FDA-filed SPL labeling · retrieved through openFDA

Pyrethrin and Piperonyl Butoxide Topical

A topical lice treatment that kills head, pubic, and body lice using a plant-based insecticide.

Brand name Vanalice
OTC Route Topical
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 1 clinical label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveDec 3, 2025
AvailabilityOTC
Boxed warningNone found in compared labels
How we combine label and product data →
✓No current FDA shortage listed · checked Sep 27, 2026
💊
HelloPharmacist Editorial Team Bottom Line
Pyrethrin and Piperonyl Butoxide is an effective topical treatment for head, pubic, and body lice when used correctly — especially when paired with thorough nit-combing. The second treatment 7 to 10 days later is essential, so don't skip it. Keep it away from the eyes and avoid it if you have a ragweed allergy; see a doctor if lice are in sensitive areas like the eyebrows or eyelashes.

📖 Pyrethrin and Piperonyl Butoxide Topical: Patient Information Guide

A plain-language walkthrough of Pyrethrin and Piperonyl Butoxide Topical — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for▾

This product treats lice infestations on the body. It targets:

  • Head lice — found in scalp hair
  • Pubic (crab) lice — found in pubic hair
  • Body lice — found on the body or clothing
💊How it's taken▾

Apply the product to dry hair or the affected skin area. For head lice, begin at the back of the neck and behind the ears. Leave the product on for exactly 10 minutes — no longer — then rinse thoroughly with warm water and soap or shampoo.

  • After washing, towel-dry hair and comb through damp hair with a fine-tooth lice comb to remove nits
  • Check daily for any lice or nits you may have missed
  • A second full treatment must be done 7 to 10 days later to kill newly hatched lice
  • Children under 2 years: ask a doctor before use

If the infestation continues after a second treatment, see a doctor for other options.

🤒Side effects — in detail▾

Most side effects with this product are mild and local (at the spot where it's applied):

  • Scalp itching
  • Scalp redness
  • Skin or scalp irritation
  • Eye irritation if the product gets in your eyes

Stop using and see a doctor if breathing becomes difficult, eye irritation develops, skin irritation doesn't go away, or signs of skin infection appear.

⚠️Warnings & precautions▾
  • Ragweed allergy: If you're allergic to ragweed, this product may cause breathing difficulty or trigger an asthma-like attack — ask a doctor before using it.
  • Eyes and sensitive areas: Never apply near the eyes, inside the nose, mouth, or vagina. If lice are in the eyebrows or eyelashes, see a doctor — do not use this product there.
  • Eye contact: Keep eyes tightly closed during use. If product gets in your eyes, flush right away with water.
  • Children under 2: Ask a doctor before use.
  • If swallowed: Call Poison Control or seek emergency help immediately.
🔀What it interacts with▾

No specific drug, food, or supplement interactions are listed for this product.

    This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

    📋Before taking it▾
    • Tell your doctor if you have ever had a reaction to this product or its ingredients
    • Do not use if you are allergic to ragweed
    • Do not use on children under 2 years old without a doctor's guidance
    • Do not apply to the eyes, eyebrows, eyelashes, nose, mouth, or vaginal area
    🚑If you take too much▾

    If this product is swallowed, get medical help or contact a Poison Control Center right away. Do not wait for symptoms to appear.

    📄 Written from Pyrethrin and Piperonyl Butoxide Topical’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

    🩺 Pharmacist Counseling Corner

    Quick, plain-English answers to the questions patients ask most about Pyrethrin and Piperonyl Butoxide Topical — the kind of thing our pharmacy team would talk through with you at the counter.

    What exactly does this product treat? ▾
    It treats lice — specifically head lice, pubic (sometimes called crab) lice, and body lice. You apply it directly to the affected area of skin or hair, not take it by mouth. It's not for lice in the eyebrows or eyelashes, so see a doctor if lice are found there.
    How long do I leave it on, and do I really need a second treatment? ▾
    You leave it on for exactly 10 minutes — no longer — then wash it off with warm water and soap or shampoo. And yes, the second treatment 7 to 10 days later is really important. It kills any lice that hatched after the first application, since the product doesn't always eliminate eggs completely on the first round.
    Is combing out nits really necessary, or can I skip that step? ▾
    Combing is a key part of the treatment. After rinsing, towel-dry your hair and use a fine-tooth lice comb while the hair is still slightly damp. Work through sections starting at the top of the head. If hair dries out during combing, dampen it a little with water. Longer hair can take an hour or two, but it's worth it.
    Can I use this on my toddler or young child? ▾
    For children 2 years and older, you can use it following the label directions. For children under 2, you need to ask a doctor first — it's not recommended for that age group without medical guidance.
    I have a ragweed allergy — is it safe for me to use this? ▾
    That's an important thing to flag. If you're allergic to ragweed, this product could cause breathing difficulty or trigger an asthma-like reaction. Talk to your doctor before using it so they can recommend the safest option for you.
    What side effects should I watch for, and when should I call a doctor? ▾
    Some scalp itching or redness is fairly common and usually mild. But stop using the product and contact a doctor if you have any trouble breathing, eye irritation, or skin irritation that doesn't clear up — or if the area looks like it might be getting infected. And if it's accidentally swallowed, call Poison Control right away.
    Is Pyrethrin and Piperonyl Butoxide Topical available over the counter? ▾
    Yes — Pyrethrin and Piperonyl Butoxide Topical is available over the counter (without a prescription) in at least some forms, according to its FDA labeling. Follow the package directions and ask your pharmacist if you're unsure which product is right for you.

    💬 Answers drafted from Pyrethrin and Piperonyl Butoxide Topical’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

    🧰 Keep exploring

    📈 How widely Pyrethrin and Piperonyl Butoxide Topical is used

    A general measure of how commonly Pyrethrin and Piperonyl Butoxide Topical is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

    Think of this as a proxy for how widely Pyrethrin and Piperonyl Butoxide Topical is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

    10,703
    Medicaid prescriptions filled (Q1–Q4 2025)
    $1.5M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

    How commonly is Pyrethrin and Piperonyl Butoxide Topical prescribed? Of the 1,597 medications we measure, Pyrethrin and Piperonyl Butoxide Topical ranks #919 by Medicaid prescriptions — more than 42% of them.

    Where Pyrethrin and Piperonyl Butoxide Topical ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5

    Utilization by Pyrethrin and Piperonyl Butoxide Topical product

    Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

    The 40 mg/mL / 3.3 mg/mL medicated shampoo is the most-dispensed Pyrethrin and Piperonyl Butoxide Topical product — about 55% of these Medicaid prescriptions.

    piperonyl butoxide 40 MG/ML / pyrethrins 3.3 MG/ML Medicated Shampoo Most dispensed

    5,855 Medicaid prescriptions (Q1–Q4 2025) 55% of Pyrethrin and Piperonyl Butoxide Topical prescriptions shown $1.3M gross reimbursement (before rebates) ≈ $224 per prescription (gross)

    Summed across the 3 of 68 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 283219

    piperonyl butoxide 0.035 MG/MG / pyrethrins 0.003 MG/MG Topical Gel

    4,848 Medicaid prescriptions (Q1–Q4 2025) 45% of Pyrethrin and Piperonyl Butoxide Topical prescriptions shown $206,343 gross reimbursement (before rebates) ≈ $43 per prescription (gross)

    Summed across the 1 of 1 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2058503

    Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

    Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Pyrethrin and Piperonyl Butoxide Topical, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 4 of 69 listed Pyrethrin and Piperonyl Butoxide Topical NDCs with Medicaid activity.

    🏷️ Sold under these brand names

    Vanalice

    🔬 Where this comes from

    Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

    📄
    FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Dec 3, 2025
    🏭
    Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Pyrethrin and Piperonyl Butoxide Topical.
    📈
    Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
    🚨
    Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
    🧾 Clinical label set — FDA-filed SPL labels retained for Pyrethrin and Piperonyl Butoxide Topical after exact ingredient or ingredient-combination matching and applicable route/form matching
    Clinical labels in scope
    1
    Linked representative label ⓘ
    GM Pharmaceuticals, INC
    Linked label effective
    Dec 3, 2025
    Composite sections available
    6
    Linked SPL Set ID
    c0205fa6-c8f4-4a28-9341-56a120843706
    Linked SPL Document ID
    4510adbf-3258-b683-e063-6394a90a53d2
    Open the linked representative label on DailyMed ↗
    NDC package records associated with this linked SPL 1

    How we combine label and product data

    HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 1 FDA-filed SPL label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

    Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. GM Pharmaceuticals, INC is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

    This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.