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Lindane

    Brands

    DEA Class;  Rx

    Common Brand Names; 

    • Scabicidal Agents

    Topical scabicide; is the gamma isomer of potent insecticide hexachlorocyclohexane (also known as BHC); used as an ectoparasitacide in scabies and pediculosis (lice). Due to concerns over neurotoxicity, lindane is a second line treatment for those intolerant or unresponsive to other therapies; some patients are more at risk; instruct patient thoroughly on proper drug use; a black-box warning has been issued in the official product labeling.

    Indicated for the treatment of scabies caused by Sarcoptes scabiei in patients who cannot tolerate or have failed treatment with other approved therapies.

    For the treatment of pediculosis capitis and pediculosis pubis.

    Not first-line

    Use caution in hepatic impairment

    >10%

    Cough (15%)

    1-10%

    Upper respiratory tract infection (6%)

    Discolored sputum (5%)

    Nausea (5%)

    Dyskinesia (4%)

    Fall (3%)

    Vomiting (3%)

    Nasopharyngitis (3%)

    Chest discomfort (2%)

    Increased bilirubin (2%)

    Decreased RBC count (2%)

    Headache (2%)

    Insomnia (2%)

    Orthostatic hypotension/decreased blood pressure (2%)

    Laceration (2%)

    Skin abrasion (2%)

    Bronchitis/pneumonia (2%)

    Discolored nasal discharge (2%)

    Oropharyngeal pain (2%)

    Falling asleep while engaged in activities of daily living, including driving, reported; many patients report somnolence, while other had no warnings signs (sleep attack); some events reported >1 yr after initiating treatment

    Rapid dose reduction, withdrawal of, or changes in dopaminergic therapy may result in a symptom complex that resembles neuroleptic malignant syndrome (eg, elevated temperature, muscular rigidity, altered consciousness, autonomic instability)

    Hallucinations may occur, accompanied by confusion, insomnia, and excessive dreaming; abnormal thinking and behavior may also occur, including, paranoid ideation, delusion, confusion, psychotic-like behavior, disorientation, aggressive behavior, agitation, and delirium

    Decreased impulse control and compulsive behaviors may emerge, including, gambling, sexual urges, spending money, binge eating, and/or other intense urges; patients may not recognize these as abnormal

    May cause or exacerbate dyskinesias

    Owing to bronchospasm risk, not recommended for patients with asthma, COPD, or other chronic lung disease

    May increase intraocular pressure in patients with glaucoma

    Pregnancy

    Use in pregnant women associated with neural tube defects and mental challenges; not recommended for treatment of pediculosis during pregnancy; pregnant patients should avoid contact with lindane as much as possible if applying to others

    Lactation

    Distributed into milk; risk of toxicity if lindane were absorbed through the skin in the course of breast-feeding if the mother has applied lindane to the chest area; discontinue nursing for at least 24 hours following application of lindane and avoid large areas of skin-to-skin contact with infant while lindane applied

    Adults

    >= 50 kg: 60 ml topically of shampoo or lotion. 
    < 50 kg: Use not recommended.

    Elderly

    Use not recommended.

    Adolescents

    >= 50 kg: 60 ml topically of shampoo or lotion. 
    < 50 kg: Use not recommended.

    Children

    >= 50 kg: 60 ml topically of shampoo or lotion. 
    < 50 kg: Use not recommended.

    Infants

    Use not recommended. 
    Premature Infants: Use contraindicated.

    Lindane

    lotion/shampoo

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