Comprehensive medication guide to Ovide including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$50 copay with most commercial insurance plans; typically Tier 2–3. Step therapy (prior OTC treatment failure) may be required. Medicaid covers it in most states.
Estimated Cash Pricing
$194–$293 retail for a 59 mL bottle; as low as $76–$100 with GoodRx or SingleCare coupons. Ask for generic malathion to access the lowest prices.
Medfinder Findability Score
45/100
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Ovide is the brand name for malathion 0.5% topical lotion, a prescription medication used to treat head lice (Pediculus humanus capitis) and their eggs (nits). It is an organophosphate pediculicide — a class of compounds that kills parasites by disrupting their nervous systems. Ovide was first FDA-approved in 1982, making it one of the longer-standing prescription lice treatments available.
Ovide is available in a single formulation: a 0.5% topical lotion in a 59 mL (2 fl oz) bottle. The vehicle contains 78% isopropyl alcohol along with terpineol, dipentene, and pine needle oil. A generic version (malathion lotion 0.5%) has been FDA-approved since 2009 and is therapeutically equivalent to the brand.
Ovide is typically prescribed as a second-line or third-line treatment when over-the-counter lice treatments like permethrin (Nix) or pyrethrin-based products (Rid) have failed. Both the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend malathion as an FDA-approved option for treatment-resistant head lice in patients 6 years and older.
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Malathion kills head lice by irreversibly inhibiting cholinesterase — an enzyme essential to normal nervous system function in lice. When cholinesterase is blocked, acetylcholine (a nerve signaling chemical) cannot be broken down and accumulates continuously. This locks the louse's nervous system in a perpetually "on" state, causing rapid, massive paralysis and death.
Inside a louse's body, malathion is partially metabolized into malaoxon — a more potent cholinesterase inhibitor — which amplifies the lethal effect. In vitro studies demonstrate that malathion 0.5% kills 100% of live lice within 10 minutes of exposure. Ovide also kills nits (eggs) through both nervous system disruption and the rapid dehydrating effect of its 78% alcohol vehicle.
Crucially, malathion operates through a completely different mechanism than pyrethroids (the active ingredients in OTC lice products like Nix and Rid). This is why Ovide remains effective against "super lice" — lice that have developed resistance to permethrin through genetic mutations in their sodium channels. After application, malathion bonds to the hair shaft and can provide residual pediculicidal protection for several weeks.
0.5% — topical lotion
59 mL (2 fl oz) bottle; apply to dry hair sufficient to wet hair and scalp; leave on 8-12 hours; approved for ages 6+
Ovide is not on the FDA's official drug shortage list as of 2026. However, it is a niche prescription product that many retail pharmacies do not routinely stock. Low, intermittent demand, high retail cost (~$250 per bottle), and flammability storage considerations mean that most large chain pharmacies don't keep it on their shelves. This creates practical unavailability that can feel like a shortage to patients.
Patients are most likely to find Ovide at independent pharmacies, specialty pharmacies, or through mail-order pharmacy services. Most pharmacies can order it through their wholesaler within 1-2 business days if asked. The generic (malathion lotion 0.5%) may be slightly more available than brand-name Ovide and is therapeutically identical.
Rather than calling pharmacies one by one, patients can use medfinder — a service that contacts pharmacies near you to find which ones can fill your Ovide prescription. Results are texted directly to you.
Since Ovide (malathion) is not a controlled substance, any licensed prescriber can write for it without special DEA authorization. There are no state-specific restrictions on who can prescribe it beyond standard prescribing licenses.
Pediatricians — most common prescribers, since head lice primarily affects school-age children
Primary care physicians (family medicine, internal medicine)
Dermatologists — specialists with particular expertise in pediculosis
Nurse practitioners (NPs) — licensed to prescribe in all 50 states
Physician assistants (PAs) — can prescribe in all states under physician supervision
Urgent care providers — can diagnose and prescribe without prior appointment
Telehealth is appropriate for Ovide prescriptions. Since head lice is easily assessed based on history and symptom description, most telehealth platforms can evaluate and prescribe Ovide during a virtual visit. This includes direct-to-consumer telehealth services (Teladoc, MDLive) and patient portal visits with existing providers.
No. Ovide (malathion 0.5% lotion) is not a controlled substance and is not scheduled under the DEA. It does not have abuse potential, and there are no special prescribing restrictions based on scheduling.
Because Ovide is not controlled, any licensed prescriber — including primary care physicians, pediatricians, nurse practitioners, physician assistants, and dermatologists — can prescribe it without a DEA number. Prescriptions can be sent electronically, called in, or faxed. Telehealth providers can also prescribe Ovide in all 50 states. There are no refill limits based on controlled substance scheduling, though the drug is typically prescribed for 1-2 applications only.
Most side effects of Ovide are mild, local reactions at the application site:
Scalp or skin irritation (most common)
Stinging sensation on the scalp
Burning feeling, particularly on irritated skin
Dry hair (from high isopropyl alcohol content)
Temporary increase in dandruff/flaking
Chemical burns, including second-degree burns (rare; occurs when too much product is applied or it runs onto non-scalp skin)
Eye irritation or mild conjunctivitis (if product contacts eyes — flush with water immediately)
Serious allergic reaction (rare): hives, difficulty breathing, swelling of face/lips/tongue — seek emergency care immediately
Cholinergic toxicity if swallowed: sweating, salivation, nausea, vomiting, bradycardia, respiratory distress — call Poison Control (1-800-222-1222) or 911 immediately
Critical flammability warning: Ovide contains 78% isopropyl alcohol. While the lotion is on the hair, avoid all heat sources (hair dryers, electric curlers, curling irons, open flames) and do not smoke. Allow hair to air-dry naturally.
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Spinosad (Natroba)
Prescription 0.9% suspension; also ovicidal; shorter 10-min contact time; approved ages 6 months+; no flammability concern; generally more widely available than Ovide
Ivermectin lotion (Sklice)
Now OTC (0.5% lotion); ovicidal; 10-min contact time; approved ages 6 months+; widely accessible at most pharmacies
Benzyl alcohol (Ulesfia)
Prescription 5% lotion; NOT ovicidal; 10-min contact; approved ages 6 months+; requires two treatments 7 days apart
Permethrin (Nix)
OTC 1% lotion; NOT ovicidal; first-line treatment; inexpensive and widely available; not effective against resistant 'super lice'
Prefer Ovide? We can find it.
Cholinesterase inhibitors (donepezil, rivastigmine, galantamine)
minorTheoretical additive cholinesterase inhibition if significant systemic absorption occurs; risk is very low with topical use as directed; disclose use to prescriber
Pyridostigmine / neostigmine (myasthenia gravis drugs)
minorTheoretical additive cholinesterase inhibition; disclose to prescriber before using Ovide
Other topical scalp preparations
moderateFDA labeling advises against concurrent application of other topical products to hair/scalp during Ovide treatment; may reduce efficacy or increase adverse effects
Ovide (malathion 0.5% lotion) is one of the most potent prescription lice treatments available, offering both pediculicidal and ovicidal activity through a mechanism of action that remains effective against pyrethroid-resistant "super lice." Approved by the FDA in 1982 and recommended by both the AAP and CDC, it has a decades-long track record.
The main challenges with Ovide are practical: its high retail price ($200-$293 cash), flammability requiring careful handling, and inconsistent pharmacy stocking. Generic malathion lotion 0.5% (available since 2009) is therapeutically identical and typically more affordable — particularly with GoodRx coupons that can reduce the price to under $100. Most pharmacies can order it within 1-2 business days if asked.
If you've been prescribed Ovide and are struggling to find it at a local pharmacy, medfinder can help. medfinder contacts pharmacies near you to find which ones can fill your prescription — saving you the time and frustration of calling around yourself.
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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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