Syrup of ipecac, an over-the-counter drug used to induce vomiting and a staple in medicine chests for use in poisoning cases, also is being abused by people with eating disorders, doctors write in the journal Pediatrics.
"More than 35,000 Americans who have anorexia nervosa-bulimia syndromes are abusing syrup of ipecac repeatedly to induce vomiting after eating and bingeing," wrote Drs. Gerald Ente and Paul H. Penzer of Wensbury, N.Y.
Abused in that way regularly, the drug can cause heart damage and was cited in the death of singer Karen Carpenter.
Such cases have led for calls to make syrup of ipecac a prescription drug, a proposal opposed by doctors from three cities in the journal's January issue:
Ente and Penzer wrote that requiring a prescription would be a mistake but that "the medical community needs to be made aware of this double-edged sword."
"We support a change in the labeling . . . that alerts the public to the dangers of repeated chronic use" of the drug, wrote Drs. Peter A. Czajka and Steven L. Russell of the University of Tennessee.
Requiring a prescription "would limit its availability for emergency use," wrote Dr. Barry H. Rumack of the University of Colorado. But he said syrup of ipecac should be kept "behind the counter" and provided "only on request," with a limit of one or two bottles to a customer.