lindane (Kwell, Scabene)

Introduction

Tradename: Kwell, Scabene.

Indications

• refractory scabies
• pediculosis (Lice)

Contraindications

• acutely inflamed skin or raw, weeping surfaces

Caution: Do not use in pregnant or nursing mothers, infants or small children because of reports of neurotoxicity & teratogenicity.

pregnancy category = b

safety in lactation = ?

Dosage

• refractory scabies:
  • apply 30 mL of 1% cream or lotion.
  • wash after 8-12 hours
  • 2 treatments 1 week apart (not ovicidal).
• Lice: 1% shampoo 30 mL/application.
• apply a thin layer of lotion & massage it on the skin from the neck to the toes
• adults: bathe & remove drug after 8-12 hours
• children: wash off after 6 hours of application

Lotion: 1% (60 mL, 473 mL)

Pharmacokinetics

• skin & adipose tissue may act as repositories for the drug

Adverse effects

• uncommon (< 1%)
  • dizziness, restlessness, ataxia, seizures*, headache, eczema, contact dermatitis, nausea/vomiting, aplastic anemia, hepatitis, hematuria, pulmonary edema
• 60% increased risk for non-Hodgkin's lymphoma

* FDA black box warning banned in California

Laboratory

• lindane in air
• lindane in water
• lindane in blood
• lindane in serum/plasma
• lindane in urine

More general terms

• antiparasitic agent

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=727