Syrup of Ipecac
An emetic derived from the dried roots of a poisonous shrub found in Europe and the Americas, used to treat accidental poisoning.
However, ipecac syrup should no longer be used routinely as a poison treatment intervention in the home, according to new guidelines issued in November 2003 by the American Academy of Pediatrics (AAP). The AAP, reversing its long-standing guidelines, said the new recommendations are based on a lack of clear evidence of ipecac’s benefit and the risk of people abusing the product. Instead, in case of possible poisoning, parents should contact the national Poison Control Hotline at 1-800-222-1222, or contact a pediatrician.
For decades, doctors have recommended that parents keep a bottle of ipecac on hand to induce vomiting when children ingest something poisonous. The antidote, made from roots of the tropical ipecac plant, induces vomiting. In the past, recommendations for using ipecac had been based more on intuition rather on than any hard evidence that home use is effective. Although earlier recommendations advised parents to call a doctor or poison control center before using the syrup, parents have not always heeded that advice. Too often, parents used ipecac inappropriately.
Scientific advisers to the U.S. Food and Drug Administration (FDA) recommended in June 2003 that the agency end over-the-counter sales of ipecac. A final FDA decision was expected in 2004.
Poison-control centers have been phasing out ipecac because it sometimes caused prolonged vomiting and lethargy similar to drowsiness that could have been caused by an overdose of sedative pills. Those symptoms can complicate diagnosis and treatment. It also may not totally empty the stomach of poison, or may linger and cause a child to vomit up other antidotes.
Another study found that home use did not reduce emergency room visits and did not improve outcomes. It is based on an analysis of data from the American Association of Poison Control Centers, which also is preparing new ipecac guidelines.
Ipecac syrup that has not expired does not need to be thrown out, but parents should not use ipecac before consulting a physician. Alternative home treatments for poisoning, such as activated charcoal or natural products, have not been shown to be effective, and in some cases are not safe or feasible to administer. Because of this, the American Academy of Pediatrics does not recommend using these products at home.
In any case, charcoal is harder for parents to administer than ipecac, because children object to the tasteless, gritty solution. For this reason, many experts believe there is still a place for syrup of ipecac in the home, although it must always be given with poison control center guidance.
While the correct dosage should be prescribed by a doctor or poison control center, a typical dose for a child over age one is two tablespoons followed by at least two to three glasses of water—not milk. If the child has not vomited within 20 minutes, the dose may be repeated. If the child still does not vomit, the poison control center should be called for further instructions.
If possible, the child should vomit into a container so that the material can be identified by medical experts at a hospital. Vomiting is effective only if it occurs within four hours of ingestion of a solid substance, or within two hours of ingestion of a liquid.
However, ipecac syrup should no longer be used routinely as a poison treatment intervention in the home, according to new guidelines issued in November 2003 by the American Academy of Pediatrics (AAP). The AAP, reversing its long-standing guidelines, said the new recommendations are based on a lack of clear evidence of ipecac’s benefit and the risk of people abusing the product. Instead, in case of possible poisoning, parents should contact the national Poison Control Hotline at 1-800-222-1222, or contact a pediatrician.
For decades, doctors have recommended that parents keep a bottle of ipecac on hand to induce vomiting when children ingest something poisonous. The antidote, made from roots of the tropical ipecac plant, induces vomiting. In the past, recommendations for using ipecac had been based more on intuition rather on than any hard evidence that home use is effective. Although earlier recommendations advised parents to call a doctor or poison control center before using the syrup, parents have not always heeded that advice. Too often, parents used ipecac inappropriately.
Scientific advisers to the U.S. Food and Drug Administration (FDA) recommended in June 2003 that the agency end over-the-counter sales of ipecac. A final FDA decision was expected in 2004.
Poison-control centers have been phasing out ipecac because it sometimes caused prolonged vomiting and lethargy similar to drowsiness that could have been caused by an overdose of sedative pills. Those symptoms can complicate diagnosis and treatment. It also may not totally empty the stomach of poison, or may linger and cause a child to vomit up other antidotes.
Another study found that home use did not reduce emergency room visits and did not improve outcomes. It is based on an analysis of data from the American Association of Poison Control Centers, which also is preparing new ipecac guidelines.
Ipecac syrup that has not expired does not need to be thrown out, but parents should not use ipecac before consulting a physician. Alternative home treatments for poisoning, such as activated charcoal or natural products, have not been shown to be effective, and in some cases are not safe or feasible to administer. Because of this, the American Academy of Pediatrics does not recommend using these products at home.
In any case, charcoal is harder for parents to administer than ipecac, because children object to the tasteless, gritty solution. For this reason, many experts believe there is still a place for syrup of ipecac in the home, although it must always be given with poison control center guidance.
While the correct dosage should be prescribed by a doctor or poison control center, a typical dose for a child over age one is two tablespoons followed by at least two to three glasses of water—not milk. If the child has not vomited within 20 minutes, the dose may be repeated. If the child still does not vomit, the poison control center should be called for further instructions.
If possible, the child should vomit into a container so that the material can be identified by medical experts at a hospital. Vomiting is effective only if it occurs within four hours of ingestion of a solid substance, or within two hours of ingestion of a liquid.
