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 the local emergency number (such as 911), or the local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.
The ingredients include:
- Piperonyl butoxide
The poisonous ingredients may go by other names.
Examples of products that contain piperonyl butoxide with pyrethrins include:
- Barc (also contains petroleum distillates)
- Lice-Enz Foam Kit
- Pyrinex (also contains petroleum distillates)
- Pyrinyl (also contains kerosene)
- Pyrinyl II
- 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:
- Difficulty breathing, shortness of breath, wheezing
- Eye irritation if it touches the eyes
- Muscle weakness
- Convulsions, tremors
- Nausea and vomiting
- Rash (allergic reaction)
- Salivating more than usual
- Chest pain
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 control 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 or a tube through the mouth into the lungs and breathing machine (ventilator)
- Chest x-ray
- CT scan (advanced imaging) of the brain for neurologic symptoms
- ECG (electrocardiogram, or heart tracing)
- Intravenous fluids (through a vein)
- Medicines to treat symptoms
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.
Cannon RD, Ruha AM. Insecticides, herbicides, and rodenticides. In: Adams JG, ed. Emergency Medicine: Clinical Essentials. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 146.
Theobald JL, Kostic MA. Poisoning. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 77.
Welker K, Thompson TM. Pesticides. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 157.
Last reviewed on: 7/20/2021
Reviewed by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.