Permethrin/ Piperonyl Butoxide/ Malathion

These indications are based on manufacturer information for both originator and generic products. For product specific indications, please refer to product specific manufacturer information

South African indications:

• Human pediculosis capitis (head lice)

Combination products may have additional pharmacological effects not accounted for by the action of the individual ingredients

Permethrin
Contraindications

• Hypersensitivity to the active ingredient or any of the excipients in this combination product
• Hypersensitivity to other other pyrethroids or pyrethrins

Cautions

• Breastfeeding
• Contact with eyes
• Flammable

Piperonyl butoxide
Contraindications

• Hypersensitivity to the active ingredient or any of the excipients in this combination product
• Children < 30 months

Cautions

• Pregnancy
• Breastfeeding
• Renal impairment
• Hepatic impairment
• Elderly
• Avoid exposure to eyes, mucous membrane or denuded
  skin
• Flammable

Malathion
Contraindication

• Hypersensitivity to the active ingredient or any of the excipients in this combination product
• Pregnancy
• Breastfeeding
• Children < 30 months

Cautions

• Renal impairment
• Hepatic impairment
• Exposure to eyes, mucous membrane or denuded skin
• Flammable

Form avail. in SA and covered in this monograph: spo

Infections caused by: Pediculus humanus capitis 

General dosing range:

• Topical (spo): Spray short 1 sec sprays to base of hair shaft, until scalp and hair base are moist; Leave for max. 10min then wash and rinse with regular shampoo

Before use, test for sensitivity on a small patch of skin on the inner arm

Eliminate dead lice and nits by means of a fine-tooth comb

To avoid recontamination, also disinfect the clothes and bedding

Only one application needed per infestation

Not established for children below 30 months

Recommendations for this combination product as per highest risk category when comparing individual active ingredients

Pregnancy

• FDA Pregnancy Category Not Rated (NR) (Piperonyl butoxide)

Breastfeeding

• Contraindicated (Malathion)

Renal Impairment

• Caution; no information available (Piperonyl butoxide, Malathion)

Hepatic Impairment

• Caution; no information available (Piperonyl butoxide, Malathion)

Elderly

• Caution; no information available (Piperonyl butoxide)

Porphyria Information

• Not yet classified (NC)

Combination products may have additional pharmacological effects not accounted for by the action of the individual ingredients

Permethrin
Skin and Subcutaneous Tissue Disorders

• Skin burning
• Pruritus
• Skin stinging
• Skin redness

Piperonyl butoxide
Central Nervous System Disorders

• Seizures
• Central nervous system depression

Respiratory Disorders

• Respiratory tract irritation

Gastrointestinal Disorders

• Nausea and vomiting
• Abdominal cramps
• Diarrhoea

Skin and Subcutaneous Tissue Disorders

• Contact allergic reaction
• Burning
• Pruritis

Sensory Disorders

• Ocular irritation

Malathion
Skin and Subcutaneous Tissue Disorders

• Burning
• Pruritis
• Irritation

Combination products may have additional pharmacological effects not accounted for by the action of the individual ingredients

Permethrin

• Corticosteroids

Piperonyl butoxide

• No information available

Malathion

• No information available

None routine

Permethrin
The principal physiological action in susceptible parasites exposed to permethrin is induction of electrochemical abnormalities across the membranes of excitable cells, leading to sensory hyper-excitability, inco-ordination and prostration.

Piperonyl butoxide
Piperonyl butoxide (PBO) is an insecticide synergist, which acts by protecting the co-applied insecticide (e.g. pyrethrins, pyrethroids and other pesticides) from metabolic attack thus allowing them to reach their biochemical targets. As a result of inhibiting oxidative processes in living organisms, PBO has intrinsic toxic potential to arthropods such as lice, ticks, mosquitoes etc.

Malathion
Malathion is an organophosphate insecticide used in the treatment of head and pubic pediculosis and scabies. Malathion exerts its action on the nervous system of the lice by irreversibly inhibiting the activity of cholinesterase, hence allowing acetylcholine accumulation in synapse that results in the death of the lice.

Spectrum of activity: Pediculus humanus capitis

COMBINATION PREPARATIONS

Permethrin/ Piperonyl Butoxide/ Malathion

Spray 0.005g/0.02g/0.0025g

• Para Plus Lice Spray (Technikon) originator