Generic Name

Lindane

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Classification

FDA Approved Indications

• Treatment of lice (pediculosis)
• Treatment of scabies

Mechanism of Action

Lindane acts as a GABA receptor antagonist in parasites, disrupting chloride ion influx and causing hyperexcitation of the nervous system, leading to paralysis and death of the lice or scabies mites.

Dosage and Administration

Adult: Apply a thin layer to affected areas, usually once; may repeat after 7 days if necessary.

Pediatric: Use with caution in children; follow specific pediatric dosing guidelines, generally similar to adult but with lower dosages and supervision.

Geriatric: Careful assessment; use with caution due to increased risk of neurotoxicity.

Renal Impairment: Use with caution; no specific dosage adjustments established.

Hepatic Impairment: Use with caution; no specific guidelines.

Pharmacokinetics

Absorption: Minimal through intact skin; more significant if skin is broken or damaged.

Distribution: Distributed in adipose tissue.

Metabolism: Metabolized in the liver.

Excretion: Excreted mainly in urine and feces.

Half Life: Approximately 3-4 days.

Contraindications

• Known hypersensitivity to lindane or other components of the formulation.

Precautions

• Neurotoxicity risk; contraindicated in infants, young children, pregnant or nursing women, and individuals with seizure disorders.
• Avoid use on broken or inflamed skin.
• Monitor for signs of neurotoxicity during and after treatment.

Adverse Reactions - Common

• Pruritus, rash, erythema (Common)
• Headache, dizziness (Common)

Adverse Reactions - Serious

• Neurotoxicity (seizures, tremors, confusion) (Rare but serious)
• Allergic reactions (anaphylaxis) (Rare)

Drug-Drug Interactions

• May increase neurotoxicity when used with other neurotoxic agents or central nervous system depressants.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Instruct to apply a thin layer, and not to reuse without medical advice.
• Warn about potential neurotoxic effects and advise seeking immediate care if symptoms occur.
• Advise against applying to broken or inflamed skin.
• Explain the importance of following dosing and application instructions carefully.

Special Considerations

Black Box Warnings:

• Neurotoxicity including seizures; the FDA recommends caution in the use of lindane as a first-line treatment.
• Use only when other safer medications are not effective or cannot be used.

Genetic Factors: None specified.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: Seizures, neurotoxicity, tremors, confusion.

Treatment: Supportive care; administer anticonvulsants if seizures occur; activated charcoal if ingestion is recent; consult poison control.

Storage and Handling

Storage: Store at room temperature, protected from moisture and light.

Stability: Stable when stored properly.