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Ipecac Side Effects

Medically reviewed by Last updated on Jun 17, 2022.

Applies to ipecac: oral syrup.


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]


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


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


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


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Further information

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Some side effects may not be reported. You may report them to the FDA.