Classifications: emetic; Therapeutic: emetic
Pregnancy Category: C
15 mL, 30 mL doses
Derived from dried roots of Cephaelis ipecacuanha. Contains cephaeline (produces emesis) and emetine, a toxic alkaloid that is excreted slowly from the body. Emetine can
cause potentially fatal cumulative toxicity with repeated use. It appears to inhibit protein synthesis and energy production
in muscle tissue with resultant skeletal and cardiac muscle toxicity.
Acts locally on gastric mucosa and centrally on chemoreceptor trigger zone (CTZ) in the medulla to induce vomiting.
Emergency emetic to remove unabsorbed ingested poisons.
Comatose, semicomatose, inebriated, deeply sedated patients; patients in shock; patients with depressed gag reflex; seizures,
active or impending; treatment of ingested strong alkali, acids, or other corrosives, strychnine, petroleum distillates,
volatile oils, or rapid-acting CNS depressants; pregnancy (category C), lactation, infants <6 mo
Impaired cardiac function; elderly; arteriosclerosis; cerebovascular disease; head trauma.
Route & Dosage
Adult: PO 30 mL followed by 12 240 mL (8 oz) glasses of water, may repeat once in 20 min if necessary
Child: PO >1 y, 15 mL followed by 12 240 mL (8 oz) glasses of water, may repeat once in 20 min if necessary; <1 y, 510 mL followed by 120240 mL (48 oz) of water, may repeat once in 20 min if necessary
- Do not confuse with ipecac fluid extract, which is 14 times stronger and has caused deaths when mistakenly given at the
same dosage as ipecac syrup.
- Do not induce vomiting if victim is unconscious, semiconscious, or convulsing.
- Store in tight containers at temperature not exceeding 25° C (77° F).
Adverse Effects (≥1%)Body as a Whole:
Achy, stiff muscles, severe myopathy, convulsions, coma. CV: Cardiomyopathy, cardiotoxicity,
cardiac arrhythmias, atrial fibrillation, tachycardia, chest pain, dyspnea, hypotension, fatal myocarditis. GI:
Diarrhea, mild GI upset. If drug is not vomited but absorbed or if ipecac overdosage: persistent vomiting,
gastroenteritis, bloody diarrhea, sensory disturbances, stomach cramps, tremor.
1530 min. Duration:
25 min. Elimination:
Metabolite can be detected in urine up to 60 d after excessive doses.
Assessment & Drug Effects
- Note: Emetic effect occurs in 1530 min and continues for 2025 min. If vomiting does not occur in 2030 min, repeat
- Contact physician immediately if vomiting does not occur within 1520 min after a second dose. Dosage should be recovered
by gastric lavage and activated charcoal if necessary.
- Note: Ipecac syrup can be cardiotoxic if not vomited and allowed to be absorbed.
- Report immediately to physician if vomiting persists longer than 23 h after ipecac syrup is given.
Patient & Family Education
- Call an emergency room, poison control center, or physician before using ipecac syrup.