This medication is used to treat head lice, tiny insects that infest and irritate your scalp. Head lice lay small white eggs (nits) at the roots of hair close to the scalp, especially on the hairline at the back of the neck and behind the ears. Spinosad works by paralyzing and killing lice and their eggs.
This medication should not be used on infants younger than 6 months due to the increased risk for serious side effects.

How to use Natroba Top
Read the Patient Information Leaflet and Patient Instructions for Use if available from your pharmacist before you start using spinosad and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
This medication is for external use only. Shake the bottle well just before using. Apply this medication to scalp hair and scalp only. Use this medication when your hair is dry. Do not wet your hair before applying. Cover your face and eyes with a towel and keep your eyes closed tightly while applying this medication and during the time it remains on your scalp and hair. Avoid getting spinosad in your eyes. If the medication gets in or near the eye, flush with plenty of water right away. Since you should keep your eyes closed during application, you may need to have another person help you apply this medication. Children will need an adult to apply this medication for them.
Completely cover the scalp with spinosad first, and then apply outward toward the ends of the hair. If you do not use enough spinosad, some lice may escape treatment. It is important to use enough medication to cover your entire scalp and scalp hair. Leave the medication on your hair for 10 minutes. Use a timer or clock and start timing after you have completely covered your hair and scalp with medication. After 10 minutes, rinse thoroughly with warm water. You or anyone who helps you apply this medication should wash hands after application. You may shampoo your hair any time after treatment.
After treatment with this medication, you may use a fine-tooth comb or a special comb for removing treated lice and nits. However, combing is not required. If you see live lice 7 days or more after treatment, a second treatment should be given. Do not repeat treatment more than once unless otherwise directed by your doctor.
Tell your doctor if your condition persists or worsens.

Skin or eye irritation/redness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before using spinosad, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: skin conditions or sensitivities.
Constant or forceful scratching of the skin/scalp may lead to a bacterial skin infection. Tell your doctor right away if you develop worsening redness or pus.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Tell your doctor if you are pregnant before using this medication.
Spinosad does not pass into breast milk. However, it is unknown if an inactive ingredient in this medication, benzyl alcohol, may pass into breast milk and harm a nursing infant. Consult your doctor before breast-feeding.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor\'s approval.

This medication may be harmful if swallowed. If swallowing or overdose is suspected, contact a poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES:
Do not share this medication with another person unless directed to do so by your doctor.
One application is usually all that is needed. To avoid giving lice to another person or getting them again, machine-wash all head wear, clothing, bed linens, and towels with hot water, then dry in a dryer at high setting for at least 20 minutes. Personal articles such as pillows or stuffed animals that cannot be washed should be dry cleaned, sealed in a plastic bag for at least 2 weeks, or sprayed with a disinfectant that kills lice. Brushes or combs should be soaked in hot water (hotter than 130 degrees F/54 degrees C) for at least 10 minutes. Furniture and floors should be thoroughly vacuumed.
People who are in close contact with the infected person, such as members of the same household, should also be checked for lice and nits. Be sure to talk with your doctor about treatment for those who have lice.

MISSED DOSE:
Not applicable.

STORAGE:
Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised February 2011. Copyright(c) 2011 First Databank, Inc.