This drug should only be used if other, safer medicines (e.g., permethrin) cannot be used or have not been effective. Do not use lindane to re-treat the same lice infestation after the first lindane treatment does not work.
Infrequently, lindane has caused seizures (sometimes death) after prolonged or repeated use. Rare (sometimes fatal) nervous system reactions such as seizures may occur, even after correct one-time use of lindane.
Lindane should not be used in premature infants or patients with poorly controlled seizures. In addition, lindane should be used with caution in infants, children, the elderly, patients with skin conditions (e.g., skin rash, psoriasis), and patients with low body weight (e.g., less than 110 pounds or 50 kilograms).
Itching may occur after either successful or failed treatments. Avoid re-applying lindane for a few months after use.

This medication is used to treat head and crab (pubic) lice. Lice are tiny insects that lay eggs (nits) on hair shafts. Lice can easily spread to those in close contact with you. Lindane works by killing the lice and nits. An infection with lice is also called an infestation. This drug should not be used to prevent lice infestation or re-infestation.

How to use Bio-Well Top
Read the Medication Guide provided by your pharmacist before you start using lindane. If you have any questions, consult your doctor or pharmacist.
This drug can be poisonous if used incorrectly. Do not take this drug by mouth, and avoid contact with your eyes, nose, or mouth. If lindane gets in these areas, rinse with water immediately and seek immediate medical attention if a burning feeling remains. Do not use if there is skin irritation (e.g., open wounds, rash, cuts, or sores) on the area to be treated unless directed to do so by your doctor.
Wash your hair with your regular shampoo (without conditioner) and dry it well. Do not apply any oil-based hair products immediately before or after using lindane. Wait at least 1 hour after drying your hair before using lindane shampoo.
Most adults require only 1 ounce (30 milliliters), but those with longer and thicker hair should use no more than 2 ounces (60 milliliters).
Shake the bottle well before use. For application, use gloves made of nitrile, latex with neoprene, or sheer vinyl to avoid unnecessary contact with your skin. Do not use natural latex gloves because more lindane can penetrate that type of glove. Apply a small amount of lindane to lightly coat your hair and scalp as directed by your doctor. Work thoroughly (do not lather) through dry hair. Do not add water. Make sure to include the fine hairs along your neck and behind your ears. Leave lindane in your hair for exactly 4 minutes (use a timer or clock). Do not cover your hair with anything (e.g., shower cap, towel). After 4 minutes, add a small amount of warm (not hot) water, rub until a lather forms, then immediately rinse away all lather. Try to keep lindane from touching other parts of your body. Do not re-apply. Dry your hair with a towel, then use the special nit comb or tweezers to remove the nits. It is best to have someone else do this for you to make sure all the nits are removed. They should wear gloves while removing the nits.
Close the bottle with any remaining lindane and throw it away out of reach from children and pets. Wash your hands well after treatment.
If an infant or young child is prescribed lindane, watch the child carefully while the lindane shampoo is in the hair to make sure the child does not touch the hair then put the hands in the mouth.
If you are putting lindane shampoo on someone else, use gloves as directed above. Wash your hands well afterwards.
The easiest way to tell if you have lice is to look for small gray-white nits fixed to the hair shafts. Symptoms of lice include an intense itching, mostly on the scalp, but also possibly on the eyebrows, eyelashes, beard, or groin. Itching may continue even after treatment with lindane shampoo. Even if the lindane kills all the lice, the dead lice can still make you itch for a long time after treatment. Ask your doctor about other medications that may be used to soothe the itching.
Inform your doctor if your condition persists or worsens 1-2 weeks after treatment.

See also Warning section.
This medication may cause stinging, burning, or redness of the skin. Inform your doctor promptly if these symptoms persist or worsen. It may mean that some of the medication was absorbed through the skin.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor immediately if these rare but very serious side effects occur: vomiting, dizziness, drowsiness, seizures.
A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

See also Warning section.
Before using lindane shampoo, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: a poorly controlled seizure disorder.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: other skin conditions (e.g., psoriasis, dermatitis), HIV infection, history of serious head injury, history of seizures, brain tumors, severe liver disease, alcohol abuse, sudden stopping of regular alcohol or sedative use.
This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.
Before having an imaging test (e.g., X-rays, CT scan) requiring the use of dye, tell your doctor that you have used this medication.
During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. If you are pregnant, do not apply lindane shampoo to others unless it is absolutely necessary and you have discussed it with your doctor. Use gloves as directed. (See How to Use section.)
Lindane passes into breast milk and could have undesirable effects on a nursing infant. Your baby should not come into direct contact with your skin while it has lindane on it. In addition, to lessen the chance of exposing your baby to the medication and possible side effects, pump your breast milk and discard it for 24 hours after using lindane. During this time, feed your baby formula or breast milk you stored from before you used lindane shampoo.

Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change the dosage of any medicine before checking with them first.
This drug should not be used with the following products because very serious interactions may occur: hair cream/ointment/oil (e.g., oil-based treatments or hair dressings, conditioners).
If you are currently using any of these products, they must be washed off before you apply lindane. Oil-based products may increase the absorption of lindane, increasing the risk of side effects.
Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use.
Also report the use of drugs which might increase seizure risk (decrease seizure threshold) when combined with lindane such as certain antibiotics (e.g., penicillins, imipenem, quinolones such as ciprofloxacin), antidepressants (e.g., amitriptyline, bupropion), drugs that suppress the immune system (e.g., cyclosporine, mycophenolate, tacrolimus), isoniazid (INH), antimalarials (e.g., chloroquine, pyrimethamine), meperidine, methocarbamol, phenothiazines (e.g., thioridazine), sedatives (e.g., zolpidem, temazepam, lorazepam), and theophylline, among others. Consult your doctor or pharmacist for details.
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

This medicine may be harmful if swallowed. If swallowing or other overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include nausea, vomiting, restlessness, unsteadiness, seizures, irregular heartbeat.

NOTES:
Do not share this medication with others.
Lice are easily passed from one person to another. All family members and people you have close contact with (especially if you have crab/pubic hair lice) should be examined.
After treatment, soak all possibly infested combs, brushes, and other hair care items in water that has been heated to 130 degrees F (54 degrees C) for 5 to 10 minutes. Also, any recently worn clothing, hats, sheets/blankets, plush/fabric toys, and towels should be washed in very hot water or dry-cleaned.
This drug is not effective for scabies. Another form of lindane is used for treating scabies.
This medication is used to treat a current infestation only. It cannot be used to prevent future infestations.

MISSED DOSE:
Not applicable.

STORAGE:
Store at room temperature between 59-86 degrees F, (15-30 degrees C) away from light and moisture. Keep the bottle tightly closed. Do not store in the bathroom. Do not freeze. Keep all medicines away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Information last revised May 2010. Copyright(c) 2010 First Databank, Inc.