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Lindane information from DrugsUpdate  

See Available Brands of Lindane in India

P - Caution when used during pregnancy
L - Contraindicated in lactation

Lindane, also known as gamma-hexachlorocyclohexane, (γ-HCH), gammaxene, Gammallin and erroneously known as benzene hexachloride (BHC), is an organochlorine chemical variant of hexachlorocyclohexane that has been used both as an agricultural insecticide and as a pharmaceutical treatment for infestations of lice and scabies.

Lindane is a neurotoxin that interferes with GABA neurotransmitter function by interacting with the GABAA receptor-chloride channel complex at the picrotoxin binding site. In humans, lindane primarily affects the nervous system, liver and kidneys, and may be a carcinogen and/or endocrine disruptor. Lindane has been indicated in one death from multiple topical applications for repeating mite infestations.

The World Health Organization classifies lindane as "Moderately Hazardous," and its international trade is restricted and regulated under the Rotterdam Convention on Prior Informed Consent. It is presently banned in more than 50 countries, and in 2009 was included in the Stockholm Convention on persistent organic pollutants, which bans its production and use worldwide.

Pharmacodynamics

Pharmacokinetics

Lindane stimulates the nervous system of parasites by direct absorption through their exoskeletons causing seizures and death.

Absorption
≤13% (systemic absorption after topical application); peak plasma concentrations after 6 hours in children.

Distribution
Stored in body fat, accumulates in brain; skin and adipose tissue.

Metabolism
Hepatic.

Excretion

Via urine and faeces; 17-22 hours (elimination half-life in children).

Lindane Indications / Lindane Uses

Information Not Available

Lindane Adverse Reactions / Lindane Side Effects

Cardiac arrhythmia, ataxia, dizziness, headache, restlessness, seizure, pain, alopecia, contact dermatitis, eczematous eruptions, pruritus, urticaria, nausea, vomiting, aplastic anaemia, hepatitis, burning and stinging, paraesthesia, haematuria, pulmonary oedema.

Potentially Fatal: Severe neurologic toxicities.

Precautions

Warnings
Reserved for patients who are intolerant or failed first-line therapy. Contraindicated in premature infants and those with uncontrolled seizure disorders. Patient counseling in proper use is required.

Neurotoxicity
Seizures and death have been reported with repeat or prolonged application and rarely with single application. Use with caution because of increased risk in infants, children, elderly, in those with other skin conditions, and in those who weigh less than 50 kg.

Special Precautions

Infants, small children, patients <50 kg, history of seizures or conditions which may increase risk of seizures. Hepatic impairment. Avoid contact with face, eyes, mucous membranes and urethral meatus. Pregnancy.

Other Drug Interactions

Enhanced absorption and increased risk of toxicity with oils and oil-based preparations.

Potentially Fatal: Increased toxicity with drugs that lower seizure threshold e.g. antidepressants, antipsychotics, ciclosporin, isoniazid.

Other Interactions

Information Not Available

Dosage

Topical/Cutaneous
Scabies
Adult: Apply a thin layer of 1% topical preparation onto all skin areas from the neck to toes. Completely wash off from the body with warm water after 8-12 hours

Topical/Cutaneous

Pediculosis
Adult: Apply 30-60 ml of 1% shampoo to dry hair. Amount depends on the length of the hair; most patients will require 30 ml (max 60 ml). Massage into hair for 4 minutes then add small quantities of water to form a good lather. Immediately rinse thoroughly until all the lather is gone. Dry the hair and comb with a fine tooth comb.

Food(before/after)

Information Not Available

List of Contraindications

Lindane and Pregnancy

Caution when used during pregnancy

Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).

Lindane and Lactation

Contraindicated in lactation

Lindane and Children

Pediatric patients have a higher surface to volume ratio and may be at risk of greater systemic exposure when lindane is applied. Infants and children may be at even higher risk because of immaturity of organ systems such as skin and liver. Use with caution in patients weighing less than 50 kg and especially in infants.

Lindane and Geriatic

Information Not Available

Lindane and Other Contraindications

Hypersensitivity. Uncontrolled seizures; broken skin; premature infant. Lactation.

Storage

Topical/Cutaneous
Store at controlled room temperature.

Lab interference

Topical/Cutaneous
Store at controlled room temperature.

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