This medication is used to treat lice, which are tiny insects that can infest and irritate the scalp (head lice), the pubic area (crabs), or the body. This medication works by paralyzing and killing lice.

Review the manufacturer's instruction sheet and carefully follow all directions for your product. If any of this information is unclear, talk to your doctor or pharmacist. Do not use more drug than recommended.

This medication is for use on the outside of the body only. Avoid applying this drug to the eyes, nose, mouth, or vagina. If this product gets in these areas, rinse with plenty of water. If irritation occurs, tell your doctor promptly.

Do not use this product on eyelashes or eyebrows. Check with your doctor if these areas have lice.

If applying this product to an infant, cover the infant's hands and feet after applying the drug to make sure this product does not get in the infant's mouth.

Apply this drug in an area with good air flow (such as near an open window).

Apply this drug to the hair and scalp once, thoroughly covering the affected area. Using a small amount of water, work the product into the hair and scalp to form a lather. Leave on for about 10 minutes or as long as directed by your doctor.

Rinse and dry with a clean towel. Use a nit removal comb (a fine-toothed comb) as directed to remove nits (lice eggs) from hair. Wash hands immediately after use.

Because this product does not affect the eggs (nits) laid by lice, repeat the application once 7 to 10 days later to kill any newly hatched lice.

Tell your doctor if your condition lasts or gets worse after the 2 treatments with this medication.

Skin irritation may occur. If this effect lasts or gets worse, tell your doctor or pharmacist promptly.

If your doctor has directed you to use this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before using pyrethrins/piperonyl butoxide, tell your doctor or pharmacist if you are allergic to it; or to chrysanthemum or ragweed; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

• skin infections

Constant or hard scratching of the skin/scalp may lead to a bacterial skin infection. Tell your doctor right away if you develop worsening redness or pus.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this drug passes into breast milk. Consult your doctor before breastfeeding.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

This medicine may be harmful if inhaled or swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669. Symptoms of overdose may include: nausea, vomiting, diarrhea, unusual drowsiness.

Do not share this medication with anyone else unless directed by your doctor.

To avoid giving lice to another person or getting them again, all headwear, scarves, coats, and bed linens should be machine-washed with hot water and dried in a dryer (at high setting) for at least 20 minutes. These items may also be dry cleaned, sealed in a plastic bag for 2 weeks, or sprayed with a disinfectant that kills lice. Brushes and combs should be soaked in hot water (hotter than 130 degrees F/54 degrees C) for 10 minutes, soaked in alcohol for 1 hour, or thrown away. Furniture and floors should be thoroughly vacuumed.

People who are in close contact with the infected person, such as members of the same household, should also be checked for lice and nits. Treatment may be considered to prevent infestation even if live lice are not found on them.

If you miss a dose, consult your doctor or pharmacist.

Store at room temperature. Do not freeze. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.