Piperonyl butoxide with pyrethrins poisoning
Piperonyl butoxide with pyrethrins is an ingredient found in medicines to kill lice. Poisoning occurs when someone swallows the product or too much of the product touches the skin.
This article is for information only. Do NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.
Pyrethrins poisoning; Lice medicine poisoning
The ingredients include:
- Piperonyl butoxide
The poisonous ingredients may go by other names.
These products contain piperonyl butoxide with pyrethrins:
- Barc (also contains petroleum distillates)
- Blue (also contains petroleum distillates)
- Control-L (also contains petroleum distillates)
- End Lice
- Lice-Enz Foam Kit
- Pyrinex Pediculicide (also contains petroleum distillates)
- Pyrinyl (also contains kerosene)
- Pyrinyl II
- Pyrinyl Plus
- R & C spray
- Rid (also contains petroleum distillates and benzyl alcohol)
- Tisit Blue (also contains petroleum distillates)
- Triple X Kit (also contains petroleum distillates)
Products with other names may also contain piperonyl butoxide with pyrethrins.
Symptoms of poisoning from these products include:
- Chest pain
- Difficulty breathing
- Eye irritation if it touches the eyes
- Muscle weakness
- Nausea and vomiting
- Rash (allergic reaction)
- Salivating more than ususal
- Shortness of breath
- Skin hypersensitivity
Seek medical help right away. Do not make a person throw up unless poison control or a health care provider tells you to. If the chemical is in the eyes, flush with lots of water for at least 15 minutes.
Before Calling Emergency
Have this information ready:
- Person's age, weight, and condition
- Name of the product (ingredients and strength, if known)
- Time it was swallowed
- The amount swallowed
Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) 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.
What to Expect at the Emergency Room
Take the container with you to the hospital, if possible.
The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated. The person may receive:
- Cleaning of exposed skin
- Washing and examination of eyes as needed
- Treatment of allergic reactions as needed
If the poison was swallowed, treatment may include:
- Activated charcoal
- Blood and urine tests
- Breathing support, including oxygen and a tube through the mouth into the lungs (extreme cases)
- Chest x-ray
- CT scan (advanced imaging) of the brain
- EKG (electrocardiogram, or heart tracing)
- Intravenous fluids (through a vein)
- Medicines to treat symptoms
- Tube through the mouth into the stomach to empty the stomach (gastric lavage)
Most symptoms are seen in people who are allergic to pyrethrins. Piperonyl butoxide is not very toxic, but extreme exposures may result in more severe symptoms.
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: Elsevier Saunders; 2007:chap 77
Cannon RD, Ruha A-M. Insecticides, herbicides, and rodenticides. In: Adams JG, Barton ED, Collings JL, DeBlieux PMC, Gisondi MA, Nadel ES, eds. Emergency Medicine. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 146.
Rhee JW. Pesticides. In: Marx, JA, Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 163.
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.
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.