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Selenium Sulfide

Class: Local Anti-infectives, Miscellaneous
ATC Class: D01AE13
VA Class: DE400
CAS Number: 7488-56-4
Brands: Selseb, Selsun Blue

Introduction

Anti-infective; cytostatic and antiseborrheic.a b c

Uses for Selenium Sulfide

Dandruff or Seborrheic Dermatitis

Treatment of dandruff and seborrheic dermatitis of the scalp.a b c

Relieve symptoms (itching and flaking of the scalp) associated with dandruff.b

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Dandruff usually responds to treatment, but tends to relapse if therapy is discontinued.b Untreated dandruff is a cosmetic problem; generally no medical disability results.b

Pityriasis (Tinea) Versicolor

Treatment of pityriasis (tinea) versicolor caused by Malassezia furfur (Pityrosporum ovale).a b c

Topical antifungals usually effective; an oral antifungal (with or without a topical antifungal) may be necessary in patients who have extensive or severe infections or those who have failed to respond to or have frequent relapses with topical therapy.d e f g

Selenium Sulfide Dosage and Administration

Administration

Topical Administration

Apply lotion or shampoo topically to the skin; apply shampoo or lotion (as a shampoo) topically to the hair and scalp.a b c

For external use only.a b c Avoid contact with eyes; do not apply to broken skin or to infected or inflamed areas.a b c (See Systemic Toxicity under Cautions.)

Shake lotion well before use.a

Lotion may damage jewelry; remove all jewelry before using.a b

For treatment of dandruff and seborrheic dermatitis of the scalp: Massage into wet scalp.a Wait 2–3 minutes, then thoroughly rinse scalp.a b Repeat application and rinse procedures.a b Wash hands thoroughly following use.a

If used before or after bleaching, tinting, or permanent waving of the hair, rinse hair with cool water for at least 5 minutes after applying lotion or shampoo.b

For treatment of tinea versicolor: Apply sufficient quantity topically to the affected skin; apply a small amount of water concurrently to form a lather.a b c Allow to remain on the skin for 10 minutes following application, then rinse skin thoroughly.a b c

Dosage

Pediatric Patients

Dandruff or Seborrheic Dermatitis
Topical

Children ≥2 years of age: Initially, apply 5–10 mL of 2.5% lotion (as a shampoo) twice weekly for 2 weeks.a b c For maintenance, apply once every 1–4 weeks.a b c

Children ≥2 years of age (as self-medication): Apply a small amount of 1% lotion as a shampoo once or twice weekly.b For maximum control, use every time patient usually shampoos hair and scalp.b

Pityriasis (Tinea) Versicolor
Topical

Children ≥2 years of age: Apply 2.5% lotion to affected areas once daily for 7 days.a b c

Adults

Dandruff or Seborrheic Dermatitis
Topical

Initially, apply 2.25% shampoo or 5–10 mL of 2.5% lotion (as a shampoo) twice weekly for 2 weeks.a b c For maintenance, apply once every 1–4 weeks.a b c

For self-medication, apply a small amount of 1% lotion as a shampoo once or twice weekly.b For maximum control, use every time patient usually shampoos hair and scalp.b

Pityriasis (Tinea) Versicolor
Topical

Apply 2.25% shampoo or 2.5% lotion to affected areas once daily for 7 days.a b c

Special Populations

No special population dosage recommendations at this time.a b c

Cautions for Selenium Sulfide

Contraindications

  • Known hypersensitivity to selenium sulfide or any ingredient in the formulation.a b c

Warnings/Precautions

Warnings

Hair and Scalp Conditions

Oiliness or dryness of the hair and scalp may occur.a b Rebound oiliness of the scalp reported.b

Discoloration of various shades of natural and dyed hair has occurred;a b minimize or prevent by rinsing hair thoroughly after treatment.a b

Diffuse hair loss reported; resolved 1–2 weeks after discontinuance of the drug.b

Sensitivity Reactions

Hypersensitivity Reactions

Hypersensitivity reactions have occurred.a b c If irritation or sensitivity occurs, discontinue drug.a b c

General Precautions

Systemic Toxicity

Risk of systemic toxicity following topical application to damaged skin.b

Do not use if acute inflammation or exudation present; risk of increased absorption.a b c

Do not apply to damaged skin (e.g., open lesions or acute inflammation or exudation of the scalp).a b c

Localized Burning or Irritation

Contact with eyes, genital area, or in skin folds may cause burning and irritation.a b c If contact with the eyes occurs, rinse eyes thoroughly with water; thoroughly rinse genital area and skin folds following topical application of the drug.a b c

Specific Populations

Pregnancy

Category C.a c

Lactation

Not known whether topical selenium sulfide is distributed into milk.c Use with caution in nursing women.c

Pediatric Use

Safety and efficacy of 2.5% lotion not established in infants.a b

Safety and efficacy of 1% lotion for self-medication not established in children <2 years of age.b

Safety and efficacy of 2.25% shampoo not established in children.c

Common Adverse Effects

Skin irritation, increased hair loss, discoloration of hair, oiliness or dryness of hair and scalp.a b c

Selenium Sulfide Pharmacokinetics

Absorption

Not absorbed following topical application of the 1% lotion to intact skin of the scalp during usual shampooing conditions.b

Percutaneous absorption may occur following topical application to damaged skin.a b (See Systemic Toxicity under Cautions.)

Distribution

Extent

Not known whether topical selenium sulfide crosses the placenta or is distributed into milk.c

Stability

Storage

Topical

Lotion

Tight container at 15–30°C.a Protect from heat; do not freeze.b

Shampoo

15–30°C; do not freeze.c

Actions and Spectrum

  • Antibacterial and mild antifungal activity.a b c

  • Mechanism of action in the treatment of dandruff and seborrheic dermatitis not fully determined.b

  • Cytostatic (antimitotic) action results in a decreased rate of cell turnover in cells with normal or higher than normal turnover rates.a b c

  • Active against Pityrosporum ovale, a yeast-like fungus that is part of the normal flora of the scalp.b

  • A definite causal relationship between P. ovale and the development of dandruff and seborrheic dermatitis not established.b

  • May be converted into selenium and sulfide ions when absorbed into epithelial tissue; selenium ions may block enzyme systems involved in the growth of epithelial tissue.b

  • Local irritant effect.b

Advice to Patients

  • May damage jewelry; advise patient to remove all jewelry before use.a b

  • Importance of applying to affected areas, using as directed, and avoiding contact with eyes.a b c (See Administration under Dosage and Administration.)

    Advise patients to thoroughly rinse eyes if drug comes into contact with eyes, and rinse the genital area and skin folds thoroughly following application of the lotion to these areas.a b c

  • Importance of not applying to broken, inflamed, or infected skin.a b c

  • Importance of discontinuing drug and consulting clinician if infected area becomes irritated or if condition worsens or does not improve following treatment.a b

  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.a c

  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, dietary supplements, and/or herbal products, as well as any concomitant illnesses.

  • Importance of informing patients of other important precautionary information. (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Selenium Sulfide

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Topical

Lotion

1%*

Selenium Sulfide

Watson

Selsun Blue

Chattem

2.5%*

Selenium Sulfide

Morton Grove, Perrigo

Shampoo

2.25%

Selseb (with propylene glycol, parabens, and urea)

Doak

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 02/2014. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Selenium Sulfide 2.5% Lotion (IVAX PHARMACEUTICALS): 118/$19.99 or 236/$29.98

Selenium Sulfide 2.5% Lotion (PERRIGO PHARMACEUTICALS): 120/$20.99 or 240/$40.97

AHFS DI Essentials. © Copyright, 2004-2014, Selected Revisions June 1, 2008. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

References

a. Perrigo. Selenium sulfide 2.5% lotion prescribing information. Bronx, NY; 2007 Jan.

b. AHFS Drug Information 2007. McEvoy GK, ed. Selenium sulfide. Bethesda, MD: American Society of Health-System Pharmacists; 2007: 3521–22.

c. Doak Dermatologics. Selseb (selenium sulfide 2.25%) shampoo prescribing information. Fairfield, NJ; undated.

d. Sunenshine PJ, Schwartz RA, Janniger CK. Tinea versicolor: an update. Cutis. 1998; 61:65-72. [PubMed 9515210]

e. Assaf RR, Weil ML. The superficial mycoses. Dermatol Clin. 1996; 14:57-67. [PubMed 8821158]

f. Hay RJ. Dermatophytosis and other superficial mycoses. In: Mandel GL, Douglas RG Jr, Bennett JE, eds. Principles and practices of infectious disease. 4th ed. New York: Churchill Livingston; 1995: 2375-86.

g. Drake LA, Dincehart SM, Farmer ER et al. Guidelines of care for superficial mycotic infections of the skin: tinea corporis, tinea cruris, tinea faciei, tinea manuum, and tinea pedis. J Am Acad Dermatol. 1996; 34:282-6. [IDIS 363962] [PubMed 8642094]

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