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FDA may reconsider ipecac's OTC status

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For nearly 40 years, ipecac syrup has been a medicine-cabinet staple in homes with young children. But many experts now say it's useless in treating poisoning and actually could cause harm.

Doubts about the value of ipecac syrup, which induces vomiting, have spurred the Food and Drug Administration to consider whether it should remain available over the counter.

The FDA's Non-Prescription Drug Advisory Committee is scheduled to review the drug's status Thursday. The agency is not bound by its advisory committees, but it usually follows their recommendations.

Because medical experts believed ipecac syrup should be readily available at home for emergency treatment of poisonings, it has been sold without a prescription ever since coming on the market in 1965. The FDA has always required that its label state: ''Before using, call physician, the Poison Control Center, or hospital emergency room.''

Toxicologist Michael Shannon of the Massachusetts-Rhode Island Poison Control Center says use of ipecac syrup has plummeted since the American Academy of Clinical Toxicology issued a position statement on it in 1997. After studying the question for two years, the toxicology group concluded that ''syrup of ipecac should not be administered routinely in the management of poisoned patients.''

Ipecac syrup probably doesn't help because the stomach contents move on to the intestines far more quickly than once thought, says Shannon, chief of emergency medicine at Boston's Children's Hospital. Even if you take ipecac within minutes of swallowing a poison, you'll expel only about 30% of it, he says.

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