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Lindane topical Pregnancy and Breastfeeding Warnings

Lindane topical Pregnancy Warnings

In a review of 229,101 deliveries to Michigan Medicaid patients, 1,417 first-trimester exposures to lindane and 4,413 exposures any time during pregnancy were recorded. A total of 64 birth defects were reported with first trimester exposure (60 expected) and included (observed/expected) 17/14 cardiovascular defects, 4/2 oral clefts, 1 polydactyly, 2 limb reductions, and 7/3 hypospadias. A significant elevated risk of hypospadias was detected (written communication, Franz Rosa, MD, Food and Drug Administration, 1994). Lindane has been detected in the umbilical cord blood in pregnant women, most of whom probably were exposed to organochlorine pesticides.

Lindane has been assigned to pregnancy category C by the FDA. Animal studies with oral lindane have suggested an increased risk of neurologic developmental abnormalities, and revealed increased stillbirths, decreased pup survival, decreased pup weight, increased motor activity, and decreased motor activity habituation. There are no controlled data in human pregnancy. One stillbirth has been reported after repeated maternal exposures; however, causality has not been clearly established. Pyrethrins with piperonyl butoxide provide a safer alternative for the treatment of lice during pregnancy. Lindane should only be used during pregnancy when the need has been clearly established.

Lindane topical Breastfeeding Warnings

Most of the breast milk in which lindane was detected, was from women exposed to organochlorine pesticides. In 1956, an epidemic of skin disease in nursing children was attributed to heavy maternal exposure to hexachlorobenzene insecticide.

Lindane is excreted into human milk. There may be a risk for serious toxicity from ingestion of lindane-containing breast milk or absorption through skin-to-skin contact. Nursing mothers should be advised of the risks and to interrupt breast-feeding, express, and discard milk, for at least 24 hours after using lindane. They should also be advised to avoided large areas of skin-to-skin contact with their infant during treatment with the lotion. Pyrethrins with piperonyl butoxide may be a safer alternative for the treatment of lice during lactation.

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