Ipecac Syrup

Trade Names:
Available as generic only
- Syrup Ipecac, USP

Pharmacology

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Produces vomiting by local irritant effect and stimulation of chemoreceptor trigger zone.

Pharmacokinetics

Elimination

Eliminated very slowly. May be detected up to 60 days in urine.

Peak

Within 20 to 30 min.

Duration

20 to 25 min.

Indications and Usage

Treatment of drug overdose and certain poisonings.

Contraindications

Do not use in semiconscious, unconscious, pregnant, or lactating persons; do not use if strychnine, corrosives (eg, alkalis, strong acids), or petroleum distillates have been ingested.

Dosage and Administration

PO 15 to 30 mL followed by 3 to 4 glasses of water. May repeat dose within 20 min if vomiting does not occur.

PO 5 to 10 mL followed by 1/ 2 glass of water.

PO 15 mL followed by 1 to 2 glasses of water.

General Advice

• Consult poison control center before administering.
• Have patient sit upright with head forward before administering dose and for 30 min or more after administration.
• Do not give if patient has ingested caustic substances or oils.

Drug Interactions

Will absorb ipecac syrup. Give activated charcoal only after ipecac syrup has produced vomiting.

Do not administer with ipecac syrup.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Heart conduction disturbances; atrial fibrillation; fatal myocarditis.

CNS

Depression.

GI

Diarrhea.

Precautions

Pregnancy

Category C .

Lactation

Undetermined.

Abuse

Severe cardiomyopathies and death may occur in bulimic and anorexic persons abusing ipecac syrup.

Syrup/Fluid extract

Do not confuse ipecac syrup with ipecac fluid extract, which is 14 times stronger and has caused some deaths.

Overdosage

Symptoms

Cardiac conduction disturbances, bradycardia, atrial fibrillation, hypotension, fatal myocarditis.

Patient Information

• Caution parents not to induce vomiting if child has swallowed caustic substance or petroleum product, or if child is unconscious, semiconscious, or having convulsions.
• Instruct parents of children younger than 1 yr to keep small amount (one 30 mL bottle) on hand for emergencies.
• Instruct parents to always consult health care provider or poison control center before administration.
• Teach parents not to exceed recommended amounts.
• Teach families to give drug with adequate amounts of water, not milk or carbonated beverages.
• Advise parents that drug has shelf life of 1 yr and should be replaced yearly. Instruct parents to check expiration date before purchasing product.
• Do not give ipecac syrup to an unconscious or drowsy child because vomited material may enter lungs and cause pneumonia.
• Teach parents to repeat dose if child does not vomit within 20 min and then to take child to emergency room, because gastric lavage may be necessary.

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