Drugs List

Therapeutic Indications

Uses

Dandruff
Seborrhoeic dermatitis

Unlicensed Uses

Pityriasis versicolor

Contraindications

Abraded or inflamed skin
Children under 5 years

Precautions and Warnings

Breastfeeding
Pregnancy

Allow 48 hours between administration and cosmetic hair treatments
Avoid broken or inflamed skin
Avoid contact with eyes
If accidental contact with the eyes occurs, rinse thoroughly with water
Do not exceed recommended dosages and frequency of administration
Advise patient to remove jewellery before applying

Pregnancy and Lactation

Pregnancy

Use selenium sulfide with caution in pregnancy.

At the time of writing there is limited published information on the use of selenium sulfide during pregnancy. The manufacturer states avoid use during pregnancy as data available is not adequate to make an assessment on its safety in pregnant women and that animal studies are insufficient in respect of foetal development. However, Schaeffer (2007) states that there is no systematic data implicating teratogenicity and that as absorption from limited topical application is limited, local application to small areas for a limited period should be acceptable.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Use selenium sulfide with caution in breastfeeding.

At the time of writing there is limited published information regarding the use of selenium sulfide during breastfeeding. The manufacturer states that due to the lack of data available, breastfeeding should be avoided during the use of selenium sulfide. Hale states that the absorption of selenium through the skin is negligible if it is not applied to broken or inflamed skin. There is no data on its effect on human breast milk. After topical use it is unlikely to be absorbed systemically and cause ill effect to the breastfed infant, but do not apply directly to the nipple.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Blistering
Burning sensation (local)
Discolouration of hair
Dry hair
Greasy hair
Hair loss
Hypersensitivity reactions
Irritation (localised)
Rash
Sensitisation
Urticaria

Presentation

Topical formulation of selenium sulfide

Drugs List

Therapeutic Indications

Uses

Dandruff
Seborrhoeic dermatitis

Unlicensed Uses

Pityriasis versicolor

Dosage

Adults

Children

Contraindications

Abraded or inflamed skin
Children under 5 years

Precautions and Warnings

Breastfeeding
Pregnancy

Allow 48 hours between administration and cosmetic hair treatments
Avoid broken or inflamed skin
Avoid contact with eyes
If accidental contact with the eyes occurs, rinse thoroughly with water
Do not exceed recommended dosages and frequency of administration
Advise patient to remove jewellery before applying

Pregnancy and Lactation

Pregnancy

Use selenium sulfide with caution in pregnancy.

At the time of writing there is limited published information on the use of selenium sulfide during pregnancy. The manufacturer states avoid use during pregnancy as data available is not adequate to make an assessment on its safety in pregnant women and that animal studies are insufficient in respect of foetal development. However, Schaeffer (2007) states that there is no systematic data implicating teratogenicity and that as absorption from limited topical application is limited, local application to small areas for a limited period should be acceptable.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Use selenium sulfide with caution in breastfeeding.

At the time of writing there is limited published information regarding the use of selenium sulfide during breastfeeding. The manufacturer states that due to the lack of data available, breastfeeding should be avoided during the use of selenium sulfide. Hale states that the absorption of selenium through the skin is negligible if it is not applied to broken or inflamed skin. There is no data on its effect on human breast milk. After topical use it is unlikely to be absorbed systemically and cause ill effect to the breastfed infant, but do not apply directly to the nipple.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Blistering
Burning sensation (local)
Discolouration of hair
Dry hair
Greasy hair
Hair loss
Hypersensitivity reactions
Irritation (localised)
Rash
Sensitisation
Urticaria

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: November 2016

Reference Sources

Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

Medications and Mothers' Milk, Sixteenth Edition (2014) Hale, T and Rowe, H, Hale Publishing, Plano, Texas.

Summary of Product Characteristics: Selsun Shampoo 2.5%. Sanofi-Aventis Pharma Limited. Revised July 2014.

NICE Evidence Services Available at: www.nice.org.uk Last accessed: 06 September 2017