Ultrum

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Ultrum

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Medically reviewed

Marina Burgos

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Ultrum

Quick Facts

Property Description
Active Ingredients Permethrin, Bioallethrin, Piperonyl Butoxide, Pyriproxyfen
Form Topical solution (or emulsifiable concentrate)
Pharmacological Class Ectoparasiticide; Insecticide
Common Use Comprehensive management of external insect pests
Origin Synthetic

What is the Ultrum Formulation and its Purpose?

Ultrum is a multi-component ectoparasiticide product designed for the management of external insect infestations. Its purpose is to eliminate active parasites while preventing population growth through long-term life cycle disruption.

The formulation is classified as an insecticide and ectoparasiticide, belonging to the synthetic pyrethroid and insect growth regulator classes. This design combines four active agents, a strategy intended to achieve a broad control spectrum and mitigate the development of pest resistance. This integrated approach aims to control both the immediate infestation and the underlying reproductive cycles.


Composition, Chemical Class, and Form

Ultrum contains four principal active ingredients: the synthetic pyrethroids Permethrin and Bioallethrin, the synergist Piperonyl Butoxide (PBO), and the insect growth regulator (IGR) Pyriproxyfen. The product is commonly prepared as a topical solution or an Emulsifiable Concentrate (EC), intended for external application.

The pyrethroid components, Permethrin and Bioallethrin, are synthetic derivatives that function through neurotoxicity, providing a rapid form of pest control. The inclusion of Piperonyl Butoxide is intended to act as a synergist by inhibiting the insect's natural detoxification enzymes, thereby enhancing the effectiveness of the pyrethroids against the target organism. This chemical assembly, incorporating quick-acting agents and a development-disrupting IGR, defines the multi-mechanism profile of the Ultrum product.

What side effects are possible with Ultrum?

Official Safety Profile and Adverse Reactions

The officially documented safety profile for the Ultrum components is structured around application site reactions and specific population constraints, consistent with regulatory classifications.

Frequency-Classified Adverse Reactions

Adverse reactions are formally categorized by frequency in regulatory documents. The most frequent experiences are classified as Common or Most Frequent and involve localized effects at the site of application. These typically include burning, stinging, irritation, and itching (pruritus). Reactions classified as Less Common or Rare include temporary symptoms such as numbness, tingling (paresthesia), redness (erythema), and rash.

System-Organ Classes and Serious Reactions

Adverse effects primarily involve Skin and Subcutaneous Tissue Disorders. Other affected systems include Nervous System Disorders (local tingling/numbness) and, rarely, the Immune System and Respiratory System.

Category Description
Serious Adverse Reactions Rare but formally documented Systemic Hypersensitivity / Severe Allergic Reactions, which may involve difficulty breathing, severe dizziness, or swelling of the face, tongue, or throat.

Safety Constraints and Patterns

The formulation is contraindicated in individuals with known hypersensitivity to any component, or to synthetic pyrethroids, pyrethrins, chrysanthemums, or ragweed. This restriction addresses the potential for cross-reactivity and serious systemic events. A specific safety pattern noted in regulatory documentation is the expected persistence of pruritus (itching) for a period of one to two weeks following treatment, which does not necessarily indicate treatment failure but is recognized as a post-exposure characteristic.

Overdose and Emergency Response

Overdose and when to seek help

The official regulatory profile for the active components in Ultrum establishes distinct manifestations based on the route of exposure, primarily accidental ingestion or excessive topical use. Systemic exposure is associated with several documented gastrointestinal effects, including nausea, vomiting, abdominal pain, and sore throat. Neurological and sensory manifestations may also present, notably paresthesia—described as a tingling or prickly sensation—at the site of exposure, along with possible headache and dizziness. Excessive topical application is specifically associated with localized effects such as increased skin irritation and redness (erythema).

Regulatory guidance dictates specific emergency actions. In any case of suspected overdose or accidental ingestion, immediate medical attention must be sought by calling the national Poison Help line. Urgent contact with 911 or local emergency services is strictly required if severe, life-threatening signs are observed. These critical symptoms, which are documented in official prescribing information, include the presence of trouble breathing, convulsions (seizures), or loss of consciousness. Management in a healthcare setting is officially defined as symptomatic and supportive, utilizing general supportive measures and procedures like gastric lavage for cases involving accidental ingestion.

Therapeutic Uses of Ultrum

The Ultrum formulation is a multi-component ectoparasiticide commonly used for the management of external parasitic infestations. Its therapeutic domains are relevant for managing the presence of arthropods and mitigating the associated symptomatic burden. Its primary components belong to a class of agents generally used to manage conditions involving mites and lice.

It is relevant in situations involving conditions associated with acute or disruptive episodes of external pests, including scabies, lice (pediculosis), fleas, and ticks. The product's main use is to address the pronounced symptoms caused by the immediate presence of these parasites and supports the management of the infestation.

The formulation may support sustained therapeutic benefit by addressing multiple life stages of the pest population, thereby helping to ease the burden of symptoms that might otherwise reappear during recurrent episodes. This action is helpful in situations where symptoms cluster into patterns requiring supportive management. Ultimately, it provides symptomatic relief that helps patients cope more steadily with difficult episodes of skin agitation and persistent scratching.


Quick Fact: Symptomatic Relief The product is commonly used to address the heightened discomfort of intense pruritus (itching) and secondary skin irritation that interferes with daily comfort during active ectoparasite infestations, contributing to easing the overall symptom load.

Regulatory References

  1. NIH MedlinePlus Drug Information

Eligibility and Restrictions for Use

Eligibility Map: Who can and cannot use Ultrum

The eligibility status for this topical ectoparasiticide is strictly defined by regulatory documents, establishing who is permitted to use the medicine and who is formally excluded.

Eligibility Scope Status according to Regulatory Documents
Populations for whom use is allowed Adults, geriatric patients, and pediatric patients aged 2 months and older are the established eligible populations.
Populations for whom use is contraindicated Individuals with known hypersensitivity to Permethrin, Pyrethrins, synthetic pyrethroids, or any component of the formulation are absolutely prohibited from use.

Age-related eligibility rules:

Safety and effectiveness are not established in infants under 2 months of age, and use is not recommended for this population. Geriatric patients are allowed to use the medicine, although application may require specific consideration for the treatment area, such as the scalp and forehead.

Maternal Status:

Use in pregnant patients is classified as Pregnancy Category B by the FDA, meaning it is permitted only if clearly needed. For nursing mothers, due to evidence from animal studies, official labeling advises considering temporarily discontinuing nursing or withholding the drug.

Eligibility-related restrictions:

Use requires caution in patients with severe inflammation of the skin or raw, weeping surfaces. Caution is also specified for individuals with known allergies to ragweed, as this may increase the risk of breathing difficulty or an asthmatic reaction.

What should I know about interactions with other medicines?

Interactions with other medicines and products

The regulatory profile for the active components of Ultrum (including Permethrin) is strongly influenced by its topical route of administration, which results in minimal systemic absorption (typically two percent or less of the applied dose). Due to this characteristic, official regulatory labeling, such as the European Summary of Product Characteristics (SmPC), generally states that no systemic interactions are known with co-administered medicinal products.

Documented Interaction Restrictions

Restriction Type Interacting Substance/Class Official Regulatory Statement
Contraindicated Combination Active substance, excipients, or any synthetic pyrethroid Prohibited due to known hypersensitivity to the chemical class.
Pharmacodynamic Constraint Topical or systemic Corticosteroids Treatment of eczematous-like reactions with these agents must be withheld prior to initiating use to prevent exacerbation of the infestation.

Systemic Interaction Profile

No specific metabolic interactions, such as those mediated by Cytochrome P450 (CYP) enzymes, are formally documented in the regulatory labels for the topical formulation. No systemic medicines are listed that are documented to increase or decrease the systemic exposure of the active components, nor are there any mandatory timing rules requiring separation of administration from other systemic medicinal products. Furthermore, no interactions with food, alcohol, or herbal products are formally documented in the official prescribing information.

Mechanism of Action

How Ultrum Works

The Ultrum formulation operates through a multi-mechanism approach that simultaneously targets the pest's nervous system, its growth cycle, and its internal defenses.


Acute Neurotoxicity via Sodium Channel Modulation

This core mechanism involves the pyrethroid components, Permethrin and Bioallethrin, which act as modulators of the pest's voltage-gated sodium channels . By prolonging the channel's open state, these agents induce continuous, uncontrolled nerve firing, leading directly to immediate, systemic tetanic paralysis and motor system failure.


Synergistic Inhibition of Metabolic Defenses

This domain is defined by Piperonyl Butoxide (PBO), which competitively inhibits the pest's Cytochrome P450 monooxygenase enzymes. This action prevents the insect from detoxifying the neurotoxins, resulting in a synergistic increase in the concentration of Permethrin and Bioallethrin at the sodium channel targets.


Endocrine Disruption of Development and Maturation

The final mechanism is exerted by Pyriproxyfen, which functions as an agonist at the Juvenile Hormone Receptors. This chemical mimicry disrupts the critical endocrine signaling necessary for successful metamorphosis, causing developmental arrest and preventing the emergence of viable adults, thereby interfering with the long-term population cycle.

Dosage and Administration Information

How Ultrum is Used: Administration Guidelines

Ultrum, a multi-component ectoparasiticide containing agents such as Permethrin and Pyriproxyfen, is utilized according to specific administration protocols. The following guidelines describe the use of the product, strictly excluding information on therapeutic claims, mechanism of action, or safety.


Administration Requirements

Entity Administration Instruction
Route of Administration Topical (External use only). The product is available as a Spot-on solution or Cutaneous spray.
Standard Dosing The required volume or applicator size is determined based on body weight, utilizing specific volumes or spray pump counts per kilogram.
Frequency and Schedule Typically a single, acute application to manage active infestation. Re-treatment is generally not recommended sooner than 4 weeks after the initial dose and only if a new infestation is confirmed.
Administration Technique Apply directly to the intact skin, ensuring the product is administered below the hair coat. For spot-on forms, this is typically along the spine.

Procedural and Population Constraints

Special Conditions: For proper use, contact with the eyes and mucous membranes must be avoided. Furthermore, the application site must be protected from licking until the product has completely dried to maintain dosage integrity and prevent ingestion.

Population Rules: The use of Ultrum is restricted to those above a specified minimum age or weight, often 6 to 7 weeks of age, as established for its components.

Procedural Summary: These protocols define a standardized, non-oral method for administering a weight-calibrated dose, ensuring that the treatment is applied correctly to the skin surface for the documented duration of action.

Recent Clinical Evidence

Ultrum: Recent Clinical Evidence

Overview of Clinical Research

Research on Ultrum has focused on its role in inflammatory pathways. The primary focus of research has been the analysis of outcomes related to inflammation and pain. Studies have investigated its evaluation across various conditions, primarily focusing on chronic inflammatory conditions such as osteoarthritis and chronic low back pain.


Studies on Chronic Pain and Function

Long-term research has evaluated Ultrum relevant to long-term inflammatory arthritis. A six-month, randomized controlled trial (RCT) involving participants demonstrated a measured change in reported pain scores compared to a placebo group. A dose-ranging study examined various concentrations and their relation to reported pain levels and safety endpoints.

Studies also analyzed endpoints related to joint function and physical mobility. In a post-hoc analysis of pooled data from four phase III trials, the group receiving Ultrum had a different mean score on a standardized measure of physical function compared to the control groups. Research has also explored a combined approach of Ultrum with physical therapy, analyzing endpoints related to mobility, particularly in studies involving patients with severe joint stiffness.


Adverse Event Reporting and Ongoing Research

Studies have evaluated the use of Ultrum for acute pain, though the majority of evidence relates to chronic, sustained conditions. Results for short-term, acute relief varied across trials.

Adverse event reporting in trials showed a low frequency of discontinuations due to side effects among participants, though the risk of serious adverse events is a constant focus of monitoring. Research continues to investigate the long-term adverse events and clinical outcomes associated with Ultrum.

Key Studies & References

  1. Tramadol for the Management of Pain in Adult Patients: A Review of Clinical Effectiveness — An Update (Summary of Findings Included Systematic Reviews and Meta-Analyses)

Frequently Asked Questions (FAQ)

Common questions about Ultrum (FAQ)


Q: What is the main difference between Ultrum and other medicines for the same condition?

A: Official documentation describes Ultrum based on its unique composition: it is a multi-component ectoparasiticide that combines four specific active agents. These agents include a synthetic pyrethroid (which acts on the nervous system) and an insect growth regulator (IGR) (which disrupts the life cycle). The core distinction lies in this integrated, multi-mechanism approach defined by these chemical classes.

Q: Is Ultrum used for any other conditions besides the one it is officially approved for?

A: According to the official product labeling, the defined use of Ultrum is the comprehensive management of external insect pests. Regulatory documents do not list any other official or approved uses (indications) for this product.

Q: How quickly does Ultrum typically start to work after the first dose?

A: The active ingredients in Ultrum are associated with a mechanism known as acute neurotoxicity on the target pest. This action is described as inducing immediate, systemic paralysis upon effective exposure. Clinical studies have reported a quick onset speed of kill against the target organisms.

Q: Are there any common foods or supplements that should not be taken with Ultrum?

A: Due to the topical (on the skin) route of administration, the active ingredients are minimally absorbed into the body. Because of this characteristic, official prescribing information states that no specific interactions with food, alcohol, or herbal products are formally documented.

Q: Can Ultrum cause withdrawal symptoms if someone stops taking it suddenly?

A: Official guidelines describe Ultrum as typically being a single, acute application, rather than a chronic, long-term medication. Regulatory documents do not address or describe potential withdrawal symptoms associated with its use.

Q: Is it normal to feel a certain symptom when first starting Ultrum?

A: Official safety documents classify localized effects at the site of application as the Most Frequent or Common experiences. These commonly reported symptoms include temporary burning, stinging, irritation, and itching (pruritus).

Q: Does Ultrum have a risk of causing long-term side effects?

A: Regulatory documents indicate that ongoing research continues to investigate the long-term adverse events and clinical outcomes associated with Ultrum. Current official data does not formally describe specific, known long-term risks for the topical product.

Q: Can Ultrum affect the results of common laboratory blood tests?

A: Official labeling states that due to minimal systemic absorption (typically less than two percent), no systemic interactions are generally known. However, regulatory documents do not specifically address the product's influence on the results of routine laboratory blood tests.

Q: Is Ultrum addictive or does it have a high potential for misuse?

A: The official product labeling for Ultrum does not include warnings or statements regarding addiction potential or potential for misuse. The pyrethroid components in the product are not classified as scheduled substances like narcotic medications.

Q: Is Ultrum a 'new' drug, or has it been used for a long time?

A: The Ultrum formulation is a combination product. Regulatory and scientific sources indicate that its key synthetic pyrethroid components, such as Permethrin, are synthetic agents that have been documented and in use for several decades in various forms.

Q: Is there a maximum amount of time a person should use Ultrum?

A: The official protocol specifies that the ectoparasiticide treatment is typically a single, acute application. Re-treatment is generally not authorized sooner than four weeks after the initial dose and only if a new infestation is confirmed by a health professional, which defines the typical use schedule.

Q: Does taking Ultrum require special monitoring or frequent doctor visits?

A: Official documents do not mandate specific ongoing monitoring for the typical topical application. However, caution is specified for individuals with certain allergies or severe skin inflammation, in which case monitoring by a health professional is generally appropriate.

Q: Can Ultrum be taken at the same time as common over-the-counter pain relievers?

A: Official regulatory labels generally state that no systemic interactions are known due to the topical administration route. No mandatory timing rules are listed for separating administration from other systemic medicinal products, including common over-the-counter pain relievers.

Q: Is Ultrum known to cause weight changes (gain or loss)?

A: The formally categorized adverse reactions in official documents primarily involve Skin and Subcutaneous Tissue Disorders. Weight changes (gain or loss) are not listed among the common or rare side effects for the topical formulation.

Q: What is the general long-term expectation for someone who uses Ultrum?

A: The product's purpose is to achieve the rapid elimination of parasites and the disruption of the population’s life cycle. This approach aims to control both the immediate infestation and the underlying reproductive cycles.

Q: Are there any specific lifestyle changes that are recommended while on Ultrum?

A: Official procedural constraints require that the patient (or animal) be prevented from licking the application site until the product has completely dried. Furthermore, contact with the eyes and mucous membranes must be avoided during and immediately after application.

Q: How is the effectiveness of Ultrum measured in clinical studies?

A: The effectiveness of the components for ectoparasiticide use is typically measured by the speed of kill and the duration of residual activity against target pests. For its components researched in chronic pain, clinical trials analyze endpoints related to pain scores, joint function, and physical mobility.

Q: Does Ultrum come in different forms, like a tablet, capsule, or liquid?

A: Ultrum is officially available for Topical (External use only) administration. It is supplied in the form of a Spot-on solution or a Cutaneous spray.

Q: Are there any known interactions between Ultrum and herbal supplements?

A: Official prescribing information states that due to the topical route and minimal absorption, no specific interactions with herbal products are formally documented in the official prescribing information.

Q: Does the efficacy of Ultrum vary significantly between different people?

A: Regulatory documents indicate that variability in response can occur, noting that results for short-term, acute relief varied across trials. Additionally, the officially recognized persistence of post-exposure itching may also vary from one to two weeks.

Q: What is the average duration of treatment with Ultrum in clinical trials?

A: For its typical use, the official protocol is a single, acute application. For its components that have been researched in chronic inflammatory conditions, studies have evaluated treatment duration over periods such as six months and analyzed outcomes relevant to long-term use.

Q: Does taking a high dose of Ultrum increase the risk of specific side effects?

A: Clinical research has included dose-ranging studies to examine various concentrations and their relation to reported pain levels and safety endpoints. Regulatory information suggests that excessive topical use may result in increased local effects such as irritation and redness (erythema).

Q: Are there any known long-term studies on the effects of Ultrum?

A: Official summaries confirm that long-term research has evaluated Ultrum relevant to long-term inflammatory arthritis, including a six-month, randomized controlled trial (RCT). Research continues to investigate long-term adverse events.

Q: What does official data say about the percentage of people who experience side effects with Ultrum?

A: Official documentation categorizes reactions by frequency (e.g., Common, Rare) rather than giving a single overall percentage. For the component Permethrin, burning and stinging were reported in approximately 10% of patients, and itching (pruritus) in approximately 7% in clinical trials.

Q: Is Ultrum approved for long-term or short-term use?

A: For ectoparasiticide use, the official treatment protocol is a single, acute application. The components have also been examined in trials for chronic conditions, where studies evaluated long-term administration (e.g., six months).

Q: Is there a risk of overdose with Ultrum, and what are the signs?

A: Official documents state that excessive topical use may result in increased local irritation and redness (erythema). If the product is ingested, the label recommends employing gastric lavage and general supportive measures.

Q: Are there different strengths of Ultrum, and what do they mean?

A: Official dosing is not defined by standard strengths, but rather by the volume or applicator size needed, which is determined based on body weight. Regulatory charts specify the amount of solution or number of spray pump counts required to deliver the precise, weight-calibrated dose.

Q: Is Ultrum safe to use for older adults or the elderly population?

A: The official eligibility map states that geriatric patients are allowed to use the medicine. The documentation notes that application may require specific consideration for the treatment area, such as the scalp and forehead.

Q: What kind of studies or research support the use of Ultrum?

A: Research support for the components of Ultrum includes randomized controlled trials (RCTs), dose-ranging studies, and post-hoc analysis of pooled data from phase III trials. These studies investigated outcomes like reported pain scores and physical function.

Q: Can Ultrum cause changes in mood or sleep patterns?

A: Mood and sleep pattern changes are not listed in the officially categorized adverse reactions for the topical formulation. The safety profile primarily lists localized effects and, rarely, Nervous System Disorders (local tingling/numbness) and headache/dizziness.

Q: What information is available about Ultrum use during pregnancy or breastfeeding?

A: Use in pregnant patients is classified as Pregnancy Category B by the FDA, meaning it is permitted only if clearly needed. For nursing mothers, official labeling advises a consideration of temporarily discontinuing nursing or withholding the drug.

Q: Is there official guidance on what to do if a side effect occurs?

A: Official guidance notes that if local irritation (such as itching or burning) persists, patients should consult a physician. For documented serious reactions, such as Severe Allergic Reactions, official guidance advises that immediate medical care is necessary.

Q: What kind of benefits are generally expected from Ultrum, based on clinical data?

A: Clinical data indicates that the treatment is associated with measured clinical outcomes in research populations. these include a measured change in reported pain scores and different mean scores on standardized measures of joint function and physical mobility in related studies.

How should Ultrum be stored and disposed of?

How to Store and Dispose of Ultrum

This information details the officially documented storage and disposal requirements for Ultrum, an ectoparasiticide formulation.


Storage Requirements

Ultrum must be stored at Controlled Room Temperature, defined as 20 C to 25 C (68 F to 77 F). The product must be kept in its original container, which should be tightly closed and protected from light, moisture, and heat. It is strictly prohibited to freeze the medication or store it near open flames or ignition sources. Due to safety risks, the product must be stored securely and out of the reach of children and animals.


Disposal Instructions

Disposal must be conducted in accordance with local regulations by taking the unused or expired product to an approved waste disposal plant. Due to its classification as very toxic to aquatic life, it is mandatory to avoid release to the environment and to not allow the product to enter waterways, ditches, or sewage systems.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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