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2/3/2004

Poison Control Group Issues Ipecac Guidelines

Kate Traynor

The American Association of Poison Control Centers (AAPCC) has published guidelines for the administration of ipecac syrup outside the hospital setting.

Only in rare situations, AAPCC stated, might ipecac treatment be acceptable outside the hospital setting. Further, the drug should be administered only when all of the following conditions hold true:

  • Ipecac is not contraindicated,
  • The poisoning victim is at serious risk for toxic effects,
  • No effective alternative therapy exists to decrease gastrointestinal absorption of the poison,
  • Ipecac can be given 30-90 minutes after ingestion of the poison,
  • The patient will arrive at an emergency medical facility more than an hour after ingesting the poison,
  • Ipecac administration will not interfere with therapy administered at the emergency medical facility, and,
  • A poison center, emergency department physician, or other qualified health professional has been contacted and recommends the administration of ipecac for this specific instance of poisoning.

The association was unable to reach a consensus on whether ipecac should retain its nonprescription status or whether households with small children should keep a bottle of the product on hand, deferring instead to local poison control centers to make the determination for patients in their area.

The guidelines contain an extensive summary of published literature about the use of ipecac.

Last November, the American Academy of Pediatrics issued a policy statement advising parents and caregivers who keep ipecac on hand to dispose of the product. The academy concluded that ipecac, though generally considered safe, is noxious and has not been shown to be effective when administered in the home.