Alcoholum benzylicum – Uses, Dosage, Side Effects

Benzyl alcohol inhibits lice from closing their respiratory spiracles, allowing the vehicle to obstruct the spiracles and causing the lice to asphyxiate. Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.

• Ulesfia (benzyl alcohol) lotion is indicated for the topical treatment of head lice infestation in patients 6 months of age and older. Ulesfia Lotion does not have ovicidal activity.
• Treatment of progressive cataract, rapid (2-3 weeks treatment) reversal of incipient cataract was obtained accompanied by a marked improvement of vision.
• Benzyl alcohol has been widely used in human medicine as an antimicrobial preservative and as a local anesthetic and antipruritic.
• It has been used for toothache, a few drops being applied to the cavity or exposed nerve.
• Benzyl alcohol is active against Gram-positive bacteria and has some weak activity against gram-negative bacteria, yeasts and molds. Benzyl alcohol also has some mild local anesthetic and anti-spasmodic properties.
• Benzyl alcohol is used as a bacteriostatic preservative at low concentrations in intravenous medications, cosmetics, and topical drugs.
• The use of benzyl alcohol as a 5% solution has been approved by the U.S. FDA for the treatment of head lice in children older than six months and in adults.^[rx] It affects the louse’s spiracles, preventing them from closing. These then become clogged with water or mineral oil or other matter and cause the insect to die from asphyxiation.
• Cold Sores
• Head Lice
• Cold Sore
• Fever blister
• Orofacial Pain
• Lice of the head

Contraindications of Benzyl Alcohol

• No known contraindications.

Benzyl Alcohol Dosage and Administration

General

Measures to Avoid Reinfestation and Transmission

• To avoid reinfestation or transmission of lice, most experts recommend that clothing, hats, bed linen, and towels that were worn or used by the infected individual during the 2 days prior to treatment should be decontaminated (machine-washed in hot water and dried in a hot dryer).
• Items that cannot be laundered can be dry-cleaned or sealed in a plastic bag for 2 weeks.
• Decontaminate combs, brushes, and hair clips used by the infected individual by soaking in hot water (>54°C) for 5–10 minutes.
• Thoroughly vacuum car seats, upholstered furniture, and floors of rooms inhabited by infested individuals. Fumigation of living areas is not necessary.
• Other family members and close contacts of the infected individual should be evaluated and treated if lice infestation is present. Some clinicians suggest treating family members who share a bed with the infested individual, even if no live lice are found on this family member. Ideally, treat all infested household members and close contacts at the same time.
• A fine-toothed or nit comb may be used to remove any remaining nits (eggs) or nit shells from the hair. Some clinicians do not consider nit removal necessary since only live lice can be transmitted but recommend it for aesthetic reasons and to decrease diagnostic confusion and unnecessary retreatment. Other clinicians recommend removal of nits (especially those within 1 cm of the scalp) to decrease the risk of reinfestation since no pediculicide is 100% ovicidal and potentially viable nits may remain on the hair after treatment. Although many schools will not allow children with nits to attend, AAP and other experts consider these no-nit policies excessive.

Administration

Topical Administration

Apply topically to scalp hair as a 5% lotion.

For external use only. Do not administer orally or intravaginally; do not apply topically to eyes.

Apply to dry scalp hair in an amount sufficient to completely saturate scalp and hair. (See Dosage under Dosage and Administration.) Massage into the hair and scalp, including areas on the back of the neck and behind ears. Leave the lotion on hair and scalp for 10 minutes, then thoroughly rinse off with warm (not hot) water. Minimize exposing other areas of skin by performing rinse at a sink (rather than in shower or bath). Hair may be shampooed after the lotion is rinsed off.

Avoid contact with eyes. Eyes should be closed tightly and covered with a soft towel or washcloth while the lotion is applied to or washed off of scalp hair. If contact with the eyes occurs, immediately flush with water.

Supervise pediatric patients during lotion application; an adult should apply and rinse the lotion for the child.

Wash hands thoroughly after applying lotion.

Dosage

Pediatric Patients

Pediculosis

Pediculosis Capitis (Head Lice Infestation)

Topical

Infants and children ≥6 months of age: Manufacturer recommends 2 applications given 7 days apart.

Apply to dry scalp hair in an amount sufficient to thoroughly saturate hair and scalp, including areas on back of neck and behind ears. The recommended amount of lotion for each application depends on hair length (see Table 1). Lotion will drip when adequate coverage achieved. After 10 minutes, thoroughly rinse lotion off with warm water. Repeat application 7 days after initial application.

Adults

Pediculosis

Pediculosis Capitis (Head Lice Infestation)

Topical

The manufacturer recommends 2 applications given 7 days apart.

Apply to dry scalp hair in an amount sufficient to thoroughly saturate hair and scalp, including areas on back of neck and behind ears. The recommended amount of lotion for each application depends on hair length (see Table 1). Lotion will drip when adequate coverage achieved. After 10 minutes, thoroughly rinse lotion off with warm water. Repeat application 7 days after initial application.

Common side effects of /Benzyl Alcohol Lotion, 5%/ include irritations of the skin, scalp, and eyes, and numbness at the site of application. As with all medications, it is important to use benzyl alcohol, 5%, as labeled to maximize benefits and minimize risks. The product should be applied only to the scalp or the hair attached to the scalp. It is not approved for use in children younger than six months. Use in premature infants could lead to serious respiratory, heart- or brain-related adverse events such as seizure, coma, or death.

References