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1994.10.15 :  Dosing Syringes Warning

Contact:  Sharon Snider (301) 443-3285
October 15, 1994
                                                            
               FDA URGES CAUTION WITH DOSING SYRINGES


     The Food and Drug Administration today alerted parents and
caregivers to use caution when giving liquid medicine to infants,
children and the elderly.

      The agency urged particular caution in the use of dosing
syringes.  These syringes, sometimes dispensed by doctors and
pharmacists, do not contain needles and are used for giving liquid
medicine.

     The syringes come with plastic caps that could accidentally
fall off into the medicine bottle or into the patient's mouth.  FDA
has received reports of syringe caps being found in liquid medicine. 
There have also been two reports of infants choking on syringe caps
and two reports of caps being swallowed.  This is particularly apt
to happen with syringes that allow medicine to be drawn and given
with the cap in place.

     Although no deaths or permanent harm occurred in the four
incidents, FDA is discussing these issues with syringe manufacturers
and has alerted the medical community to the potential problem.

     "Dosing syringes can be easy to use and help ensure that
patients get the right amount of medicine," said FDA Commissioner
David A. Kessler, M.D.  "However, they have to be used correctly or
they can cause harm."

     To prevent problems, parents and caregivers should be sure to
remove the caps from all oral syringes before drawing medicine or 
giving it to a patient.  Once removed, the cap should be discarded. 
In most cases, it is not necessary to recap the syringe.

      FDA also reminds parents and caregivers to avoid inadvertently 
over- or underdosing patients when using medication cups.  The cups
often are provided as caps for bottles of nonprescription liquid
medications for colds and flu, providing a convenient measure.

     FDA has received numerous reports in which parents misread the
medication cup markings, used a dose cup from the wrong bottle of
medicine, or misread the directions, providing children with several
times the recommended dosage.

     Even seemingly low doses of the common painkiller
acetaminophen--if over the recommended amount--can be dangerous if
given over a period of several days.

     "If the label says to give two teaspoonsful every four hours,
that's the amount the child or elderly person should get at the
prescribed intervals,"  Kessler said.

     FDA has taken steps to ensure that the labeling of all
nonprescription liquid medicines is compatible with their dose cups
and that the cups are easily readable.

     The agency advises against the use of standard tableware 
teaspoons and tablespoons when giving medicine to children and the
elderly because they generally cannot be used to measure liquids
accurately.

     FDA is one of eight Public Health Service agencies in HHS.

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