Lindane

What it is and how it works

Lindane (gamma-benzene hexachloride) is an organochlorine insecticide absorbed through the exoskeleton of arthropods. It acts on GABA-gated chloride channels, causing neuronal hyperexcitability, convulsions and death of mites and lice and their ova.

Indications

Second-line treatment of scabies (lotion) and head or pubic lice (shampoo) in patients who cannot tolerate or have failed safer first-line therapies.

Dosage and administration (summary)

Single application only. Lotion 1%: apply a thin layer to dry skin from the neck down and wash off after 8–12 hours. Shampoo 1%: apply to dry hair, leave for 4 minutes, lather and rinse; do not repeat.

Contraindications

Premature neonates; uncontrolled seizure disorders; crusted (Norwegian) scabies and conditions with broken or inflamed skin that increase absorption; hypersensitivity.

Warnings and precautions

Neurotoxicity, including seizures and deaths, has been reported, mainly after excessive or repeated application, oral ingestion or use in high-risk groups; caution in infants, children, the elderly, patients under 50 kg and those with skin disorders or HIV. Do not apply immediately after a bath, avoid contact with eyes and mucous membranes, and do not cover with occlusive dressings. Avoid concurrent use of drugs that lower seizure threshold.

Pregnancy

Avoid in pregnancy; safer alternatives should be used.

Storage and supply

Store below 25 °C.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.