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Pyrethrins; Piperonyl Butoxide Shampoo

Piperonyl butoxide and pyrethrins combine in a shampoo to treat lice. Lice are tiny insects that live and feed on a human’s scalp. Lice easily spread through human contact and cause itching. Avoid washing your hair with other hair products before applying this medication to your scalp. Follow the instructions on the label to use as directed.

What is this medication?

PYRETHINS; PIPERONYL BUTOXIDE (pi RETH rins; PI per on il byoo TOX ide) is used to treat lice. It acts by destroying the lice, but it does not destroy their eggs (nits). This medicine may be used to treat head lice, body lice, or pubic lice.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): A200 Lice Killing, A200 LiceTreatment, Lice Killing Shampoo, LiceMD Complete, Pronto, Pronto Plus, Pronto Shampoo with Conditioner, RID Complete Lice Elimination, RID Lice Killing

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What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

  • asthma
  • an unusual or allergic reaction to pyrethrins, piperonyl butoxide, other medicines, foods, dyes, ragweed, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

How should I use this medication?

This medicine is for external use only. Do not take by mouth. Follow the directions on the product label. Do not wash hair with conditioner or a combination shampoo-conditioner immediately before applying this medicine. Follow product-specific instructions for length of application and product removal. All products should be rinsed from the hair over a sink or tub to limit skin exposure; do not use hot water. In general, do not re-wash the hair for 1 to 2 days after use.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 2 years old for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

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What if I miss a dose?

If you miss a dose, use it as soon as you can. If it is almost time for your next dose, use only that dose. Do not use double or extra doses.

What may interact with this medication?

Interactions are not expected.

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

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What should I watch for while using this medication?

Lice infections can cause itching and irritation. This medicine may cause more itching for a short time after use. This does not mean that the medicine did not work.

Lice can be spread from one person to another by direct contact with clothing, hats, scarves, bedding, towels, washcloths, hairbrushes, and combs. All members of the house should be checked for lice. Treat everyone who is infected. For cases of pubic lice, sexual partners should be treated at the same time to prevent reinfection.

To prevent reinfection or spreading of the infection, the following steps should be taken: Machine wash all clothing, bedding, towels, and washcloths in very hot water and dry them using the hot cycle of a dryer for at least 20 minutes. Clothing or bedding that cannot be washed should be dry cleaned or sealed in an airtight plastic bag for 4 weeks. Shampoo any wigs or hairpieces. You should also wash all hairbrushes and combs in very hot soapy water (above 130 F) for 5 to 10 minutes. Do not share your hairbrushes or combs with other people. Wash all toys in very hot water (above 130 F) for 5 to 10 minutes or seal in an airtight plastic bag for 4 weeks. Also, clean the house or room by vacuuming furniture, rugs, and floors.

What side effects may I notice from receiving this medication?

Side effects that you should report to your doctor or health care professional as soon as possible:

  • allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
  • breathing problems
  • skin burning, irritation

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

  • dry, itchy, red skin
  • tingling sensation

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

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Note: Introduction and Additional Common Questions written and medically approved by Cleveland Clinic professionals.

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