The Demise of Ipecac

In 1965, at the urging of 4 organizations (the American Academy of Pediatrics, the American Medical Association, the American Association of Poison Control Centers, and the Food and Drug Administration’s [FDA’s] Medical Advisory Board), the FDA agreed to grant syrup of ipecac over-the-counter status.1,2 Over the previous 12 years, pediatricians and toxicologists were persuaded that the drug was both safe and effective for treatment of childhood poisonings, justifying its unrestricted availability. In 1985, the Academy recommended that ipecac be discussed with and given to parents at the 6-month (infant) visit.3,4 Although the efficacy of ipecac at improving outcome after childhood poisoning had not been rigorously proven and despite reports of failures,5 adverse outcomes,6,7 and even malicious use, the medication became an integral part of pediatric anticipatory guidance. Widespread use of ipecac in poisoned children was strongly advocated both because of its apparent ability to reduce morbidity and because it significantly reduced the need for emergency department referral.8 …