Position Statement: Syrup of Ipecac Use in the Home

Purpose:

To define the position of the Minnesota Regional Poison Center (MRPC) on the use of syrup of ipecac in potential poisonings.

Position Statement:
Syrup of Ipecac should no longer be used routinely as a home treatment strategy.  The first action for a caregiver of a child who may have ingested a toxic substance should be to consult the Poison Center. Syrup of ipecac may have some utility, especially in rural areas, under very limited circumstances, and after contacting a poison center. The MRPC does not advocate purchasing syrup of ipecac, but keeping existing syrup of ipecac on hand until the expiration date is acceptable.

Rationale:
In 2003, the MRPC used syrup of ipecac in only 69 of 31,039 pediatric exposure cases (0.2%). Although syrup of ipecac will induce vomiting in a high percentage of patients in whom it is administered, its effectiveness in preventing drug absorption has been demonstrated for only a few substances and only if administered promptly after ingestion.1,3   Furthermore, clinical trials have not adequately demonstrated that syrup of ipecac positively affects patient outcome.1,3  The use of syrup of ipecac is an unpleasant therapy, which may result in persistent vomiting and could delay or complicate other therapies.2  The potential value in the small percentage of patients who may benefit from its use are outweighed by these shortcomings.2,3 

References:

1. Position statement: ipecac syrup. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. J Toxicol Clin Toxicol. 1997;35(7):699-709.

2.  AAP Committee on Injury, Violence, and Poison Prevention.  Policy Statement: Poison Treatment in the Home. Pediatrics 2003; 112(5): 1182-1185.

3.  American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists.  Position Paper: Ipecac Syrup.  J Toxicol Clin Toxicol 2004; 42(2): 133-143.