Remove small spots in B&w drawing

Cleaning up a b&w drawing, I want to remove small spots. Spots are only a few pixels in size, of irregular shapes, and not touching the other areas of the drawing. In grayscale, there is a way to remove spots but not in b&w. Converting b&w to grayscale and then using this can work but it's not effective for the larger spots. Any ideas on removing these with a process or macro?