Lindane

Administration

  • Type: Pediculicide
  • Dosage Forms:
  • Routes of Administration: topical
  • Common Trade Names:

Adult Dosing

Second line therapy only for patients who have failed other agents

  • Scabies: apply thin layer and massage on entire body except face, remove after 8-12h
  • Head lice: apply 1-2 oz of shampoo on dry hair, leave on for 4min, lather/rinse and remove nits with fine comb

Pediatric Dosing

Second line therapy only for patients who have failed other agents Caution if patient weighs <50kg

  • Scabies: apply thin layer and massage on entire body except face, remove after 8-12h
  • Head lice: apply 1-2 oz of shampoo on dry hair, leave on for 4min, lather/rinse and remove nits with fine comb

Special Populations

Pregnancy Rating

  • Pregnancy Category C

Lactation risk

  • Do not breastfeed for 24h after application

Renal Dosing

  • Adult:
  • Pediatric:

Hepatic Dosing

  • Adult: Use caution
  • Pediatric: Use caution

Contraindications

  • Allergy to class/drug
  • Premature neonates (<28 do) (increased absorption)
  • Uncontrolled seizure disorder
  • Norwegian (crusted) scabies
  • Skin conditions that may increase systemic absorption (weeping surface, inflamed skin etc)
  • Caution with:
    • HIV infection
    • Prior seizure
    • Prior head trauma
    • CNS tumor
    • Severe hepatic cirrhosis
    • Excess alcohol use or abrupt withdrawal from alcohol or benzos
    • Concomitant use of meds that lower seizure threshold
    • Weight <50kg

Adverse Reactions

Serious

  • Neurotoxicity (seizures), ataxia
  • Arrhythmia
  • Pulmonary edema
  • Aplastic anemia

Common

  • Skin irritation, contact dermatitis, alopecia, urticaria
  • Dizziness
  • Restlessness
  • Hematuria
  • Paresthesia
  • Nausea/vomiting

Pharmacology

  • Half-life: 17-22h
  • Metabolism: liver
  • Excretion: urine and 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 of parasite"[1]

Comments

  • Black box for neurotoxicity, banned in several countries and California due to neurotoxicity

See Also

References

Authors:

Claire