Lindane belongs to the group of medication called insecticides. It is used to treat head lice and pubic lice in people who cannot use other therapies. Lindane is also used to treat scabies in people who cannot use other therapies. It works by paralyzing mites that cause lice and scabies, killing them and their eggs.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor or pharmacist.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor or pharmacist has not recommended it.

Parents or caregivers who are applying this medication to affected people should wear gloves made of nitrile, latex with neoprene, or vinyl. Regular latex gloves are not enough to stop this medication from being absorbed through the skin.

Head lice:

1. Wash your hair with regular shampoo and dry it completely. Do not use any conditioner.
2. Wait at least one hour before applying the lindane shampoo. Shake the bottle well and thoroughly cover your hair with the product. Apply the shampoo over a sink to reduce the amount of shampoo that may touch your skin.
3. The amount you should use depends on the length of your hair, but typically 30 mL to 60 mL is needed. Follow the directions on the label to find the right amount for you.
4. Make sure that the hair on the back of your neck and behind your ears is fully covered with the shampoo.
5. Leave it in for 4 minutes. Then, begin adding small amounts of warm (not hot) water to your hair in order to lather the shampoo.
6. Rinse all of the lather out of your hair immediately with warm water over a sink.
7. Towel-dry your hair and use the nit comb to remove nits.
8. Check your hair and remove nits daily for 7 days after treatment. If live lice and nits are still seen in your hair 7 days after treatment, speak to your doctor or pharmacist. Do not treat with lindane again. You may need to use a different product.

Scabies:

1. Do not use other medications or make-up on your skin while using this medication. Do not use this medication right after a bath since warm skin might absorb too much of the medication.
2. Shake the lindane lotion bottle well and apply a thin, even layer on all of your skin area from your chin to your toes.
3. Make sure enough lotion is applied to the folds in your skin, hands, feet (including soles), between fingers and toes, underarms, and groin. Avoid applying the medication to your face and eyes.
4. Wear loose-fitting clothing after applying to avoid making your skin warm or moist.
5. You should remove the lotion 8 to 12 hours after applying it, using warm water. Do not leave the lotion on for more than 12 hours.
6. For children 6 years and older, remove the lotion with warm water 6 to 8 hours after applying it. During treatment, children should wear long sleeves, long pants, and gloves or mitts to prevent lindane from getting in the mouth.
7. If you still see live mites or new lesions on the skin after treatment, talk to your doctor or pharmacist. Do not treat with lindane again. You may need to use a different product.

Since lice and scabies are spread through contact, you should make sure that your family members and sexual partner(s) are examined for lice infestation. If they are infested, they should speak to their doctor or pharmacist immediately about using this product or other treatment options. Also notify your child's school, daycare, or other people who have been in close contact.

To prevent reinfestation, contaminated items such as bedding, clothing, towels, and hats should be washed in hot water and dried in the dryer using the hot cycle for at least 20 minutes. If items cannot be washed and dried this way, dry-clean them or seal them in a plastic bag for 2 weeks and wash normally. For head lice, combs and brushes should be soaked in hot water above 54°C or in undiluted lindane for 5 to 10 minutes and rinsed with hot water.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor or pharmacist has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor or pharmacist.

It is important that this medication be used exactly as prescribed by your doctor or pharmacist.

Store this medication at room temperature and keep it out of the reach of children.

Lindane should not be used by anyone who:

• is allergic to lindane or to any of the ingredients of the medication
• is a premature baby
• has a history of seizures
• has a skin rash, skin abrasion, skin inflammation, or Norwegian (crusted) scabies
• has extensive dermatitis (such as atopic dermatitis or psoriasis)

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is used in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• alopecia (hair loss)
• burning, stinging, tingling, itching, or red skin
• headache
• rough, dry patches of skin
• skin rash

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• dizziness
• nausea
• vomiting

Seek immediate medical attention if any of the following occur:

• seizures

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Accidental swallowing: Swallowing lindane may cause dizziness, seizures, and death. If you or someone else swallows lindane, contact your doctor or a poison control centre immediately.

Inhalation: Inhaling lindane vapours may cause nausea; vomiting; headache; and irritation of the ears, nose, and throat. If you experience these symptoms, contact your doctor.

Seizures: When too much of this medication is absorbed through the skin, it can cause seizures and rarely, death. People at risk of absorbing more of this medication through their skin (e.g., infants, children, seniors, people weighing less than 50 kg, people with skin conditions such as dermatitis or psoriasis) and people at risk of seizures (e.g., people with a history of head injury or seizures; people with HIV, severe liver problems, or brain tumours; and people taking medications that increase the risk of seizures, who suddenly stop using alcohol or sedatives, or who drink large amounts of alcohol) should discuss with their doctor how this medication may affect their medical condition and whether any special monitoring is needed.

Skin: Even after treatment, itching resulting from lice or scabies infestation can last for several weeks. This does not mean that the treatment did not work. If you continue to experience itchiness, talk to your doctor or pharmacist about treatment options.

Pregnancy: Lindane should not be used during pregnancy. Women who are pregnant should also avoid applying lindane on someone else.

Breast-feeding: Lindane passes into breast milk. Lindane may also interfere with the production of breast milk. This medication should not be used by women who are breast-feeding. If you are breast-feeding, talk to your doctor or pharmacist about other alternatives.

Children: Children are at an increased risk of absorbing too much lindane into their bloodstream. If possible, a safer option should be used in children. Lindane is not recommended for use in children under 6 years old. If lindane is used to treat scabies in young children, they should be dressed in long sleeves, pants, and gloves or mitts to prevent the possibility of lindane entering the mouth.

Seniors: Seniors may be more at risk of experiencing side effects from this medication. Seniors should speak with their doctor or pharmacist before using this medication.

There may be an interaction between lindane and any of the following:

• cream, ointments, or oil applied before lindane
• medications that increase risk of seizure such as:
• antipsychotics (e.g., haloperidol, olanzapine)
• certain antidepressants (e.g., amitriptyline, imipramine)
• cholinesterase inhibitors (e.g., neostigmine)
• chloroquine
• cyclosporine
• imipenem
• isoniazid
• meperidine
• methocarbamol
• mycophenolate mofetil
• quinolones (e.g., moxifloxacin, ciprofloxacin)
• radiographic contrast agents
• tacrolimus
• theophylline
• oil treatments or oil-based hair preparations applied before lindane shampoo

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.