We have reported a fatal complication of a therapeutic dose of
ipecac syrup administered in a hospital emergency room. This child received 15 ml of
ipecac syrup shortly after ingesting one to five
tablets of
chlorpheniramine maleate (4 mg). A prolonged course of
vomiting (more than 24 hours) eventually resulted in
gastric rupture and death. While the use of
ipecac is both efficacious and safe in the overwhelming majority of cases, there have been documented fatalities after appropriate doses. For this reason, ongoing education for physicians is important; education of parents is also warranted since wide-scale distribution to families is the accepted standard. Because most patients stop
vomiting within two to three hours after
ipecac administration, we recommend that children with persistent
vomiting should be observed in a medical facility, where
electrolyte levels can be measured and fluids can be replaced if necessary.