Piperonyl butoxide/pyrethrum extract (On the skin)
Piperonyl Butoxide (PIP-er-oh-nil byoo-TOX-ide), Pyrethrum Extract (pye-REE-thrum EX-trackt)
Treats head lice, pubic lice (crab lice), and body lice.
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When This Medicine Should Not Be Used:This medicine is not right for everyone. Do not use it if you had an allergic reaction to piperonyl or pyrethrum.
How to Use This Medicine:
Foam, Gel/Jelly, Shampoo, Spray, Liquid
- Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions. The directions might be different for the shampoo, rinse, gel, mousse, or other forms of this medicine.
- Follow the instructions on the medicine label if you are using this medicine without a prescription.
- This medicine is for use on the skin and scalp only. Do not get it in your eyes, nose, mouth, or vagina. Do not use on skin areas that have cuts or scrapes. If it does get on these areas, rinse it off right away.
- Shake the medicine well before using.
- Protect the eyes with a towel and keep eyes tightly closed while medicine is being applied.
- Apply medicine to hair. Some forms, such as the shampoo, must be used on dry hair. Other forms, such as the gel, must be used on damp hair.
- Leave the medicine on the hair for 10 minutes. Rinse well with warm water and soap or shampoo, then towel dry.
- For head lice, start with the back of the neck and behind the ears.
- Comb hair in sections, 1 or 2 inches wide. Use a fine-toothed comb or a special lice or nit (egg) comb. Remove any lice or nits by hand using a throw-away glove. Seal lice or nets in a bag and throw away.
- You might need to comb through the hair more than once, if there are still lice or nits.
- Keep your comb clean and check hair daily for any lice or nits that you missed, to prevent lice from coming back.
- You will need a second treatment in 7 to 10 days to kill any newly hatched lice.
- Do not inhale this medicine. Do not puncture or burn the container.
- Store the medicine in a closed container at room temperature, away from heat or open flame, moisture, and direct light.
Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
Warnings While Using This Medicine:
- Make sure your doctor knows if you are pregnant or breastfeeding, or if you have asthma or an allergy to ragweed.
- This medicine should not be used for lice in the eyebrows or eyelashes unless your doctor tells you to.
- All members of your household should be checked, because lice are easily spread from one person to another. Your sexual partner must also be checked.
- To prevent reinfection, wash your clothes, bedding, and personal items (including towels, hats, combs, brushes) in hot, soapy water.
- Call your doctor if your symptoms do not improve or if they get worse.
- Some forms of this medicine can catch fire. Do not use while smoking or near an open flame.
Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
- Red or swollen eyes
If you notice other side effects that you think are caused by this medicine, tell your doctor
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088
Last Updated: 6/2/2022