II. Indications
- Third-line topical Antiparasitic Agent (other agents are preferred)
III. Contraindications
- Infants
- Caution in young children and elderly
- Caution in weight <50 kg
- Seizure Disorder
IV. Precautions
- Carcinogenic
- Much greater risk of toxicity (esp. neurotoxicity) than with other agents
- CNS toxicity 2-4 fold over Permethrin
- Seizure risk in epileptics and children
V. Mechanism
- Organochlorine similar to DDT
- Used as an Insecticide for hardwood logs and on crops
- Lindanes use as a topical pediculicide and scabicide is related to its neurotoxic effects in these Parasites
- Organochlorine Agents
- Chlorobenzilate
- Dicofol
- Dienochlor
- Endosulfan
- Lindane
VI. Medications
- Lindane 1% Shampoo (60 ml)
- Lindane 1% Lotion (60 ml)
VII. Dosing
- Quantity
- Adult (and child age >6 years): 30 to 60 ml
- Child age <6 years: 30 ml
-
Scabies
- Apply lotion to skin from neck to toes
- Wash off in 8 to 12 hours
- May repeat application in 1 week
- Treat all family members
-
Lice
- Apply Shampoo to dry hair
- Massage into hair for 4 minutes before rinsing
- Rinse thoroughly
- Comb with fine tooth comb to remove nits
- Repeat treatment in one week
VIII. Adverse Effects
- Neurotoxicity
- Mechanism
- Disrupts axonal Sodium and Potassium flow
- Affects both central and Peripheral Nerves
- Higher toxicity in broken skin and young children
- Findings
- Seizure
- Headache
- Paresthesias
- Incoordination
- Tremor
- Deaths have occurred
- Mechanism
- Other adverse effects (large exposures, ingestions)
- Nose and throat irritation (inhalational exposure)
- Anemia
- Hepatotoxicity
- Arrhythmia
- Skin Irritation (topical)
- Carcinogenic
- Management of toxicitiy
- Skin Decontamination
- ABC Management
- Seizure control with Diazepam
- Intravenous Fluids (D5W) with Thiamine
IX. Pharmacokinetics
- Percutaneous absorption 10-20 fold over Permethrin
- Serum levels are 40 fold higher than Permethrin
X. Safety
- Pregnancy Category B (but not recommended)
- Unknown safety in Lactation
XI. Resources
- Lindane Lotion (DailyMed)
- Lindane (EPA)
- Lindane (Wikipedia)
XII. References
Images: Related links to external sites (from Bing)
Related Studies
Definition (MSHCZE) | Organochlorový insekticid, který se užíval proti vším a svrabu. Prokázalo se, že způsobuje rakovinu. |
Definition (NCI) | The gamma-isomer of benzene hexachloride, a colorless to white colored, synthetic, crystalline solid with a slight musty odor that emits toxic fumes of hydrochloric acid and other chlorinated compounds when heated to decomposition. Lindane is used as an insecticide for hardwood logs, lumber, and crops. Lindane also has topical pediculicide and scabicide activities probably due to its neurotoxic effects. Inhalation exposure to this substance causes severe irritation of the nose and throat, causes anemia, and affects the liver, nervous, cardiovascular, and immune system. Lindane is reasonably anticipated to be a human carcinogen. |
Definition (MSH) | An organochlorine insecticide that has been used as a pediculicide and a scabicide. It has been shown to cause cancer. |
Definition (CSP) | gamma isomer of benzene hexachloride, a carcinogenic insecticide more potent than DDT (chlorophenothane); it is used to kill lice and mites, applied topically to the skin. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) , Hazardous or Poisonous Substance (T131) |
MSH | D001556 |
SnomedCT | 77496001, 49490007, 333056004 |
LNC | LP15064-6, MTHU002397 |
English | Benzene Hexachloride, gamma-Benzene Hexachloride, gamma-Hexachlorocyclohexane, Hexachlorane, Hexachloride, Benzene, Hexachloride, gamma-Benzene, Hexachlorocyclohexane, Lindane, Cyclohexane, 1,2,3,4,5,6-hexachloro-, (1alpha,2alpha,3beta,4alpha,5alpha,6beta)-, gamma Benzene Hexachloride, gamma Hexachlorocyclohexane, g-Benzene Hexachloride, gamma-HCH, (1alpha,2alpha,3beta,4alpha,5alpha,6beta)1,2,3,4,5,6-Hexachlorocyclohexane, Gammahexachlorcyclohexane, Gammahexachlorocyclohexane, Benzene hexachloride, gamma benzene hexachloride (medication), gamma benzene hexachloride, Lindane [Chemical/Ingredient], lindane products, LINDANE, lindane, Benzene hexachloride (substance), Lindane product, gamma Benzene hexachloride, Lindane product (product), gamma Benzene hexachloride (substance), gamma hexachlor, Lindane product (substance), Gamma hexachlorocyclohexane |
Swedish | Lindan |
Czech | hexachlorocyklohexan, lindan, gama-benzenhexachlorid, gama-hexachlorcyklohexan, benzenhexachlorid, hexachloran, lindan (BHC), gama benzene hexachloride, hexachlorcyklohexan |
Finnish | Lindaani |
Russian | GEKSAKHLORTSIKLOGEKSAN, LINDAN, BENZOLGEKSAKHLORID, GAMMA-BENZOLGEKSAKHLORID, БЕНЗОЛГЕКСАХЛОРИД, ГАММА-БЕНЗОЛГЕКСАХЛОРИД, ГЕКСАХЛОРЦИКЛОГЕКСАН, ЛИНДАН |
Japanese | γ-ベンゼンヘキサクロライド, ベンゼンヘキサクロリド, ベンゼンヘキサクロライド, ヘキサクロルシクロヘキサン, リンダン, 六塩化ベンゼン, ヘキサクロロシクロヘキサン, ガンマ-ベンゼンヘキサクロライド |
Spanish | lindano, lindano, producto (producto), lindano (producto), lindano, producto, hexaclorociclohexano, hexacloruro de benceno, hexacloruro de benceno (sustancia), hexacloruro de gamma benceno (sustancia), hexacloruro de gamma benceno, Hexaclorociclohexano, Hexacloruro de Benceno, Hexacloruro de gammabenceno, Lindano |
Polish | Gameksan, Lindan, Heksachlorocykloheksan |
French | Lindane, Hexachlorocyclohexane, Hexachloro-cyclohexane |
German | Benzen-Hexachlorid, Gamma-Benzen-Hexachlorid, Hexachlorcyclohexan, Lindan |
Italian | Lindano |
Portuguese | Hexacloreto de Benzeno, Hexacloreto de gama-Benzeno, Hexaclorocicloexano, Lindano |
Ontology: Hydrocarbons, Chlorinated (C0020247)
Definition (NCI) | Organochlorines are a group of compounds belonging to the chlorinated hydrocarbon pesticides (as aldrin, DDT, or dieldrin). These compounds are believed to associated with many cancers, especially with breast cancer. |
Definition (CSP) | organic compound that contains carbon and hydrogen, with chlorine atoms substituting for one or more hydrogens. |
Definition (MSH) | Hydrocarbon compounds with one or more of the hydrogens replaced by CHLORINE. |
Concepts | Organic Chemical (T109) |
MSH | D006843 |
SnomedCT | 56181003 |
LNC | LP14503-4, MTHU003714 |
English | Chlorinated Hydrocarbons, Hydrocarbons, Chlorinated, Chlorine Compounds, Organic, Compounds, Organic Chlorine, Organic Chlorine Compounds, chlorohydrocarbon, ORGANOCHLORINE CPDS, Hydrocarbons, Chlorinated [Chemical/Ingredient], chlorinated hydrocarbon, chlorohydrocarbons, chlorinated hydrocarbons, Hydrocarbons.chlorinated, Chlorohydrocarbons, Chlorinated hydrocarbon, Chlorinated hydrocarbon (substance), Chlorinated hydrocarbon, NOS, Compounds, Organochlorine, Organochlorine Compounds, Organochlorine Compound, Organochlorines |
Swedish | Kolväten, klorerade |
Czech | uhlovodíky chlorované |
Finnish | Kloorihiilivedyt |
Russian | KHLORIROVANNYE UGLEVODORODY, UGLEVODORODY KHLORIROVANNYE, УГЛЕВОДОРОДЫ ХЛОРИРОВАННЫЕ, ХЛОРИРОВАННЫЕ УГЛЕВОДОРОДЫ |
Japanese | 塩素化炭化水素, 炭化水素-塩素化 |
Italian | Composti organici del cloro, Composti organoclorici, Idrocarburi clorinati |
Croatian | Not Translated[Hydrocarbons, Chlorinated] |
Polish | Chloropochodne węglowodorów |
Spanish | hidrocarburo clorado (sustancia), hidrocarburo clorado, Hidrocarburos Clorados |
French | Hydrocarbures chlorés |
German | Chlorierte Kohlenwasserstoffe, Kohlenwasserstoffe, chlorierte |
Portuguese | Hidrocarbonetos Clorados |
Ontology: Kwell (C0591692)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D001556 |
English | pediculicides gamma benzene hexachloride (kwell), gamma benzene hexachloride (Kwell), Kwell |
Czech | Kwell |