Comprehensive medication guide to Malathion including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$10–$60 copay with most commercial insurance; typically Tier 2–3 on formularies; some plans require prior authorization documenting failed first-line treatment. Medicare Part D generally covers malathion.
Estimated Cash Pricing
$250–$260 retail for malathion 0.5% lotion (59 mL); as low as $76.35 with a GoodRx coupon or $140 with SingleCare at participating pharmacies.
Medfinder Findability Score
45/100
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Malathion (brand name Ovide) is a prescription topical medication used to treat head lice (Pediculus humanus capitis) and their eggs (nits) in adults and children 6 years of age and older. It belongs to a class of drugs called organophosphate pediculicides — medications that kill parasitic insects by disrupting their nervous system.
Malathion was first approved by the FDA in 1982 under the brand name Ovide. A generic version was FDA-approved in 2009 and is considered therapeutically equivalent. Both are available in a 0.5% topical lotion in a 59 mL bottle.
Malathion is typically prescribed as a second-line or third-line treatment — meaning it is used when over-the-counter options like permethrin (Nix) or pyrethrin-based shampoos (Rid) have failed or when pyrethroid resistance is suspected. It is both pediculicidal (kills live lice) and ovicidal (kills eggs), which distinguishes it from many first-line agents.
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Malathion is an organophosphate cholinesterase inhibitor. It works by irreversibly binding to and disabling the enzyme acetylcholinesterase in the louse's nervous system. This enzyme is responsible for breaking down acetylcholine, the neurotransmitter that allows lice to control their muscles and nervous system.
When cholinesterase is blocked, acetylcholine accumulates at nerve junctions. Nerve signals fire uncontrollably, causing the louse's muscles to contract continuously until the insect is paralyzed and dies. This mechanism is fundamentally different from pyrethroid-based treatments (permethrin, pyrethrins), which target sodium channels — making malathion effective against pyrethroid-resistant lice.
Malathion is also ovicidal — it penetrates the lice egg casing and kills the developing embryo before it hatches. This dual action (killing both live lice and eggs) is why a single 8-12 hour treatment often clears an infestation completely. Mammals rapidly detoxify malathion via liver hydrolysis, which is why it is selectively toxic to insects at therapeutic doses.
0.5% — topical lotion
59 mL bottle; apply to dry hair in sufficient amount to wet scalp and hair; leave on 8-12 hours; single application usually sufficient; repeat in 7-9 days only if live lice persist
Malathion is not on the FDA's official drug shortage list as of 2026 — meaning it is being manufactured and distributed. However, many patients find it difficult to locate at their local pharmacy. This is because malathion is a niche, slow-moving product that most community pharmacies choose not to stock routinely.
Key factors limiting availability: low and unpredictable prescription volume (it's second-line), flammability storage requirements (78% isopropyl alcohol vehicle), and a high retail price (~$250/bottle) that makes it a financial risk for pharmacies that rarely fill it. Large chain pharmacies (CVS, Walgreens, Walmart Pharmacy) are more likely to carry it than small independents.
If your local pharmacy doesn't have malathion, use medfinder to search pharmacies near you — medfinder contacts pharmacies on your behalf and texts you which ones have it in stock. Mail-order pharmacies (Express Scripts, CVS Caremark, OptumRx) can also fill and deliver malathion prescriptions.
Malathion is not a controlled substance, so any licensed prescriber can issue a prescription. There are no DEA scheduling requirements or special prescribing certifications needed.
Pediatricians (most common prescribers for children)
Primary Care Physicians (family medicine, internal medicine)
Dermatologists
Nurse Practitioners (NPs)
Physician Assistants (PAs)
Urgent care providers
Telehealth providers can also prescribe malathion since it is not a controlled substance. Platforms such as Teladoc, MDLive, and many telehealth services connected to major health systems can evaluate and prescribe for head lice during a virtual visit. This makes getting a prescription convenient even without an in-person appointment.
No. Malathion (Ovide) is not a controlled substance. It has no DEA schedule designation. This means any licensed prescriber — including primary care physicians, pediatricians, nurse practitioners, physician assistants, and dermatologists — can prescribe it without special DEA authorization.
Because malathion is not a controlled substance, telehealth providers can also prescribe it. Prescriptions can be sent electronically to any pharmacy. There are no quantity limits, mandatory drug tests, or refill restrictions associated with its non-controlled status. Your prescription is probably not routinely refillable because treatment is typically a one-time or two-application course — but this reflects the clinical use pattern, not regulatory restriction.
The following side effects are most commonly reported with malathion use:
Scalp irritation and redness
Stinging or burning sensation on the scalp (especially on broken skin)
Dry hair (temporary, resolves after washing)
Strong odor (due to terpineol, dipentene, and pine needle oil in vehicle)
Eye irritation if product contacts eyes
Chemical burns (including second-degree burns): Rare but reported. Discontinue use if significant skin damage occurs. Risk increases with excessive application or contact with non-scalp skin.
Fire hazard: Not a medical side effect, but a critical safety issue. The 78% isopropyl alcohol vehicle is highly flammable. Do NOT use heat appliances or smoke while product is in hair.
Ingestion toxicity: If swallowed, malathion can cause serious cholinergic symptoms. Keep out of reach of children. Call Poison Control (1-800-222-1222) immediately if ingested.
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Spinosad (Natroba)
0.9% suspension; ovicidal; single 10-minute application; FDA-approved age 4+; not flammable; no nit combing required
Ivermectin lotion (Sklice)
0.5% lotion; single 10-minute application; no nit combing; FDA-approved age 6 months+
Benzyl alcohol (Ulesfia)
5% lotion; not ovicidal; two 10-minute applications 7 days apart; FDA-approved age 6 months+
Permethrin (Nix)
1% OTC cream rinse; first-line treatment; not reliably ovicidal; resistance common; requires two applications
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Organophosphate pesticides (carbaryl, diazinon, parathion, demeton)
moderateAdditive cholinesterase inhibition possible with concurrent occupational or agricultural exposure to other organophosphate or carbamate insecticides. Advise patients in agricultural/pest control settings.
Heat sources and open flames
majorMalathion lotion is highly flammable (78% isopropyl alcohol). Exposure to hair dryers, curling irons, cigarettes, or open flames while lotion is in hair is a serious fire safety hazard.
Malathion (Ovide) remains a clinically valuable prescription option for head lice, particularly for cases where over-the-counter pyrethroids have failed or pyrethroid resistance is suspected. Its dual pediculicidal and ovicidal activity makes it effective in a single treatment for most patients. The main practical challenges are its 8-12 hour application time, flammability risk, and difficulty finding it at local pharmacies.
If cost is a concern, GoodRx coupons can reduce the price from $250+ retail to as low as $76 — a significant saving. Most commercial insurance and Medicare Part D plans also cover malathion, though prior authorization may be required in some cases.
If you're having difficulty finding malathion at a pharmacy near you, medfinder can help. medfinder contacts pharmacies in your area to check who has your medication in stock, then texts you the results — saving you the frustrating experience of calling pharmacy after pharmacy.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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