Lindane topical
Indications
Lindane topical is used for:
Scabies, Pediculosis
Adult Dose
Topical/Cutaneous
Scabies
Adult: Apply a thin layer of 1% topical preparation onto all skin areas from the neck to toes. Completely wash off from the body with warm water after 8-12 hr.
Topical/Cutaneous
Pediculosis
Adult: Apply 30-60 ml of 1% shampoo to dry hair. Amount depends on the length of the hair; most patients will require 30 ml (max 60 ml). Massage into hair for 4 min then add small quantities of water to form a good lather. Immediately rinse thoroughly until all the lather is gone. Dry the hair and comb with a fine tooth comb.
Child Dose
Scabies
Lotion: Apply thin layer and massage on skin on entire body except face; bathe and remove drug 8-12 hr after application
Head Lice or Crab Lice
Apply 1-2 oz of shampoo (not to exceed 2 oz) on dry hair; leave on 4 min, lather, rinse, remove nits with fine comb
One time application usually sufficient; may use other pediculicide in 1 wk if necessary
Renal Dose
Administration
Contra Indications
Hypersensitivity. Uncontrolled seizures; broken skin; premature infant. Lactation.
Precautions
Infants, small children, patients <50 kg, history of seizures or conditions which may increase risk of seizures. Hepatic impairment. Avoid contact with face, eyes, mucous membranes and urethral meatus. Pregnancy.
Neurotoxicity, including seizures and death, has been reported with repeat or prolonged application, and rarely with single application.
Use with caution in those at risk for neurotoxicity including infants, children, elderly persons, those who weigh <50 kg, or those with a history of seizures. It is contraindicated in premature infants and in those with uncontrolled seizure disorders. Counseling the patient on proper use is required.
Use only in patients who have failed first line treatments
Provide patient with medication use guide with instructions on how to use
Pregnancy-Lactation
Pregnancy Category: C
Lactation: distributed in breast milk, do not nurse for 24 hr post-application (express milk & discard)
Interactions
Enhanced absorption and increased risk of toxicity with oils and oil-based preparations.
Potentially Fatal: Increased toxicity with drugs that lower seizure threshold e.g. antidepressants, antipsychotics, ciclosporin, isoniazid.
Adverse Effects
Side effects of Lindane topical :
Frequency Not Defined
Slight local irritation (including eczematous eruptions, rash, conjunctivitis)
Repeated application frequently causes contact dermatitis
CNS toxicity (seizures)
Cardiac arrhythmia
Ataxia
Dizziness
Restlessness
Pain
Seizure
Alopecia
Urticaria
Hematuria
Pulmonary edema
Hepatitis
Nausea/vomiting
Paresthesia
Aplastic anemia
Mechanism of Action
Lindane stimulates the nervous system of parasites by direct absorption through their exoskeletons causing seizures and death.