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Ipecac Side Effects

Not all side effects for ipecac may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to ipecac: oral syrup

In addition to its needed effects, some unwanted effects may be caused by ipecac. In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking ipecac, check with your doctor or nurse as soon as possible:

Symptoms of overdose (may also occur if ipecac is taken regularly)
  • Diarrhea
  • fast or irregular heartbeat
  • nausea or vomiting (continuing more than 30 minutes)
  • stomach cramps or pain
  • troubled breathing
  • unusual tiredness or weakness
  • weakness, aching, and stiffness of muscles, especially those of the neck, arms, and legs

For Healthcare Professionals

Applies to ipecac: oral syrup

General

Chronic ipecac abuse has occurred, particularly in patients with eating disorders (anorexia or bulemia). Chronic diarrhea, vomiting, colitis, muscle weakness, lethargy, hypothermia, impaired peripheral vascular circulation, elevated plasma CPK concentrations, cardiomyopathy, fever, hepatic and renal dysfunction, dental abnormalities, and interstitial edema have been reported.[Ref]

Cardiovascular

Each 30 mL of ipecac contains approximately 21 mg of emetine. An acute lethal dose is estimated to be less than or equal to 20 mg/kg of emetine. Emetine is slowly eliminated by the kidney (detectable in the urine 40 to 60 days after short term amebicide therapy) and accumulation occurs with chronic use.[Ref]

Cardiovascular side effects have included tachycardia, palpitations, prolonged QT and PR intervals, inverted T waves, ST segment abnormalities, decreased cardiac output, and hypotension. Vascular accidents or hemorrhage due to emesis-induced blood pressure increases have occurred in patients with cardiovascular dysfunction. Accumulation of the emetine alkaloid during chronic ingestion has resulted in toxic myopathy. Fatalities have occurred.[Ref]

Musculoskeletal

Musculoskeletal side effects have included skeletal muscle toxicity due to emetine accumulation with chronic dosing. Reversible myopathy with symptoms of weakness and stiffness has occurred.[Ref]

Gastrointestinal

Gastrointestinal side effects have included protracted vomiting (< 5%), diarrhea (16% to 26% in one case series), anorexia, and esophagitis. Esophageal Mallory-Weiss tears, strictures and ulcerations have also been reported.[Ref]

Nervous system

Nervous system side effects have included drowsiness (20%), lethargy, and irritability.[Ref]

Metabolic

Metabolic alterations such as electrolyte imbalance and dehydration have occurred with repeat vomiting during acute therapy and with chronic administration.[Ref]

Respiratory

Respiratory effects occurring during emesis have included aspiration pneumonitis, pneumomediastinum, and retropneumoperitoneum.[Ref]

Dermatologic

Dermatologic side effects have included rash or dry skin during chronic use of ipecac.[Ref]

References

1. Sutphen JL, Saulsbury FT "Intentional ipecac poisoning: Munchausen syndrome by proxy." Pediatrics 82 (1988): 453-6

2. McClung HJ, Murray R, Braden NJ, Fyda J, Myers RP, Gutches L "Intentional ipecac poisoning in children." Am J Dis Child 142 (1988): 637-9

3. Berkner P, Kastner T, Skolnick L "Chronic ipecac poisoning in infancy: a case report." Pediatrics 82 (1988): 384-6

4. Isner JM "Effects of ipecac on the heart." N Engl J Med 314 (1986): 1253

5. Dresser LP, Massey EW, Johnson EE, Bossen E "Ipecac myopathy and cardiomyopathy." J Neurol Neurosurg Psychiatry 56 (1993): 560-2

6. Friedman EJ "Death from ipecac intoxication in a patient with anorexia nervosa." Am J Psychiatry 141 (1984): 702-3

7. Friedman AG, Seime RJ, Roberts T, Fremouw WJ "Ipecac abuse: a serious complication in bulimia." Gen Hosp Psychiatry 9 (1987): 225-8

8. Dawson JA, Yager J "A case of abuse of syrup of ipecac resulting in death." J Am Coll Health 34 (1986): 280-2

9. Klein-Schwartz W, Gorman RL, Oderda GM, Wedin GP, Saggar D "Ipecac use in the elderly: the unanswered question." Ann Emerg Med 13 (1984): 1152-4

10. Adler AG, Walinsky P, Krall RA, Cho SY "Death resulting from ipecac syrup poisoning." JAMA 243 (1980): 1927-8

11. Schiff RJ, Wurzel CL, Brunson SC, Kasloff I, Nussbaum MP, Frank SD "Death due to chronic syrup of ipecac use in a patient with bulimia." Pediatrics 78 (1986): 412-6

12. Rosenberg NL, Ringel SP "Myopathy from surreptitious ipecac ingestion." West J Med 145 (1986): 386-8

13. Palmer EP, Guay AT "Reversible myopathy secondary to abuse of ipecac in patients with major eating disorders." N Engl J Med 313 (1985): 1457-9

14. Bennett HS, Spiro AJ, Pollack MA, Zucker P "Ipecac-induced myopathy simulating dermatomyositis." Neurology 32 (1982): 91-4

15. Siegel AJ "Effects of ipecac on the heart." N Engl J Med 314 (1986): 1254

16. Brotman MC, Forbath N, Garfinkel PE, Humphrey JG "Myopathy due to ipecac syrup poisoning in a patient with anorexia nervosa." Can Med Assoc J 125 (1981): 453-4

17. Mateer JE, Farrell BJ, Chou SS, Gutmann L "Reversible ipecac myopathy." Arch Neurol 42 (1985): 188-90

18. Tandberg D, Liechty EJ, Fishbein D "Mallory-Weiss syndrome: an unusual complication of ipecac-induced emesis." Ann Emerg Med 10 (1981): 521-3

19. Nagao T, Ibayashi S, Fujii K, Sugimori H, Sadoshima S, Fujishima M "Treatment of warfarin-induced hair loss with ubidecarenone." Lancet 346 (1995): 1104-5

20. Persson CG "Ipecacuanha asthma: more lessons." Thorax 46 (1991): 467-8

21. Kulig K "Effects of ipecac on the heart." N Engl J Med 314 (1986): 1254

22. Spadaro A, Riccieri V, Siliscavalli A, Sensi F, Taccari E, Zoppini A "Comparison of cyclosporin a and methotrexate in the treatment of psoriatic arthritis: a one-year prospective study." Clin Exp Rheumatol 13 (1995): 589-93

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.

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