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Selenium Sulfide

Pronunciation

(se LEE nee um SUL fide)

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Foam, External:

Tersi: 2.25% (70 g [DSC]) [contains trolamine (triethanolamine)]

Lotion, External:

Selsun: 2.5% (120 mL [DSC])

Generic: 2.5% (118 mL, 120 mL)

Shampoo, External:

Anti-Dandruff: 1% (207 mL) [contains brilliant blue fcf (fd&c blue #1), menthol]

Dandrex: 1% (240 mL)

Brand Names: U.S.

  • Anti-Dandruff [OTC]
  • Dandrex [OTC]
  • Selsun [DSC]
  • Tersi [DSC]

Pharmacologic Category

  • Antiseborrheic Agent, Topical
  • Topical Skin Product

Pharmacology

May block the enzymes involved in growth of epithelial tissue

Absorption

Topical: None through intact skin, but can be absorbed through damaged skin

Use: Labeled Indications

Dandruff, scalp seborrhea: Treatment of dandruff and seborrheic dermatitis of the scalp.

Tinea versicolor (excluding shampoo): Treatment of tinea versicolor.

Contraindications

Hypersensitivity to selenium sulfide or any component of the formulation.

Dosing: Adult

Note: Tersi foam has been discontinued in the US for more than 1 year.

Dandruff, scalp seborrhea: Topical:

Foam: Rub into affected skin twice daily.

Lotion: Massage ~5 to 10 mL into wet scalp; leave on scalp for 2 to 3 minutes, then rinse scalp thoroughly. Repeat application and rinse thoroughly. Usually 2 applications each week for 2 weeks with provide control. After this, may repeat at less frequent intervals (eg, once weekly, every 2 to 4 weeks).

Shampoo: Massage shampoo into wet scalp then rinse thoroughly. Use at least twice weekly for best results.

Tinea versicolor: Topical:

Foam: Rub into affected skin twice daily.

Lotion: Apply to affected area and lather with small amounts of water; leave on skin for 10 minutes, then rinse thoroughly; repeat once every day for 7 days.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Note: Tersi foam has been discontinued in the US for more than 1 year.

Dandruff, scalp seborrhea: Children and Adolescents: Topical: Refer to adult dosing.

Tinea versicolor: Children and Adolescents: Topical: Refer to adult dosing.

Administration

Shake well before using. For external use only; not for ophthalmic, oral, anal or intravaginal use. Do not use when acute inflammation or exudation is present or on damaged skin or mucous membranes. For color treated or permed hair, it is especially important to rinse hair thoroughly after treatment. May damage jewelry; remove before treatment.

Storage

Store at room temperature.

Foam: Contents under pressure. Contains flammable materials. Do not puncture or incinerate. Do not expose to temperatures over 120ºF (48ºC) even when empty.

Drug Interactions

There are no known significant interactions.

Adverse Reactions

Frequency not defined.

Central nervous system: Lethargy

Dermatologic: Alopecia or hair discoloration, unusual dryness or oiliness of scalp

Gastrointestinal: Vomiting following long-term use on damaged skin, abdominal pain, garlic breath

Local: Burning, itching, irritation, stinging (transient)

Neuromuscular & skeletal: Tremor

Miscellaneous: Diaphoresis

Warnings/Precautions

Concerns related to adverse effects:

• Local effects: Skin irritation or sensitization may occur; discontinue use if irritation or sensitivity occurs.

Other warnings/precautions:

• Appropriate use: For external use only; not for ophthalmic, oral, anal or intravaginal use. Due to the risk of systemic toxicity, do not use when acute inflammation or exudation is present or on damaged skin or mucous membranes.

• Self-medication (OTC use): Shampoo: When used for self-medication, contact a health care provider before use if the seborrheic dermatitis is in other areas other than the scalp. Discontinue use and contact a healthcare provider if condition worsens or does not improve after regular use.

Pregnancy Risk Factor

C

Pregnancy Considerations

Animal reproduction studies have not been conducted. Some manufacturers recommend against using selenium sulfide for the treatment of tinea versicolor in pregnant women.

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience scalp irritation, hair discoloration, or hair thinning or loss. Have patient report immediately to prescriber severe skin irritation (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.

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