lindane(redirected from 1,2,3,4,5,6-hexachlorocyclohexane)
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Pharmacologic class: Chlorinated hydrocarbon
Therapeutic class: Scabicide, pediculocide
Pregnancy risk category C
FDA Box Warning
• Use only in patients who can't tolerate or have failed first-line treatment with safer drugs.
• Seizures and deaths have occurred with repeat or prolonged application, and in rare cases after a single application used as directed. Use cautiously in infants, children, elderly patients, persons with other skin conditions, and in those weighing less than 110 lb (50 kg).
• Drug is contraindicated in premature infants and patients with uncontrolled seizure disorders.
• Instruct patient about proper drug use, amount to apply, how long to leave it on, and importance of avoiding retreatment.
Absorbed through parasitic ova and arthropods, which stimulates parasitic nervous system and results in seizures and death of parasite
Indications and dosages
➣ Secondary treatment of scabies
Adults and children: Apply enough lotion on dry skin to cover entire surface from neck down. Rub in well, and leave in place 12 hours. Then wash skin thoroughly.
➣ Secondary treatment of Pediculosis capitis (head lice) or Pediculosis pubis (pubic lice)
Adults and children: Apply enough shampoo to dry hair (1 oz or less for short hair, 1½ oz for medium length hair, up to 2 oz for long hair) to thoroughly wet hair and skin or scalp of affected and surrounding hairy areas. Leave in place 12 hours. Then wash hair thoroughly.
• Hypersensitivity to drug or its components
• Seizure disorder
• Crusted (Norwegian) scabies and other conditions that may increase systemic drug absorption
• Premature neonates
Use cautiously in:
• conditions that increase seizure risk (such as history of seizures, head injury, AIDS)
• skin conditions
• concurrent use of skin creams, oils, or ointments
• patients weighing less than 50 kg (110 lb)
• elderly patients
• breastfeeding patients
• infants or children.
• To apply, wear gloves made of nitrile, latex with neoprene, or sheer vinyl.
• Before applying lindane shampoo, use regular shampoo without conditioner; rinse and dry hair completely. Wait 1 hour before using lindane shampoo.
• Don't use lindane lotion or shampoo with other lotions, creams, or oils.
• Thoroughly wash skin after lotion has been in place for 12 hours.
CNS: dizziness, seizures, headache, anxiety, paresthesia
EENT: irritation of eyes, nose, and throat (from vapor inhalation)
GI: nausea and vomiting (from vapor inhalation)
Hematologic: aplastic anemia (with prolonged use)
Skin: dermatitis, urticaria, pruritus, alopecia
Drug-drug. Drugs that lower seizure threshold, antidepressants: increased seizure activity
• Monitor drug efficacy.
☞ Emphasize that drug is for external use only, and that ingesting even small amounts can be fatal.
• If drug will be applied by another person, tell patient that this person must wear gloves made of nitrile, latex with neoprene, or sheer vinyl.
• Instruct patient using lindane lotion to wash, rinse, and dry skin well before applying lindane if skin has cream, lotion, ointment, or oil on it. If he takes a warm bath or shower before applying lindane, instruct him to let skin dry and cool down. Then tell him to apply lindane to dry skin, rub in well, leave on skin for 8 to 12 hours, and then remove it by washing thoroughly.
• Instruct patient using lindane shampoo to apply enough shampoo to dry hair to thoroughly wet the hair and skin or scalp of affected and surrounding hairy areas, and then rub shampoo thoroughly into hair and skin or scalp and let it sit for 4 minutes. Then tell him to add just enough water to work up a good lather, then rinse thoroughly and dry hair with clean towel. When hair is completely dry, instruct him to comb it with a fine-toothed comb to remove any remaining nits or nit shells. Tell him not to use shampoo in combination with oils, lotions, or creams.
• To avoid reinfestation, instruct patient to launder all recently worn or used clothing, bed linens, and towels in hot water.
• Caution patient to avoid contact with eyes when applying lotion or shampoo.
• Tell patient with scabies that sexual contacts and other close personal contacts should be examined and, if necessary, treated.
• Advise female patient to inform prescriber if she plans to breastfeed.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs mentioned above.