Ipecac Syrup (Oral)

Ipecac syrup is an oral medication taken by mouth to induce vomiting after certain types of poisonous substances have been ingested.

Overview

The only form of Ipecac that should be used is the syrup as it is the appropriate strength to treat poison ingestion. Ipecac products that are labeled as Ipecac Fluidextract or Ipecac Tincture should not be used to treat poisoning as these forms of the medication are too strong and could cause severe side effects or death.

Do not use Ipecac if strychnine or high aspiration substances such as gasoline, kerosene, paint thinner or cleaning fluid corrosives such as alkalines or strong acids have been ingested. Using Ipecac with these types of poisons can cause pneumonia, throat injury or seizures.

Ipecac should not be used as a weight-loss medication as this can result in serious heart problems or death.

Ipecac should be taken as soon as possible after ingestion of a toxic substance for maximum benefit. The syrup begins working within 15 to 60 minutes and is more effective when taken with water.

Conditions Treated

  • Emergency treatment for some poisons
  • Bronchitis in children (associated with Croup)
  • Amoebic Dysentery (a severe form of diarrhea)
  • Coughing (as an expectorant)
  • Loss of appetite

Type Of Medicine

  • Emetic

Side Effects

Along with Ipecac's desired effects, this medication may also cause a variety of side effects. While not all side effects may occur in everyone, if they do occur, you may need to seek immediate medical attention.

Overdose of Ipecac may cause irregular or fast heartbeat, prolonged vomiting or continued vomiting (for more than 30 minutes), impaired peripheral vascular circulation, trouble breathing, hepatic and renal dysfunction, diarrhea, unusual lethargy or weakness, hypothermia, dental problems, asthma, interstitial edema, rhinitis, stomach pain or cramps, or aching and stiffness of muscles in the neck, arms and legs.

Cardiovascular system side effects include heart palpitations, decreased cardiac function, hypotension, or tachycardia. Patients with existing cardiovascular issues have experienced vascular hemorrhage due to emesis-induced increase in blood pressure.

Chronic administration can result in repeated vomiting which can cause metabolic changes such as dehydration and electrolyte imbalances.

Side effects to the respiratory system include mediastinal emphysema, a condition where air is present in the space between the lungs (also known as mediastinum). Other respiratory effects include Aspiration pneumonitis (obstruction of the airway) and pneumonia.

Gastrointestinal side effects can include protracted vomiting, diarrhea, esophagitis, strictures, ulcerations, and Esophageal Mallory-Weiss tears, which are tears in the inner lining where the stomach meets the esophagus.

Nervous system side effects can include lethargy, irritability and increased drowsiness.

Musculoskeletal side effects have been seen, including muscular stiffness and weakness and toxicity of the muscles due to emetine accumulation from higher dosages.

Other side effects from chronic use of Ipecac can include rash and dry skin.

Patients with eating disorders can abuse Ipecac, particularly those patients with anorexia or bulimia.

Seek medical attention immediately if any of the side effects listed here occur while taking Ipecac.

Dosage

This medication should only be taken as directed by your physician and given to persons who are fully conscious. Unless otherwise directed, this medication should not be taken in larger doses or more often than recommended. Higher than recommended doses can result in damage to the heart, muscles, and could result in death.

Dosing of Ipecac is different for different and you should always follow your doctor's orders when taking this medication. If your prescribed dosage is different than what is listed here, do not change it unless under the advice of your physician.

The recommended dosage of Ipecac syrup for treatment of poison ingestion include:

  • Adults and teenagers: 1 to 2 tablespoons (or 15 to 30 milliliters) immediately followed by 240 ML of water (one full glass). If vomiting does not occur within 20-30 minutes, doses of 1-2 tablespoons may be taken once. If vomiting has not occurred after the second dose, you should immediately see your doctor or go to the emergency room.
  • Children from 1 to 12 years of age: 1 tablespoonful (or 15 milliliters) immediately followed by 120 ML -240 ML of water (one half to one full glass) before or after the dose. If vomiting does not occur within 20-30 minutes, another dose of 1 tablespoonful may be taken once. If vomiting has not occurred after the second dose, you should immediately see your doctor or go to the emergency room.
  • Children 6 months to 1 year of age: 12 teaspoons (5 to 10 milliliters) immediately followed by 120 ML -240 ML of water (one half to one full glass) before or after the dose. If vomiting does not occur within 20-30 minutes, another dose of 1 -2 teaspoons may be taken once. If vomiting has not occurred after the second dose, you should immediately see your doctor or go to the emergency room.
  • Children under 6 months of age: Ipecac should not be given to children under 6 months of age unless supervised by your physician.

This medication should not be taken with carbonated beverages, milk or milk products. Carbonated beverages taken with this medication could cause swelling of the stomach and milk or milk products may prevent this medication from working effectively.

This medication should not be given to drowsy persons as vomiting while drowsy or unconscious could cause the vomited substance to enter the lungs and cause pneumonia.

If your physician has advised you to take this medication along with activated charcoal for poisoning treatment, wait to take the activated charcoal until after you have taken this medication and vomiting has ceased; approximately 30 minutes. Once you have stopped vomiting, then you can take the activated charcoal.

A 30 milliliter dose of Ipecac contains approximately 21 milligrams of emetine. A lethal dose of Ipecac contains approximately less than or equal to 20 milligrams/kilograms of emetine. Emetine is slowly flushed out through the kidneys and can accumulate through chronic use of Ipecac.

Ipecac comes in varying strengths; the dosage of medicine you take will depend on the strength of the medicine. The problem for which you are taking this medicine will affect the amount of each dose, the number of doses per day, the time between doses, and the length of time you take this medication.

Interactions

Always tell your physician about any prescription or over-the-counter medications, supplements, or vitamins you are currently taking when being prescribed this medication. It is important to keep a list of any medication you are taking with you to the doctor so you can be sure to let them know as this medication does interact with other drugs.

Ipecac has been known to have moderate interactions with medications containing charcoal. Activated charcoal can bind the syrup of Ipecac and decrease its effectiveness.

The following charcoal products are known to interact with Ipecac:

  • Actidose Plus Sorbitol
  • Actidose with Sorbitol
  • Actidose-Aqua
  • Actidose-Aqua Advanced
  • Activated Charcoal
  • Active Carbon
  • Carbomix
  • Carbsorb X
  • Char-Flo with Sorbitol
  • Charcoaid
  • Charcoaid 2000
  • Charcoaid-G
  • Charcoal
  • Charcoal Plus DS
  • Charcoal/Simethicone
  • Charcocaps
  • Charcodote
  • Charcotabs
  • Charcotrace
  • Chem Mart Nasal Decongestant Capsules
  • Eucarbon
  • EZChar
  • Flatulex
  • Healthstream Activated Charcoal
  • Insta-char
  • Insta-Char with Sorbitol
  • JL Bragg's Medicinal Charcoal
  • Karbons
  • Liqui-Char
  • Liqui-Char with Sorbitol
  • Medicoal
  • Norit
  • Optimum Charcoal
  • Pharmacia Carbosorb

There are no other known medications that interact with Ipecac, however, always consult with your physician on all medications you are taking when being prescribed Ipecac.

Warnings

Before taking this medicine, you must weigh the risks of taking it against the benefits. You should discuss this with your doctor and take the following into consideration:

  • Interactions with other medications: While this medication should not be used with the medications listed in the Interactions section, sometimes these medicines can be taken together. In this case, your doctor may want to adjust your dosage or take additional precautions. Always consult with your physician about any over-the-counter or prescription medications or vitamins/supplements you are taking to ensure you will not trigger a bad interaction with Ipecac.
  • Allergic Reactions: Consult with your physician if you have had any unusual or allergic reaction to any medication, including Ipecac. Also let your physician know if you have allergies to dyes, foods, animals, or preservatives. When taking the non-prescription form of this medication, read the label ingredients carefully.
  • Pediatric Use: Before giving Ipecac to an infant or young child (particularly under the age of 6 moths), contact a poison control center near you, your physician, or an emergency room for instructions on how to administer this drug. Infants and young children are at a greater risk of choking on their vomit when taking Ipecac.
  • Geriatric Use: This medication is safe for use in older adults. Tests have shown side effects are no different in geriatric patients than in younger adults and children.
  • Breast Feeding: Studies show that women who are breastfeeding can take this medication with minimal risk to the infant.

Storage

This medication should be stored in a closed container at room temperature, away from direct light, moisture and heat. Do not freeze this product.

Always keep this product out of the reach of children.

Do not keep this medication after its expiration date or after you no longer need it.

Once you have opened the bottle of Ipecac, it may evaporate over time and should be replaced with a new bottle.

Summary

Ipecac syrup is beneficial to treat poison ingestion in children and adults; however, it should not be used when substances such as strychnine, gasoline, kerosene, paint thinner, cleaning fluid corrosives, alkalies or strong acids have been ingested.

This medication should always be taken as directed and taken with water.

This medication has specific doses for adults and children and should be taken as directed by your physician or as per the label instructions.

This medication's main adverse reaction is with charcoal products. While it can be taken with charcoal products, these should only be combined under the supervision of your physician.

When used correctly, Ipecac can induce vomiting and relieve symptoms of certain poisons that have entered the body.