Lindane

Lindane is a prescription medication used to remove lice (tiny bugs that can attach to the skin on the head or the pubic area) and to treat scabies (a skin condition in which tiny bugs crawl under the skin, lay eggs, and cause severe itching).

This medication comes in the form of a shampoo and a lotion. The shampoo is used to remove lice, and the lotion is used to treat scabies.

Lindane Shampoo is a prescription medication used to remove lice. Lindane Lotion is a prescription medication used to treat scabies. Both products are usually only used in adults and children who weigh at least 110 pounds, after safer medications have not made the lice or scabies go away.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Lindane Shampoo and Lindane Lotion may cause serious side effects such as seizures (convulsions, fits) or death. See "Drug Precautions" section.

These medicines can also make you feel sleepy, dizzy, or can cause body shaking that you cannot control.

The most common side effects of Lindane Shampoo and Lindane Lotion are:

• Itching skin
• Burning skin
• Dry skin
• A skin rash

These are not all of the possible side effects of Lindane Shampoo and Lindane Lotion. For more information, ask your doctor or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Some medicines may increase your chances of having a seizure if you take them while using Lindane. Especially tell your doctor if you take medicines called sedatives (drugs to help you sleep).

Lindane Shampoo and Lindane Lotion are poisons if you do not use them in the right way. Lindane Shampoo and Lindane Lotion go through your skin and can affect your brain and nerves. These medicines can cause seizures, also called convulsions, "fits" or epilepsy.

• Seizures and death can happen in people who use Lindane Shampoo or Lotion too much or too often.
• Seizures can happen in some people even if they use Lindane Shampoo  and Lindane Lotion exactly as directed.

If you or a family member has a seizure while using Lindane Shampoo or Lindane Lotion, get emergency help right away.

Do not use Lindane Shampoo unless:

• You have lice and another medicine did not work for you, or
• You cannot use other, safer medicines to treat your lice
• Do not use Lindane Shampoo more than 1 time to treat an attack of lice. Do not use Lindane Shampoo to treat a second attack that comes soon after the first episode. No one knows a safe time to reuse Lindane Shampoo. Even if you still itch even after using Lindane Shampoo, do not use more or use it again. Lice (bugs) can make you itch for some time even after all of the bugs are dead.
• Do not use more Lindane Shampoo than your doctor tells you.
• Do not keep Lindane Shampoo on your hair for more than 4 minutes.
• Do not put Lindane Shampoo in your mouth because it is a poison if taken by mouth. If you get Lindane Shampoo in your mouth or swallow Lindane Shampoo, call your area Poison Control Center right away and get emergency help.

Do not use Lindane Shampoo:

• if you do not have lice. Lindane Shampoo does not stop you from getting lice. Lindane Shampoo only kills the lice you already have.
• if you have or have ever had seizures, also called convulsions, "fits" or epilepsy, especially if they have been hard to control.
• if you have used Lindane Shampoo in the past few months. You should see your doctor if you think that you need another treatment.
• unless it is the only medicine you can use for lice.
• if you had a bad reaction to Lindane Shampoo before. Do not use Lindane Shampoo again.
• if you have open sores or crusted (scabby) sores on the skin around your head and neck, or lots of broken skin.
• if you need to treat a premature or young baby. More of the applied Lindane can go through the skin of babies and go to their brains where it can harm them.
• if you have scabies. These need a different medicine that you use in a different way.
• if you are allergic to Lindane Shampoo or any of its ingredients. The active ingredient is lindane.
• while you are breastfeeding. Lindane Shampoo can get in your milk and may be fed to your baby. Your baby may get sick. Ask your doctor for a safer medicine. If you use Lindane Shampoo, pump your breast milk and throw the milk away for at least 24 hours after using the medicine. During this time, feed your baby formula or breast milk that you stored from before you used Lindane Shampoo.

Do not use Lindane Lotion unless:

• You have scabies and were treated with another medicine that did not work for you, or
• You cannot use other safer medicines to treat your scabies.

• Do not use Lindane Lotion more than 1 time to treat an attack of scabies. Do not use Lindane Lotion to treat a second attack of scabies that comes soon after the first episode. Using it more than 1 time can cause seizures and death. No one knows a safe time to reuse Lindane Lotion. Even if you still itch after using Lindane Lotion, do not use more or use it again. Scabies (mites) can make your skin itch for a few weeks even after all of the bugs (mites) are dead.
• Do not use more Lindane Lotion than your doctor tells you.
• Do not keep Lindane Lotion on your skin for more than 8 to 12 hours.
• Do not put Lindane Lotion in your mouth because it is a poison if taken by mouth. If you get Lindane Lotion in your mouth or swallow Lindane Lotion, call your area Poison Control Center right away and get emergency help.

Do not use Lindane Lotion:

• if you do not have scabies. Lindane Lotion does not stop you from getting scabies. Lindane Lotion only kills the scabies you already have.
• if you have or have ever had seizures, also called convulsions, "fits" or epilepsy, especially if they have been hard to control.
• if you used Lindane Lotion in the past few months. You should see your doctor if you think you need another treatment.
• unless it is the only medicine you can use for scabies.
• if you had a bad reaction to Lindane Lotion before. Do not use Lindane Lotion again.
• if you have open sores or crusted (scabby) sores on your skin, or lots of broken skin.
• if you have head or body lice. These need a different medicine that you use in a different way.
• if you are allergic to Lindane Lotion or any of its ingredients. The active ingredient is lindane. 
• if you need to treat a premature or young baby. More lindane can go through the skin of babies and go to their brains where it can harm them.
• while you are breastfeeding. Lindane Lotion can get in your milk and be fed to your baby. Lindane Lotion on your skin can also go to your baby. Your baby may get sick. Ask your doctor for a safer medicine. If you use Lindane Lotion, pump your breast milk and throw away the milk for at least 24 hours after using the medicine. During this time, feed your baby formula or breast milk you stored from before you used Lindane Lotion.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Lindane, there are no specific foods that you must exclude from your diet when receiving Lindane Shampoo or Lindane Lotion.

Tell your doctor if you:

• have used Lindane Shampoo or Lindane Lotion in the past few months.
• ever had a seizure or problem that could increase your chances of getting a seizure (like a head injury, tumor in your brain or spinal cord, cirrhosis of the liver, or heavy alcohol drinking)
• have HIV or AIDS. 
• are pregnant. Use Lindane Shampoo or Lindane Lotion only if needed.
• have a sexual partner and your lice (crabs) are in your pubic (crotch) area. Your partner should get checked and treated for lice so they don't give them back to you. Don't share your Lindane Shampoo with your partner.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Some medicines may increase your chances of having a seizure if you take them while using Lindane. Especially tell your doctor if you take medicines called sedatives (drugs to help you sleep).

Tell your doctor if you are pregnant. Lindane Shampoo and Lindane Lotion can reach your baby and may harm it. Ask your doctor for a safer medicine. Use Lindane Shampoo or Lindane Lotion only if needed.

Do not use Lindane Shampoo or Lindane Lotion while you are breastfeeding. These medicines can get in your milk and be fed to your baby. Lindane Lotion on your skin can also go to your baby. Your baby may get sick. Ask your doctor for a safer medicine. If you use Lindane Shampoo or Lindane Lotion, pump your breast milk and throw away the milk for at least 24 hours after using the medicine. During this time, feed your baby formula or breast milk you stored from before you used Lindane Lotion.

Lindane Shampoo

Before you put it on:

• Make sure you know how to use it exactly as your doctor prescribes.
• If you are putting Lindane Shampoo on another person, wear special gloves made of nitrile, latex with neoprene, or sheer vinyl. Do not use natural latex gloves because more Lindane can go through that kind of glove. Keep the gloves on until the Lindane Shampoo is washed out of your hair. Wash your hands well when you are done.
• Make sure your hair and skin on your head and neck do not have any other shampoo, cream, or oil on it. Oils can make the Lindane Shampoo go through your skin faster and may increase the risk of seizures.

When you put it on:

• Shake the bottle of Lindane Shampoo well.
• Make sure your hair is clean and dry before using Lindane Shampoo, but do not wash your hair within 1 hour before using Lindane Shampoo. Use regular shampoo without conditioner and dry your hair.
• Use just enough Lindane Shampoo on your dry hair to wet your hair and scalp. Do not add water to your hair at this time. Also, put Lindane Shampoo on the short hairs at the back of your neck.
• Keep Lindane Shampoo on your hair for 4 minutes. Use a watch or clock to time yourself.
• Do not wear a shower cap or any covering on your head while you wait for the 4 minutes to pass.
• Close the bottle with the leftover Lindane Shampoo and throw it away in a trash can out of the reach of children.

When you are supposed to wash it off:

• After 4 minutes has passed, soap up or lather the Lindane Shampoo. Use a small amount of warm water to do this. Hot water is not safe. Then wash the Lindane Shampoo off your head. Again, use warm, but not hot water. Do not leave any Lindane Shampoo on your head or hair. It will not kill more of the lice and may continue to go through your skin and cause serious problems, such as seizures.

After you wash off Lindane Shampoo:

• Dry your hair with a towel. Use a special comb called a nit comb or tweezers to remove the dead nits (lice eggs) from your hair. Someone else will probably have to do this for you.
• All recently worn clothing, underwear, pajamas, hats, used sheets, pillowcases, and towels should be washed in very hot water or dry-cleaned.
• Do not use Lindane Shampoo again. If you think you need to use it again, you must check with your doctor to find out if and when it is most safe.

You may still itch after you have used Lindane Shampoo. This does not mean you need more Lindane Shampoo. Even after all the lice (bugs) are dead, they can still make your skin itch for a long time. Lindane Shampoo sometimes makes this itch even worse. Talk to your doctor about things you can do to soothe the itch.

What should you avoid while using Lindane Shampoo?

• Do not get Lindane Shampoo in your eyes. If you do, rinse your eyes with water right away. Get medical help if your eyes keep hurting.
• Do not get Lindane Shampoo on your hands. Wear special gloves made of nitrile, latex with neoprene, or sheer vinyl. Do not use natural latex gloves. Wash your hands well when you are done.
• If you are pregnant, do not use Lindane Shampoo unless you have talked to your doctor about using it. Avoid putting Lindane Shampoo on others if you are pregnant.
• Do not use oils on your skin or hair, just before or after using Lindane Shampoo. Oils include oil-based hair products and conditioners.

Lindane Lotion

Before you put it on:

• Make sure you know how to use it exactly as your doctor prescribes.
• If you are putting Lindane Lotion on another person, wear special gloves made of nitrile, latex with neoprene, or sheer vinyl. Do not use natural latex gloves because more lindane can go through that kind of glove. Wash your hands well when you are done.
• Make sure your skin is clean and does not have any other lotion, cream, or oil on it. Oils can make Lindane Lotion go through your skin faster and may increase the risk of seizures.
• Wait for at least 1 hour after bathing or showering before you put Lindane Lotion on your skin. Wet or warm skin can make the Lindane Lotion go through your skin faster and may increase the risk of seizures.

When you put it on:

• Shake the bottle of Lindane Lotion well.
• Put Lindane Lotion under your fingernails, because the scabies really like to stay there. Trim your fingernails short. Use a toothbrush to get the Lindane Lotion under your fingernails. Wrap this toothbrush in paper and throw this toothbrush away. Do not use it in your mouth.
• Put a very thin layer of the Lindane Lotion on your skin from the neck down. You may have some Lindane Lotion left in the bottle.
• Do not cover over the Lindane Lotion on your skin with anything that does not breathe, like diapers with a plastic lining, plastic clothes, tight clothes, or blankets.
• Close the bottle with the leftover Lindane Lotion and throw it away in a trash can out of the reach of children.

When you are supposed to wash it off:

• Wash the Lindane Lotion off your skin after 8 to 12 hours. You must wash the Lindane Lotion off your body completely. Use warm, but not hot water. Lindane Lotion will not kill any more scabies after 8 to 12 hours. After 8 to 12 hours, Lindane Lotion can cause serious health problems, such as seizures and death.

After you wash off the Lindane Lotion:

• All recently worn clothing, underwear, pajamas, used sheets, pillowcases, and towels should be washed in very hot water or dry-cleaned.
• Do not use Lindane Lotion again. If you think you need to use it again, you must check with your doctor to find out when it is most safe.

You may still itch after you use Lindane Lotion. This does not mean you need more Lindane Lotion. Even after all the scabie bugs (mites) are dead, they can still make your skin itch for a few weeks. Lindane Lotion sometimes makes this itch even worse. Talk to your doctor about things you can do to soothe the itch.

What should you avoid while using Lindane Lotion?

• Do not get Lindane Lotion in your eyes. If you do, rinse your eyes with water right away. Get medical help if your eyes keep hurting.
• Do not let your skin touch other people's skin while you have Lindane Lotion on. Make sure your skin does not touch your baby or small child.
• If you are pregnant, do not use Lindane Lotion, or apply Lindane Lotion to others unless it is needed and you have talked to your doctor about using it. See the special glove advice below if you have to put Lindane Lotion on others.
• Do not use oils on your skin or hair just before or after using Lindane Lotion. Oils include skin lotions and moisturizers, and oil-based hair products and conditioners.
• Do not get Lindane Lotion on your hands if you are putting it on someone else.Wear special gloves made of nitrile, latex with neoprene, or sheer vinyl. Do not use natural latex gloves. Wash your hands well when you are done.

Do not put Lindane Lotion or Lindane Shampoo in your mouth because they are poisons if taken by mouth. If you get Lindane Lotion or Lindane Shampoo in your mouth or swallow Lindane Lotion or Lindane Shampoo, call your area Poison Control Center right away and get emergency help.

WARNINGS

Lindane Lotion and Lindane Shampoo should only be used in patients who cannot tolerate or have failed first-line treatment with safer medications for the treatment of scabies.

Neurologic Toxicity

Seizures and deaths have been reported following Lindane Lotion or Lindane Shampoo use with repeat or prolonged application, but also in rare cases following a single application used according to directions. Lindane Lotion should be used with caution for infants, children, the elderly, and individuals with other skin conditions (e.g., atopic dermatitis, psoriasis) and in those who weigh < 110 lbs (50 kg) as they may be at risk of serious neurotoxicity.

Contraindications

Lindane Lotion and Lindane Shampoo is contraindicated in premature infants and individuals with known uncontrolled seizure disorders.

Proper Use

Instruct patients on the proper use of Lindane Lotion and Lindane Shampoo, the amount to apply, how long to leave it on, and avoiding retreatment. Inform patients that itching occurs after the successful killing of scabies and is not necessarily an indication for retreatment with Lindane Lotion and Lindane Shampoo.