Version May 2024
Pediculus humanus infestations: Topical: Apply to dry hair and/or other infested area; allow to remain on area for 10 minutes and then wash and rinse; repeat treatment in 7 to 10 days.
There are no dosage adjustments provided in the manufacturer’s labeling.
There are no dosage adjustments provided in the manufacturer’s labeling.
Refer to adult dosing.
Pediculus humanus infestations: Children ≥2 years and Adolescents: Topical: Refer to adult dosing.
There are no dosage adjustments provided in the manufacturer’s labeling.
There are no dosage adjustments provided in the manufacturer’s labeling.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.
Central nervous system: Localized burning
Dermatologic: Burning sensation of skin, pruritus, skin irritation (with repeat use), stinging of the skin
OTC labeling: Hypersensitivity to pyrethrins, piperonyl butoxide, or any component of the formulation. When used for self-medication, do not use near eyes; inside nose, mouth, or vagina; or on infestations in eyebrows or eyelashes
Concerns related to adverse effects:
• Topical irritation: Scalp itching and/or redness may occur.
Other warnings/precautions:
• Appropriate use: For external use only. A second treatment must be done in 7 to 10 days to kill any newly hatched lice.
• OTC labeling: Discontinue use and contact healthcare provider if breathing difficulty or eye irritation occurs or if skin or scalp irritation continues or infection occurs.
• Ragweed allergy: May cause difficulty in breathing or an asthmatic attack.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Kit:
A-200 Lice Treatment Kit:
Shampoo: Pyrethrins 0.33% and piperonyl butoxide 4% (120 mL)
[packaged with nit removal comb and household permethrin spray]
LiceMD Complete:
Gel: Pyrethrins 0.33% and piperonyl butoxide 4% (236 mL [DSC])
[packaged with non-medicated shampoo, nit removal comb, and gloves]
LiceMD Treatment:
Gel: Pyrethrins 0.33% and piperonyl butoxide 4% (118 mL)
[packaged with nit removal comb and gloves]
Pronto Plus Complete Lice Removal System:
Shampoo: Pyrethrins 0.33% and piperonyl butoxide 4% (60 mL)
[packaged with lice egg removal gel, nit removal comb, and household permethrin spray]
RID Lice Treatment Complete:
Shampoo: Pyrethrins 0.33% and piperonyl butoxide 4% (118 mL)
[packaged with hair comb out spray (detangler), nit removal comb and household permethrin spray]
VanaLice:
Gel: Pyrethrins 0.3% and piperonyl butoxide 3.5%
[packaged with nit removal comb]
Shampoo:
A-200 Maximum Strength: Pyrethrins 0.33% and piperonyl butoxide 4% (60 mL, 120 mL) [contains benzyl alcohol; packaged with nit removal comb]
Licide: Pyrethrins 0.33% and piperonyl butoxide 4% (120 mL [DSC]) [packaged with nit removal comb; also available in a kit containing shampoo, household spray, and nit removal comb]
RID Lice Killing: Pyrethrins 0.33% and piperonyl butoxide 4% (59 mL, 118 mL, 236 mL) [packaged with nit removal combs]
No
Gel (VanaLice External)
0.3-3.5% (per mL): $0.21
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Topical: For external use only. Avoid touching eyes, mouth, or other mucous membranes. Apply enough solution to completely wet infested area, including hair (product is applied to DRY hair). For head lice, first apply behind ears and to back of neck. Allow to remain on area for 10 minutes; do not leave on longer than 10 minutes. Wash area thoroughly with warm water and soap or shampoo, and then thoroughly rinse. For head lice, use fine-toothed comb or the special lice/nit comb to remove lice and eggs from hair. Remove any remaining nits by hand (using a disposable glove). Keep out of eyes when rinsing hair; protect eyes with a wash cloth or towel.
Topical: For external use only. Avoid touching eyes, mouth, or other mucous membranes. Apply product to dry hair; apply enough solution to completely wet infested area, including hair. For head lice, first apply behind ears and to back of neck. Allow to remain on area for 10 minutes; do not leave on longer than 10 minutes. Wash area thoroughly with warm water and soap or shampoo, and then thoroughly rinse. For head lice, use fine-toothed comb or the special lice/nit comb to remove lice and eggs from hair. Remove any remaining nits by hand (using a disposable glove). Keep out of eyes when rinsing hair; protect eyes with a wash cloth or towel.
Pediculus humanus infestations: Treatment of Pediculus humanus infestations (head lice, body lice, pubic lice, and their eggs)
None known.
There are no known significant interactions.
The CDC considers pyrethrins/piperonyl butoxide as one of the drugs of choice for the treatment of pubic lice during pregnancy (CDC [Workowski 2021]).
Pyrethrins/piperonyl butoxide is one of the drugs of choice for the treatment of pubic lice in patients who are breastfeeding (CDC [Workowski 2021]).
Pyrethrins are derived from flowers that belong to the chrysanthemum family. The mechanism of action on the neuronal membranes of lice is similar to that of DDT. Piperonyl butoxide is usually added to pyrethrin to enhance the product's activity by decreasing the metabolism of pyrethrins in arthropods.
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