In a recent post, I spoke about the danger of the misuse of prescription diabetes medication by patients seeking to maximize weight-loss caused by this medication’s side-effects. Today, I want to discuss a substance that poses perhaps an even greater risk. It’s something that most parents have in their medicine cabinets; it is available without a prescription; it is a common over-the-counter medication (OTC); and it is associated with perhaps the most widely reported risk for misuse by patients with eating disorders.

I am talking about the tragically famed yet deadly OTC emetic called Ipecac®. Infamous, because it is associated with the death of anorexia sufferer Karen Carpenter. Deadly, because studies show that it can be fatal in as little as two doses. Tragic, because it is sometimes misused as a purging agent by eating disorder patients in order to repeatedly induce vomiting.

Ipecac® is intended solely for emergency use and the administration of Ipecac® syrup should occur only in response to a specific recommendation from a poison center, emergency room physician, or other qualified medical personnel. The dangers of unsupervised Ipecac® use cannot be overstated.

Put simply, unsupervised, improper use of the emetic can be fatal.The active ingredient, emetine, has a long (30-60 day) medication half-life. Therefore, repeated use of the substance can result in an accumulation of large amounts of the drug in the body over time. Eating Disorder patients who use the syrup to induce vomiting can develop irreversible myocardial toxicity.

In 2003, the American Association of Pediatrics (AAP) recommended to reverse their policy regarding home use of Ipecac®. The AAP had previously recommended that parents keep a one-once bottle of Ipecac® syrup in their homes for use in the event of an accidental ingestion of a toxic substance – but ONLY when advised to do so by a physician or poison control center. Today, the AAP urges parents to cease using the emetic for poison control and to no longer store the substance in their homes. In addition, the FDA is considering taking the remedy off the OTC shelves.

If you or someone you know has used the emetic, doctors advise a thorough medical exam (including a neuromuscular exam, an EKG and an echo-cardiogram) to determine if any damage has occurred to the heart muscle. If no damage to the heart muscle has occurred, full recovery is possible.

*Additional Resource: The National Poison Control Center at 1-(800)-222-1222.