Ipecac was used in cough mixtures as an
expectorant or an
emetic from the 18th until the early 20th century. For instance, ipecac and
opium were used to produce
Dover's powder, which was used in syrup form. In 1965, the
Food and Drug Administration (FDA) approved the sale of up to one ounce of syrup of ipecac without a prescription. At the time it was approved, its use was recommended by the
American Academy of Pediatrics,
American Association of Poison Control Centers,
American Medical Association, and the FDA's medical advisory board as a method to induce vomiting "for quick first-aid use in the home, under medical supervision", for use in cases of accidental
poisoning. Current guidelines from the
American Academy of Pediatrics, however, strongly advise against this and in fact recommend the disposal of any syrup of ipecac present in the home. Many toxicological associations have also issued position papers recommending against its use as a first-line treatment for most ingested poisons, because of a lack of evidence that syrup of ipecac actually helps improve the outcome in cases of poisoning. Moreover, accidental overdose of ipecac can result when administered in the home. When dealing with poisoning cases in the hospital, it became difficult to obtain a
differential diagnosis when syrup of ipecac had been administered, as this can add further symptoms. A 2005 review by a
Health Resources and Services Administration-funded scientific panel concluded that vomiting alone does not reliably remove poisons from the
stomach. The study suggested that indications for use of ipecac syrup were rare, and patients should be treated by more effective and safer means. Additionally, its potential
side effects, such as
lethargy, can be confused with the poison's effects, complicating
diagnosis. The use of ipecac may also delay the use of other treatments (e.g.,
activated charcoal,
whole bowel irrigation, or oral
antidotes) or make them less effective.
Misuse Ipecac has been used by people with
bulimia nervosa as a means to achieve
weight loss through induced
vomiting. Repeated use in this manner is believed to cause damage to the heart and muscles, which can ultimately result in the user's death. Misuse of ipecac has been considered a possible cause of death of singer
Karen Carpenter in 1983 who suffered from anorexia nervosa. It has also been used as an agent for
Münchausen syndrome by proxy. == Mechanism of action ==