SELENIUM SULFIDE

SELENIUM SULFIDe
(se-lee'nee-um)
Exsel, Selsun, Selsun Blue
Classifications: antibiotic; antifungal;
Therapeutic: topical antibiotic; topical antifungal, antiseborrheic

Pregnancy Category: C

Availability

1% lotion, shampoo

Action

Has antibacterial and mild antifungal and antiseborrheic activity. Absorption of selenium sulfide into epithelial tissue cells is followed by degradation of compound to selenium and sulfide ions. Selenium ions block enzyme systems involved in epithelial cell growth. As a result, rate of turnover in cells with normal or higher than normal turnover rates is reduced.

Therapeutic Effect

Active against Pityrosporum ovale, a yeast-like fungus found in the normal flora of the scalp. Also decreases rate of growth of the epithelial cells of the scalp and other epithelial layers of cells in the body.

Uses

Itching and flaking of the scalp associated with dandruff, seborrheic dermatitis of the scalp, and tinea versicolor.

Contraindications

Kidney failure or biliary tract obstruction, GI malfunction; Wilson's disease; application to damaged or inflamed skin surfaces; as treatment of tinea versicolor during pregnancy; pregnancy (category C) as antiseborrheic only when clearly needed; lactation, children <2 y.

Cautious Use

Prolonged skin contact; use in genital area or skin folds.

Route & Dosage

Dandruff Control, Seborrheic Dermatitis
Adult/Child: Topical Massage 5–10 mL of a 1–2.5% solution into wet scalp and leave on for 2–3 min, rinse thoroughly, then repeat application and rinse well again (initially, shampoo 2 times/wk for 2 wk, then decrease to once q1–4wk prn)

Tinea Versicolor
Adult/Child: Topical Apply a 2.5% solution to affected area with a small amount of water to form a lather, leave on for 10 min, then rinse thoroughly, repeat once/d for 7 d

Administration

Topical
  • Wash hands thoroughly after application of selenium sulfide to affected areas. Remove jewelry before treatment; drug will damage it.
  • Rinse genital areas and skin folds well with water and dry thoroughly after treatment for tinea versicolor to prevent irritation.
  • Store at 15°–30° C (59°–86° F) in tight container; protected from heat. Avoid freezing.

Adverse Effects (≥1%)

Skin: Skin irritation (stinging), rebound oiliness of scalp, hair discoloration, diffuse hair loss (reversible), systemic toxicity (if applied to abraded, infected skin).

Pharmacokinetics

Absorption: No percutaneous absorption if skin is intact.

Nursing Implications

Assessment & Drug Effects

  • Monitor therapeutic effectiveness.

Patient & Family Education

  • Rinse thoroughly with water if lotion contacts eyes in order to prevent chemical conjunctivitis.
  • Do not use drug more frequently than required to maintain control of dandruff.
  • Hair loss is reversible, usually within 2–3 wk after treatment is discontinued.
  • Discontinue use if skin is irritated or treatment fails. Systemic toxicity may result from application of lotion to damaged skin (percutaneous absorption) or from prolonged use (overdosage). Toxicity symptoms include tremors, anorexia, occasional vomiting, lethargy, weakness, severe perspiration, garlicky breath, lower abdominal pain. Symptoms disappear 10–12 d after treatment is stopped.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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