Kwell-R Uses

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What is Kwell-R?

Kwell-R, formerly known as gamma benzene hexachloride, is an insecticide and is used to treat scabies and lice infestations.

Kwell-R cream and lotion are usually used to treat only scabies infestation. Kwell-R shampoo is used to treat only lice infestations.

Kwell-R is available only with your doctor's prescription.

Kwell-R indications

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Kwell-R Shampoo is indicated for the treatment of head lice (infestations of Pediculosis humanis capitis), crab lice (infestations of Pthirus pubis), and their ova only in patients who

  1. cannot tolerate other approved therapies, or
  2. have failed treatment with other approved therapies.

Kwell-R Shampoo should be used in the context of an overall lice management program that includes:

Caregivers applying this product to patients should wear gloves less permeable to Kwell-R such as nitrile, latex with neoprene or sheer vinyl, and thoroughly clean hands after application. Natural latex gloves should be avoided because they are more permeable to Kwell-R.

Kwell-R Shampoo does not prevent infestation or reinfestation and should not be used to ward off a possible infestation.

How should I use Kwell-R?

Use Kwell-R lotion as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Kwell-R lotion.

Uses of Kwell-R in details

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This medication is used to treat scabies only after safer medications (such as permethrin or crotamiton) have failed or caused side effects. It works by killing the tiny insects (mites) and their eggs, which cause scabies. An infection with scabies is also called an infestation. This drug should not be used to prevent scabies infestation or re-infestation.

How to use Kwell-R topical

Read the Medication Guide provided by your pharmacist before you start using Kwell-R. 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 Kwell-R gets in these areas, rinse with water right away 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.

Trim your nails short and clean your skin well with warm (not hot) water before using, but wait at least 1 hour after bathing/showering before use. Wet or warm skin can increase the absorption of Kwell-R into your bloodstream. An average-sized adult requires only 1 ounce (30 milliliters), but larger persons should use no more than 2 ounces (60 milliliters).

Make sure your skin is clean and does not have other lotions, creams, ointments, or oils on it. These products can increase the absorption of Kwell-R through your skin and into your bloodstream, which increases the risk of serious side effects. If you are currently using any of these products, they must be washed off before you apply Kwell-R.

Shake the bottle well before use. Apply a very thin layer of lotion once over your entire body from the neck down to the bottoms of your feet or as directed by your doctor. Use a toothbrush to apply Kwell-R under your nails (scabies mites prefer this area). Do not use this toothbrush in your mouth afterward. Wrap the toothbrush and throw it in the trash with the closed bottle of any unused Kwell-R out of the reach of children and pets.

After application, do not cover your skin with fabric that does not breathe (e.g., disposable/plastic diaper, tight clothes, blankets). Avoid skin-to-skin contact with anyone while Kwell-R is on your body.

Leave the medication on the skin for 8-12 hours. Leaving it on overnight is usually enough. Do not leave it on the skin more than 12 hours. Leaving it on longer will not kill any more scabies mites/eggs, but your risk of serious (possibly fatal) seizures will be increased. Remove Kwell-R lotion by washing very well in a shower or bath, using warm (not hot) water.

If an infant or young child is prescribed Kwell-R, watch the child carefully after applying the lotion to make sure the child does not put their hands/feet into their mouth while the medication is on their skin.

If you are applying Kwell-R on another person, wear disposable gloves (made of nitrile, latex with neoprene, or sheer vinyl) to decrease the risk of contacting this drug and possible side effects. Do not use natural latex gloves because more Kwell-R can penetrate that type of glove. Wash your hand well afterwards.

Symptoms of scabies include an intense itching which is generally worse at bedtime. You may also see small, fine, wavy lines on the skin with a tiny insect at the end (a burrow). Burrows are usually found on finger/toe webs, wrists, elbows, armpits, belt line, lower buttocks, female nipples, or male genitals. Even if Kwell-R kills all the scabies, the dead mites 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 2-3 weeks after treatment.

Kwell-R description

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An organochlorine insecticide that has been used as a pediculicide and a scabicide. Kwell-R has been banned in California, United Kingdom, Australia, and many western countries due to concerns about neurotoxicity and adverse effects on the environment. In Canada, Kwell-R is not recommmended as a first-line therapy due to reports of resistance, neurotoxicity, and bone marrow suppression, but has been approved by the FDA as a second-line therapy for topical treatment of pediculosis capitis (head lice), pediculosis pubis (pubic lice), or scabies in patients greater than two years of age who cannot tolerate or have failed first-line treatment. Kwell-R is still allowed for pharmaceutical use until 2015.

Kwell-R dosage

Apply a thin layer of Kwell-R Lotion over all skin from the neck down. One ounce is sufficient for an average adult. Do not prescribe more than 2 ounces for larger adults. Apply only once. Wash off in 8 to 12 hours. Do not retreat.

Patients should be provided specific information on use of product. Patients should be instructed on proper use of Kwell-R Lotion, especially the amount to apply, how long to leave on and the need to avoid retreatment. Patients should be informed that itching occurs after the successful killing of scabies (lice) and continued itching is not necessarily an indication for retreatment with Kwell-R Lotion.

A Kwell-R Lotion Medication Guide must be given to the patient each time Kwell-R Lotion is dispensed, as required by law. The Kwell-R Lotion Medication Guide is an important part of the risk management program for the patient.

How supplied

Kwell-R Lotion, USP 1% is supplied in patient-size 2 fl oz (60 mL) bottles. SHAKE WELL BEFORE USING

Store at controlled room temperature, 15 ° - 30 °C (59 ° - 86 °F).

Manufactured By: Morton Grove Pharmaceuticals, Inc. Morton Grove, IL 60053. REV. 06-05. Distributed By: Alliant Pharmaceuticals, Inc. Alpharetta, GA 30004. FDA Rev date: 10/9/2001

Kwell-R interactions

See also:
What other drugs will affect Kwell-R?

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Oils may enhance absorption of Kwell-R, therefore, patients and caregivers applying the shampoo to others should avoid using oil treatments, or oil-based hair dressings or conditioners immediately before and after applying Kwell-R Shampoo.

In addition, there are many drugs that may lower the seizure threshold, and Kwell-R Shampoo should be prescribed with caution in patients taking these medications. Drugs that may lower the seizure threshold include, but are not limited to the following:

Kwell-R side effects

See also:
What are the possible side effects of Kwell-R?

Applies to Kwell-R topical: topical cream, topical lotion, topical shampoo

In addition to its needed effects, some unwanted effects may be caused by Kwell-R topical. In the event that any of these side effects do occur, they may require medical attention.

Severity: Moderate

If any of the following side effects occur while taking Kwell-R topical, check with your doctor or nurse as soon as possible:

Rare

Side Effects: Post Treatment

After you stop taking this drug, it is possible that you may still experience side effects that need medical attention. If you notice any of the following side effects check with your doctor immediately:

Serious side effects have resulted in patients using Kwell-R. Sometime it has occurred even when used according to the labeled directions. Serious side effects have been reported following Kwell-R use with repeat or prolonged use, but also in rare cases following a single application. You should discuss these possible effects with your doctor.

Kwell-R contraindications

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What is the most important information I should know about Kwell-R?

Do not apply this medication to the face, eyes, nose, or mouth. Flush with water if you get medication in any of these areas. Seek medical attention if Kwell-R topical is ingested or if irritation is persistent.

Do not use more of this medication than is recommended. Using more than the prescribed amount of Kwell-R topical may cause seizures or other dangerous side effects.

Treat sexual and other close contacts who are also infected. Do not use Kwell-R topical to treat contacts who are not infected in an attempt to prevent infection from occurring.

To prevent reinfection, wash all clothing, hats, bed clothes, bed linens, hair brushes, and combs in hot water with a strong cleanser.

Talk to your doctor before using a second dose of Kwell-R topical. Using Kwell-R topical too soon after the first dose may cause seizures and/or death.

Active ingredient matches for Kwell-R:

Lindane


List of Kwell-R substitutes (brand and generic names)

Sort by popularity
Unit description / dosage (Manufacturer)Price, USD
Kwellada Lotion 1% lotion 1 % (Reed & Carnrick, Division Of Block Drug Company (Canada) Ltd.)
Lotion; Topical; Lindane 1%
Shampoo; Topical; Lindane 1%
Lindane 1% Lotion 60ml Bottle$ 142.33
Lindane 1% Shampoo 60ml Bottle$ 142.33
Lindane 1% lotion$ 5.16
Lindane lotion 10 mg/mL (Morton Grove Pharmaceuticals, Inc. (US))
Lindane shampoo 10 mg/mL (Morton Grove Pharmaceuticals, Inc. (US))
60 milliliter in 1 bottle
Emulsion; Topical; Lindane 1%
Liquid; Topical; Lindane (Dakota)
Ointment; Topical; Lindane (Dakota)
LINOSCAB LOTION 1 bottle / 100 ML lotion each (Admit Pharmaceuticals Pvt Ltd)$ 0.41

References

  1. DailyMed. "LINDANE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "lindane". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "lindane". http://www.drugbank.ca/drugs/DB00431 (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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