Lindane

Aka: Lindane, Kwell, Organochlorine, Gamma Benzene Hexachloride

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II. Precautions

  1. Do not use in infants
  2. Much greater risk of toxicity than with other agents
  3. Percutaneous absorption 10-20 fold over Permethrin
  4. Serum levels are 40 fold higher than Permethrin
  5. CNS toxicity 2-4 fold over Permethrin
    1. Seizure risk in epileptics and children

III. Mechanism

  1. Organochlorine similar to DDT
  2. Organochlorine Agents
    1. Chlorobenzilate
    2. Dicofol
    3. Dienochlor
    4. Endosulfan
    5. Lindane

IV. Indications

  1. Scabies
  2. Lice

V. Preparation

  1. Lindane 1% Shampoo (60 ml)
  2. Lindane 1% Lotion (60 ml)

VI. Directions for use

  1. Scabies
    1. Apply lotion to skin from neck to toes
    2. Wash off in 6 to 8 hours
    3. Repeat application in 1 week
  2. Lice
    1. Apply Shampoo to dry hair
    2. Massage into hair for 4 minutes before rinsing
    3. Rinse thoroughly and comb with fine tooth comb
    4. Repeat treatment in one week

VII. Adverse Effects

  1. Mechanism
    1. Disrupts axonal Sodium and Potassium flow
    2. Affects both central and Peripheral Nerves
    3. Higher toxicity in broken skin and young children
  2. Effects: Neurotoxicity
    1. Seizure
    2. Headache
    3. Paresthesias
    4. Incoordination
    5. Tremor
  3. Management of toxicitiy
    1. Skin Decontamination
    2. ABC Management
    3. Seizure control with Diazepam
    4. Intravenous Fluids (D5W) with Thiamine

VIII. References

  1. Meinking (1996) Arch Dermatol 132:959-62 [PubMed]

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