Piperonyl butoxide with pyrethrins is an ingredient found in medications to kill lice. Poisoning occurs when someone swallows the product or too much of the product touches the skin.
This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.
Seek immediate medical help. Do not make a person throw up unless told to do so by Poison Control or a health care professional. If the chemical is in the eyes, flush with lots of water for at least 15 minutes.
Before Calling Emergency
Determine the following information:
Patient's age, weight, and condition
Name of the product (ingredients and strengths if known)
Time it was swallowed
The amount swallowed
The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.
This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.
Take the container with you to the hospital, if possible.
The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The patient may receive:
Cleaning of exposed skin
Washing and examination of eyes as necessary
Treatment of allergic reactions as necessary
If the poison was swallowed, treatment may include:
Blood and urine tests
EKG (electrocardiogram, or heart tracing)
Intravenous (through the vein) fluids
Tube through the mouth into the stomach to empty the stomach (gastric lavage)
Most symptoms are seen in patients who are allergic to pyrethrins. Piperonyl butoxide has a low toxicity, but extreme occupational exposures may result in more severe symptoms.
Keep all medicines in child-proof bottles and toxins in their original containers, labeled, and out of the reach of children.
Robey WC III, Meggs WJ. Insecticides, herbicides, rodenticides. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004:chap 182.
Borron, SW. Pyrethrins, Repellants, and Other Pesticides. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 77.
Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.