Dosing and uses of Lindane
Adult dosage forms and strengths
lotion/shampoo
- 1%
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
Other Indications & Uses
Pubic lice & ova; cream & lotion indicated for scabies ONLY if intolerant to or failed first-line Tx
Pediatric dosage forms and strengths
lotion/shampoo
- 1%
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
Lindane adverse (side) effects
Frequency not defined
Slight local irritation (including eczematous eruptions, rash, conjunctivitis)
Repeated application frequently causes contact dermatitis
CNS toxicity (seizures)
Warnings
Black box warnings
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.
Contraindications
Premature neonates (<28 do) (increased absorption), uncontrolled seizure disorder, hypersensitivity, Norwegian (crusted) scabies, skin conditions that may incr systemic absorption
Retreatment
Cautions
Not first-line
Risk of serious neurotoxicity in children weighing <50 kg
HIV infection, history of head trauma or a prior seizure, CNS tumor, severe hepatic cirrhosis, excessive use of alcohol, abrupt withdrawal from alcohol or sedatives, concomitant use of medications known to lower seizure threshold
Pregnancy and lactation
Pregnancy category: C
Lactation: distributed in breast milk, do not nurse for 24 hr post-application (express milk & discard)
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Lindane
Absorption: slowly & incompletely absorbed through intact skin when applied topically
Metabolism: liver
Excretion: urine & feces
Mechanism of action
Following absorption through the chitinous exoskeleton of arthropods, cyclic chlorinated hydrocarbons like lindane presumably stimulate the nervous system, resulting in seizures & death
