ipecac

More about Ipecac: Purpose Recommended dosage Precautions Side effects Interactions Resources

Definition

Ipecac is a medicine commonly used to induce vomiting in cases of accidental poisoning. It is also a homeopathic remedy.

Description

The medicinal effects of ipecac were recognized centuries ago by the Portuguese who settled in South America. They found a plant that can make people vomit and appropriately named it Caephalis ipecacuanha, meaning sick-making plant. Syrup of ipecac is now considered the safest drug to treat poisoning and is often the most effective. There are different types of ipecac preparations that vary greatly in strength. Syrup of ipecac is best for use at home to treat accidental poisoning. Ipecac fluid extract and ipecac tincture should be avoided as they are much stronger compounds and can be toxic.

Ipecacuanha is a homeopathic remedy made from ipecac by a process of dilution and succussion (shaking). In contrast to syrup of ipecac, it is given to relieve vomiting.

— Mai Tran

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(ĭp'ĭ-kăk'yū-ăn'ə)
n.

1. 1. A low-growing tropical American shrub (Cephaelis ipecacuanha) having roots and rhizomes that yield emetine.
   2. The dried roots and rhizomes of this shrub.
2. A medicinal preparation made from the dried roots and rhizomes of this shrub that is used to induce vomiting, particularly in cases of poisoning and drug overdose.

[Short for Portuguese ipecacuanha, from Tupi ipekaaguéne : ipeh, low + kaâ, leaves + guéne, vomit.]

For more information on ipecac, visit Britannica.com.

Drug Forms:
• Ipecac oral syrup (below)
• Ipecac Oral syrup

Español:
• Jarabe oral de ipecacuana
• Ipecacuana, Jarabe oral

Ipecac oral syrup

What is ipecac oral syrup?

IPECAC SYRUP is used as an emergency treatment for certain kinds of poisoning or drug overdose. When the syrup is taken by mouth, it causes vomiting of the poison or drug. However, always check with your poison control center before taking or giving ipecac to another person; not all poisonings should be treated with ipecac syrup. The National Poison Control Hotline (1—800—222—1222) will connect you to the nearest Poison Control Center. Ipecac syrup is currently available without a prescription.

What should I tell my health care provider before I take this medicine?

They need to know if you or the person that will receive ipecac have any of these conditions (get emergency help as soon as you can):
• an inability to vomit
• bleeding in the head, head tumor, intracranial hypertension, or recent head injury
• coma, or possibility of falling into a coma
• confusion
• heart disease
• neuromuscular disease
• poisoning with petroleum products (such as kerosene, gasoline, fuel oil, paint thinner, or cleaning fluids)
• recent heavy alcohol use
• seizures (convulsions)
• severe drowsiness or tiredness
• shock
• strong acid or alkali poisoning (such as caustic soda, lye, drain cleaners, oven cleaners, or automatic dishwasher detergent)
• strychnine poisoning
• stroke or transient ischemic attack (TIA)
• an unusual reaction to ipecac, other medicines, foods, dyes, or preservatives
• pregnant
• breast-feeding

How should I take this medicine?

Only take ipecac syrup if directed by your emergency health care provider or poison control center; seek emergency help and advice right away.

If ipecac treatment is appropriate, give ipecac as soon after ingestion of the poison or drug overdose as possible; ideally, within 1 hour. Follow the directions on the label. Shake well before using. Use a specially marked spoon or container to measure the medicine; household spoons are not always accurate. Take ipecac syrup by mouth while standing or seated. Take with plenty of water (8 ounces for adults or 4 ounces for small children). Do not take with milk or food. The water may be given first in the case of small or scared children. Do not lie down for at least an hour after taking ipecac.

Vomiting may not occur for 20 minutes after taking ipecac. If vomiting does not occur within 20 minutes, repeat the dose. If vomiting does not occur after the second dose, follow the instructions provided by your health care provider or poison control center. Do not take more than the recommended dose, do not take extra doses, and do not take more often than directed.

What if I miss a dose?

This does not apply.

What drug(s) may interact with ipecac?

• alcohol
• charcoal
• medicines that treat nausea and vomiting (examples: promethazine, granisetron, ondansetron, prochlorperazine and thiethylperazine)

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking ipecac?

Contact your nearest poison control center or the National Poison Control hotline (1—800—222—1222) before you take ipecac or give ipecac to another person. Some poisonings or overdoses should not be treated with ipecac syrup.

Do not take ipecac syrup with milk or food.

Do not give ipecac syrup to an unconscious, very confused, or drowsy person.

What side effects may I notice from taking ipecac?

Side effects that you should report to your prescriber or health care professional as soon as possible:
• black, tarry stools
• dizziness or fainting spells
• fast or irregular heartbeat
• cough, chest pain, or trouble breathing
• coughing up blood
• fever
• muscle weakness or stiffness
• nausea or vomiting that lasts longer than 2 hours
• severe diarrhea
• severe headache
• unusual tiredness

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• stomach pain
• diarrhea
• drowsiness

Where can I keep my medicine?

Store unopened bottles at room temperature, approximately 25 degrees C (77 degrees F). Keep out of the reach of children.

Throw away any unused portion after opening the bottle. Throw away and replace your unopened bottle of ipecac after the expiration date.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

Description

There are two categories of ipecac preparations—a syrup used in standard medical practice and a homeopathic remedy. They are given for different purposes. The medicinal effects of ipecac were recognized centuries ago by the Portuguese who settled in South America. They found a plant that can make people vomit and appropriately named it Cephalis ipecacuanha, meaning sick-making plant. Nowadays, ipecac is used to treat a variety of conditions. Its most widely accepted use is to induce vomiting in cases of accidental poisoning. When ipecac is swallowed, a substance in it called cephaeline irritates the stomach and causes vomiting. Syrup of ipecac is now considered the safest drug to treat poisoning and is often the most effective. There are different types of ipecac preparations that vary greatly in strength. Syrup of ipecac is best for use at home to treat accidental poisoning. Ipecac fluid extract and ipecac tincture should be avoided, as they are much stronger compounds and can be toxic.

Ipecacuanha is a homeopathic remedy made from ipecac by a process of dilution and succussion (shaking). In contrast to syrup of ipecac, it is given to relieve vomiting.

General Use

Treatment of Poisoning

Standard medical practice uses ipecac to cause vomiting in cases of poisoning in order to remove the toxic substance from the stomach before absorption occurs. It can be used on animals as well as humans. Ipecac is safer and more effective than many other methods for inducing vomiting, such as sticking a finger down a child's throat or using saltwater. There are times, however, when ipecac should not be used because it can make certain kinds of poisoning worse. Syrup of ipecac should not be used if the poison is one of the following.

• strychnine
• alkalis (lye)
• strong acids
• kerosene
• fuel oil
• gasoline
• coal oil
• paint thinner
• cleaning fluid

Poisoning is a potentially serious condition. It is best to contact a local poison control center, local hospital emergency room, or the family doctor for instructions before using syrup of ipecac.

Ipecac's reputation for inducing vomiting has encouraged some bulimics to take it on a regular basis in order to purge the contents of the stomach after an eating binge. This misuse of ipecac is extremely dangerous; it can cause heart problems, tears in the esophagus or stomach lining, vomiting blood, seizures, or even death.

Homeopathy

The homeopathic remedy made from ipecac is called Ipecacuanha. Homeopathic preparations are given for a reason completely opposite from that of standard allopathic treatment. In homeopathy, ipecac is given to stop vomiting rather than to induce it. According to Hahnemann's law of similars, a substance that would cause vomiting in large doses when given to a healthy person will stimulate a sick person's natural defenses when given in extremely diluted and carefully prepared doses. Ipecacuanha is a favorite homeopathic remedy for morning sickness associated with pregnancy. It is also given to stop nausea that is not relieved by vomiting; when the vomitus is slimy and white; when there is gagging and heavy salivation; when the tongue is clean despite the patient's feelings of nausea; and when the patient is not thirsty. The nausea may be accompanied by a headache, cough, or heavy menstrual bleeding. The modalities (circumstances) that suggest Ipecacuanha as the appropriate homeopathic remedy is that the patient feels worse lying down; in dry weather; in winter; and when exercising or moving about.

A homeopathic practitioner would not necessarily prescribe ipecac for all cases of nausea. Arsenicum would be given when the nausea is caused by food poisoning and accompanied by strong thirst, Nux vomica when the nausea is the result of overindulgence in food or alcohol and accompanied by gas or heartburn. A sick child might be given Pulsatilla, particularly if rich foods have been eaten.

On the other hand, a homeopathic practitioner may prescribe ipecac for any of the following conditions that are not related to nausea and vomiting.

• nosebleeds producing bright red blood
• dental bleeding
• diarrhea with cramping abdominal pain. The stools are green with froth or foam.
• Asthma of sudden onset. The patient has to sit up in order to breathe, but cannot bring up any mucus in spite of violent coughing.
• hoarseness or loss of voice following a cold
• physical or mental exhaustion

Preparations

Syrup of Ipecac

Syrup of ipecac is made from the dried roots and rhizomes (underground stems) of Cephaelis ipecacuanha. It is available over the counter in 0.5–1 oz bottles. Larger bottles require a doctor's prescription. The dosage for infants under 6 months old should be prescribed by the family doctor or poison control center. For children six months to one year, the usual dose is 5–10 ml or 1–2 tsp. One-half or one full glass (4–8 oz) of water should be taken immediately before or after the dose. The dose may be repeated once after 20–30 minutes if vomiting does not occur. For children one to 12 years of age, the usual dose is 15 ml (1 tbsp) to be taken with one full glass (8 oz) of water. Adults and teenagers should take 15–30 ml of ipecac with at least 1 full glass of water. Syrup of ipecac should not be taken with milk or soda drinks as these foods may prevent it from working properly. If vomiting does not occur within 20–30 minutes after the first dose, a second dose may be needed. If the second dose fails to induce vomiting, the patient should be taken to a hospital emergency room.

If both activated charcoal and syrup of ipecac are recommended to treat poison, ipecac must be used first. Activated charcoal should not be taken until 30 minutes after taking syrup of ipecac, or until the vomiting caused by ipecac stops.

Homeopathic Preparations

Ipecacuanha is available as an over-the-counter remedy in 30x potency. This is a decimal potency, which means that one part of ipecac has been mixed with nine parts of alcohol or water; 30x means that this decimal dilution has been repeated 30 times. The dilute solution of ipecac is then added to sugar tablets so that the remedy can be taken in tablet form.

Precautions

Syrup of Ipecac

For inducing vomiting in cases of accidental poisoning, only the syrup form of ipecac should be used. Syrup of ipecac should not be mixed with milk or carbonated drinks as they may prevent vomiting. If syrup of ipecac is not immediately available in the home, it generally cannot be used. A 2002 report studied parents' attempts to administer the syrup upon calling a poison center when they felt they could obtain it within 15 minutes. However, actual time to administration was generally closer to 30 minutes. The report recommended that parents not be referred to purchase ipecac when their children have ingested a significant amount of a poisonous substance and the syrup is not already available in the home.

Syrup of ipecac should not be used in the following situations (contact poison control center or family doctor for alternative treatments).

• Poisoning caused by strychnine; sustained-release theophylline; such corrosive substances as strong alkalis (lye); strong acids (such as toilet bowl cleaner); and such petroleum products as kerosene, gasoline, coal oil, fuel oil, paint thinner, or cleaning fluids.
• Overdoses of medications given for depression.
• Excessive vomiting.
• A serious heart condition.
• Timing. Do not give ipecac more than 4–6 hours after the poison was ingested.
• Pregnancy.
• Very young children (less than six months old). Infants and very young children may choke on their own vomit or get vomit into their lungs.
• Drowsy or unconscious patients.
• Seizures.

Homeopathic Preparations

Ipecacuanha should not be given after Arsenicum or Tabac because these remedies will counteract it.

Side Effects

The following side effects have been associated with the use of syrup of ipecac.

• Loose bowel movements.
• Diarrhea.
• Fast irregular heartbeat.
• Inhaling or choking on vomit.
• Stomach cramps or pains.
• Coughing.
• Weakness.
• Aching.
• Muscle stiffness.
• Severe heart problems often occur in cases of ipecac abuse. Because ipecac stays in the body for a long time, damage to the heart frequently occurs in persons who repeatedly take ipecac to induce vomiting.
• Seizures. These are most likely to occur in patients who accidentally swallow ipecac or in ipecac abusers.
• Death. Deaths have been reported due to ipecac abuse in bulimic persons.

Homeopathic Ipecacuanha has been highly diluted and is relatively nontoxic.

Interactions

Ipecac should not be given together with other drugs because it can decrease their effectiveness and increase their toxicity. If both syrup of ipecac and activated charcoal are needed to treat suspected poisons, ipecac should be given first. Activated charcoal should not be given until vomiting induced by ipecac has stopped. Soda should also be avoided because it can cause the stomach to swell. The person should lie on the stomach or side in case vomiting occurs.

Homeopathic Ipecacuanha is considered complementary to Arnica and Cuprum. It is counteracted by Arsenicum and Tabac.

Resources

Books

Cummings, Stephen, MD, and Dana Ullman, MPH. Everybody's Guide to Homeopathic Medicines. New York: G. P. Putnam's Sons, 1991.

Ellenhorn's Medical Toxicology, 2nd ed. Baltimore: Williams & Wilkins, 1997.

Hammond, Christopher. The Complete Family Guide to Homeopathy: An Illustrated Encyclopedia of Safe and Effective Remedies. New York: Penguin Studio, 1995.

PDR Nurse's Drug Handbook. Montvale, NJ: Delmar Publishers, 2000.

Periodicals

J. Garrison, et al. "Effectiveness of Home Ipecac Syrup Administration When It Is Not Initially Available." Journal of Toxicology:Clinical Toxicology (August 2002): 618.

Organizations

American Foundation for Homeopathy. 1508 S. Garfield, Alhambra, CA 91801.

Homeopathic Educational Services. 2124B Kittredge St., Berkeley, CA 94704. (510) 649-0294. Fax: (510) 649-1955.

[Article by: Mai Tran; Teresa G. Odle]

The dried rhizome and roots of Cephaelis ipecacuanha or Cephaelis acuminata; used as an emetic or expectorant. Called also ipecacuanha; the common preparation is syrup of ipecac.

This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)

Dansk (Danish)
n. - [zool.] brækrod

Français (French)
n. - ipéca

Deutsch (German)
n. - Brechwurz

Ελληνική (Greek)
n. - (φυτολ.) ιπέκα, ιπεκακουάνα

Italiano (Italian)
ipecacuana

Português (Portuguese)
n. - ipecacuanha (f) (Bot.)

Русский (Russian)
ипекакуана, рвотный корень

Español (Spanish)
n. - ipecacuana

Svenska (Swedish)
n. - ipecacuanha (bot. el. farmakol.), kräkrot

中文（简体）(Chinese (Simplified))
吐根, 吐根树

中文（繁體）(Chinese (Traditional))
n. - 吐根, 吐根樹

한국어 (Korean)
n. - 토근(남아메리카산의 꼭두서닛과 식물의 뿌리)

日本語 (Japanese)
n. - トコン, 吐根

עברית (Hebrew)
n. - ‮איפקקואנה (שורש צמח דרום אמריקני, המשמש כמשלשל), השימוש באיפקקואנה כמשלשל‬

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