Syrup of Ipecac OTC or not OTC?. Milton Tenenbein, MD Nonprescription Drug Advisory Committee Bethesda MD; June 12, 2003. Syrup of Ipecac OTC or not OTC?. That is the question. Objectives. to discuss the need for OTC status of syrup of ipecac
Milton Tenenbein, MD
Nonprescription Drug Advisory Committee
Bethesda MD; June 12, 2003
That is the question.
1. Role of gut decontamination?
2. Role of ipecac in gut decontamination?
2a. Benefits and risks of ipecac?
2b. Literature assessment of benefits/risk?
2c. Remote populations?
3. Abuse potential of syrup of ipecac?
4. What are alternatives to ipecac?
1. Child resistant closures
2. Safer medications
Gastrointestinal decontamination is cardinal principle in the management of the overdose patient.
Clin Toxicol 1981;18:969-972
“The ipecac story is but another example of a seemingly sensible preventive health strategy being universally recommended and widely accepted before its efficacy and validity has been established.”
There are no data that support benefit for the patient from ipecac in the home.
There are data that support lack of benefit for the patient treated with ipecac in the hospital.
decreased hospital visits
“Home use of ipecac was very weakly associated with increased, not decreased referral to the ED.” *
* Bond GR. Home syrup of ipecac use after pediatric pharmaceutical exposure does not reduce emergency department use or improve outcome. Pediatrics, in press.
Charcoal in the Home
Clin Pediatr Emerg Med 2000;1:191-194
Role of gut decontamination?
Role of ipecac in gut decontamination?
Benefits and risks of ipecac?
Literature assessment of benefits/risk?
Abuse potential of syrup of ipecac?
What are alternatives to ipecac?
Since the use of ipecac in the home will no longer be recommended and since there is a potential for its misuse and abuse, it makes no sense for it to remain as an OTC drug.