PYRETHINS; PIPERONYL BUTOXIDE (pi RETH rins; PI per on il byoo TOX ide) treats lice, tiny insects that live in hair. It works by killing the lice. It does not kill the eggs, so a second treatment is needed.

How should I use this medication?

This medication is for external use only. Do not take by mouth. Use it as directed on the product label. Do not use a conditioner or a shampoo with a conditioner on the hair before using this medication. Follow product-specific instructions for length of application and product removal. Rinse out 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 care team about the use of this medication in children. While this medication may be used for children as young as 2 years 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.

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.

Where should I keep my medication?

Keep out of the reach of children and pets. Store between 15 and 30 degrees C (59 and 86 degrees F). Get rid of any unused medication after the expiration date. To get rid of medications that are no longer needed or have expired: -Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location. -If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put it in the trash, empty the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.

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.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible: -Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome): -Burning or pain at application site -Mild skin irritation, redness, or dryness

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.

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, ragweed, other medications, foods, dyes, or preservatives -Pregnant or trying to get pregnant -Breast-feeding

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.

What should I watch for while using this medication?

Lice infections can cause itching and irritation. This medication may cause more itching for a short time after use. This does not mean that the medication did not work. Head lice is spread to others by direct contact with clothing, hats, scarves, bedding, towels, washcloths, hairbrushes, and combs. All members of your household should be examined for head lice. Anyone with lice should get treated. Ask your care team if you have questions. Do the following to prevent giving lice to others or getting a second infection. Machine wash all clothing, bedding, towels, and washcloths in very hot water. Dry them in the dryer using the hot cycle for 20 minutes or longer. Shampoo wigs or hairpieces. Wash all hairbrushes and combs in very hot soapy water for 5 to 10 minutes. Do not share your hairbrushes or combs with other people. Wash all toys in very hot water for 5 to 10 minutes. Vacuum furniture, rugs, and floors. If clothing, bedding, rugs, or toys cannot be washed, seal them in an airtight plastic bag for 2 weeks.