to the traditional first-line agents should there be concerns over resistance or the use of insecticides in patients.3
Its use is supported by data citing cure rates of 82% and minor adverse effects (mild erythema and scalp pruritis).4 A systematic review from 2011 eludes that IPM may actually be more effective at eradicating lice compared to permethrin and pyrethrins.5 In addition, there are also no known contraindications for this agent, other than it is only approved for use in children over the age of 2 years.3 While there is no information about drug interactions and studies haven’t looked at pregnancy or lactating populations, since it’s a non-insecticide, it is unlikely that its use in special populations or concomitantly with other medications would be an issue.
Since it is not an ovicidal agent, it does require two applications administered 7-10 days apart. IPM costs roughly $13 for one bottle, and is covered by Non-insured Health Benefits (NHIB). 6-7
References:
1. Health Canada. Drugs and health products. 2013; http://webprod5.hc-sc.gc.ca/dpd-bdpp/dispatch-repartition.do?lang=eng
2. Ministry of Health and Long-term Care; Committee to Evaluate Drugs (CED). Isopropyl myristate. 2010 http://www.health.gov.on.ca/english/providers/program/drugs/ced/pdf/resultz.pdf
3. Miller, P. Patient Self-Care; Second Edition. Parasitic skin infections: lice and scabies. 2010;679-688
4. Kaul N, Palma K, Silagy S, Goodman J and Toole J. North American efficacy and safety of a novel pediculicide rinse, isopropyl myristate 50% (Resultz). Journal of Cutaneous Medicine and Surgery. 2007; (11)5: 161-167
5. Burgess I. Head lice. Clinical Evidence 2011;05:1703
6. Finlay J, MacDonald NE; Canadian Pediatric Society (CPS) Infectious Disease and Immunization Committee. Position statement: head lice infestations: a clinical update. Paediatr Child Health. 2008; 13(8):692-696
7. Rx Files. Over the Counter Products – Head Lice. 2010. 97