Brazil Root, Brazilian Ipecac, Callicocca ipecacuanha, Cartagena Ipecac, Cephaelis acuminata, Cephaelis ipecacuanha, Ipéca, Ipéca du Brésil, Ipéca du Nicaragua, Ipéca du Panama, Ipecacuana, Ipécacuana, Ipecacuanha, Matto Grosso Ipecac, Nicaragua Ipecac, Panama Ipecac, Psychotria ipecacuanha, Racine Brésilienne, Rio Ipecac, Uragoga granatensis, Uragoga ipecacuanha.
Ipecac is a plant. It is used to make medicine. Ipecac syrup is available both as a nonprescription product and as an FDA-approved prescription product.
Ipecac is taken by mouth to cause vomiting after suspected poisoning. It is also used to treat bronchitis associated with croup in children, a severe kind of diarrhea (amoebic dysentery), and cancer. Ipecac is also used as an expectorant to thin mucous and make coughing easier. Small doses are used to improve appetite.
Health professionals sometimes give ipecac by IV (intravenously) for hepatitis and pockets of infection (abscesses).
How does it work?
Ipecac contains chemicals that irritate the digestive tract and trigger the brain to cause vomiting.
Possibly Ineffective for...
- Poisoning. Taking syrup of ipecac causes vomiting. This might help remove up to 54% of ingested poison when taken within 10 minutes of poisoning. However, taking ipecac 90 minutes after poisoning does not seem to be effective. Also, ipecac's effectiveness in preventing pediatric deaths with routine use at home has never been proven. In 1983 the American Academy of Pediatrics recommended that all households keep a 1-ounce bottle of syrup of ipecac at home. Ipecac could then be used on the advice of a physician, emergency department, or poison control center to cause vomiting. However, this recommendation has been reversed. Ipecac does not seem to improve outcomes when given after poisonings to people who show minimal symptoms. Also, taking ipecac before other poison-specific antidotes that are taken by mouth might decrease the effects of these other antidotes and might increase the risk of aspiration pneumonia.
Insufficient Evidence to Rate Effectiveness for...
- Thinning mucous to make coughing easier.
- Bronchitis associated with croup.
- Amoebic dysentery.
- Loss of appetite.
- Other conditions.
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).
Ipecac is POSSIBLY SAFE for most people when taken by mouth and used for a short time. It can cause nausea, vomiting, stomach irritation, dizziness, low blood pressure, shortness of breath, and a fast heartbeat.
Ipecac is POSSIBLY UNSAFE when allowed to touch the skin or when inhaled. Ipecac contains emetine, with can irritate the skin and respiratory tract.
Ipecac is LIKELY UNSAFE when taken by mouth long-term or in large amounts, as well as when injected at a dose of more than 1 gram. Misuse of ipecac can lead to serious poisoning, heart damage, and death. Signs of poisoning include difficulty breathing, digestive tract problems, abnormal heart rates, blood in the urine, convulsions, shock, coma, and death.
Ipecac is UNSAFE when used in high doses or in children under the age of one year. Children are more sensitive than adults to the side effects of ipecac. Misuse of ipecac can lead to serious poisoning, heart damage, and death. Signs of poisoning include difficulty breathing, digestive tract problems, abnormal heart rates, blood in the urine, convulsions, shock, coma, and death.
Pregnancy and breast-feeding: It is LIKELY UNSAFE to use ipecac if you are pregnant. It might stimulate the uterus and cause a miscarriage. Not enough is known about the safety of using ipecac if you are breast-feeding. Stay on the safe side and avoid use.
Unconsciousness or certain kinds of poisonings: Ipecac should not be used in people who are unconscious or have been poisoned with certain chemicals including corrosives, petroleum products, strychnine, and others. Talk to your healthcare provider or poison control center about whether ipecac is appropriate to use in each case of suspected poisoning. If ipecac is used incorrectly, serious complications can arise including damage of the esophagus, pneumonia, and convulsions.
Digestive tract problems including ulcers, infections, or Crohn's disease: Ipecac can irritate the digestive tract. Don't use it if you have one of these conditions.
Heart disease: Ipecac can affect the heart. Don't use it if you have a heart condition.
The following doses have been studied in scientific research:
- To cause vomiting after suspected poisoning: 15 mL ipecac syrup followed by 1-2 glasses of water. This dose may be repeated once in 20 minutes if vomiting does not occur. Before using ipecac syrup to treat poisoning, call a poison control hotline for advice. Ipecac syrup is available both as a nonprescription product and as an FDA-approved prescription product.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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Adler, A. G., Walinsky, P., Krall, R. A., and Cho, S. Y. Death resulting from ipecac syrup poisoning. JAMA 5-16-1980;243(19):1927-1928. View abstract.
Albertson, T. E., Derlet, R. W., Foulke, G. E., Minguillon, M. C., and Tharratt, S. R. Superiority of activated charcoal alone compared with ipecac and activated charcoal in the treatment of acute toxic ingestions. Ann.Emerg.Med 1989;18(1):56-59. View abstract.
Andersen, J. M., Keljo, D. J., and Argyle, J. C. Secretory diarrhea caused by ipecac poisoning. J.Pediatr.Gastroenterol.Nutr. 1997;24(5):612-615. View abstract.
Asano, T., Ishihara, K., Wakui, Y., Yanagisawa, T., Kimura, M., Kamei, H., Yoshida, T., Kuroiwa, Y., Fujii, Y., Yamashita, M., Kuramochi, T., Tomisawa, H., and Tateishi, M. Absorption, distribution and excretion of 3H-labeled cephaeline- and emetine-spiked ipecac syrup in rats. Eur.J Drug Metab Pharmacokinet. 2002;27(1):17-27. View abstract.
Auerbach, P. S., Osterloh, J., Braun, O., Hu, P., Geehr, E. C., Kizer, K. W., and McKinney, H. Efficacy of gastric emptying: gastric lavage versus emesis induced with ipecac. Ann.Emerg.Med. 1986;15(6):692-698. View abstract.
Bader, A. A. and Kerzner, B. Ipecac toxicity in "Munchausen syndrome by proxy". Ther.Drug Monit. 1999;21(2):259-260. View abstract.
Bennett, H. S., Spiro, A. J., Pollack, M. A., and Zucker, P. Ipecac-induced myopathy simulating dermatomyositis. Neurology 1982;32(1):91-94. View abstract.
Berkner, P., Kastner, T., and Skolnick, L. Chronic ipecac poisoning in infancy: a case report. Pediatrics 1988;82(3):384-386. View abstract.
Berrens, L. and YOUNG, E. Studies on the allergen in ipecacuanha. I. Isolation and identification of the inhalant allergen. Int Arch Allergy Appl.Immunol. 1962;21:335-346. View abstract.
Berrens, L. and YOUNG, E. Studies on the allergen in ipecacuanha. II. Heterogeneity of the purified allergen. Int Arch Allergy Appl.Immunol. 1963;22:51-59. View abstract.
Birmingham, C. L. and Gritzner, S. Heart failure in anorexia nervosa: case report and review of the literature. Eat.Weight.Disord. 2007;12(1):e7-10. View abstract.
Blue, J. A. Rhinitis medicamentosa. Ann.Allergy 1968;26(8):425-429. View abstract.
Bond, G. R. Home syrup of ipecac use does not reduce emergency department use or improve outcome. Pediatrics 2003;112(5):1061-1064. View abstract.
Bond, G. R., Requa, R. K., Krenzelok, E. P., Normann, S. A., Tendler, J. D., Morris, C. L., McCoy, D. J., Thompson, M. W., McCarthy, T., Roblez, J., and . Influence of time until emesis on the efficacy of decontamination using acetaminophen as a marker in a pediatric population. Ann.Emerg.Med 1993;22(9):1403-1407. View abstract.
Boxer, L., Anderson, F. P., and Rowe, D. S. Comparison of ipecac-induced emesis with gastric lavage in the treatment of acute salicylate ingestion. J.Pediatr. 1969;74(5):800-803. View abstract.
Brotman, M. C., Forbath, N., Garfinkel, P. E., and Humphrey, J. G. Myopathy due to ipecac syrup poisoning in a patient with anorexia nervosa. Can.Med.Assoc.J. 9-1-1981;125(5):453-454. View abstract.
Colletti, R. B. and Wasserman, R. C. Recurrent infantile vomiting due to intentional ipecac poisoning. J.Pediatr.Gastroenterol.Nutr. 1989;8(3):394-396. View abstract.
Combs, A. B. and Acosta, D. Toxic mechanisms of the heart: a review. Toxicol.Pathol. 1990;18(4 Pt 1):583-596. View abstract.
Curtis, R. A., Barone, J., and Giacona, N. Efficacy of ipecac and activated charcoal/cathartic. Prevention of salicylate absorption in a simulated overdose. Arch.Intern.Med 1984;144(1):48-52. View abstract.
Day, L., Kelly, C., Reed, G., Andersen, J. M., and Keljo, J. M. Fatal cardiomyopathy: suspected child abuse by chronic ipecac administration. Vet.Hum.Toxicol. 1989;31(3):255-257. View abstract.
Dresser, L. P., Massey, E. W., Johnson, E. E., and Bossen, E. Ipecac myopathy and cardiomyopathy. J.Neurol.Neurosurg.Psychiatry 1993;56(5):560-562. View abstract.
Eldridge, D. L., Van, Eyk J., and Kornegay, C. Pediatric toxicology. Emerg.Med Clin North Am 2007;25(2):283-308. View abstract.
Freedman, G. E., Pasternak, S., and Krenzelok, E. P. A clinical trial using syrup of ipecac and activated charcoal concurrently. Ann.Emerg.Med. 1987;16(2):164-166. View abstract.
Friedman, A. G., Seime, R. J., Roberts, T., and Fremouw, W. J. Ipecac abuse: a serious complication in bulimia. Gen.Hosp.Psychiatry 1987;9(3):225-228. View abstract.
Friedman, E. J. Death from ipecac intoxication in a patient with anorexia nervosa. Am.J.Psychiatry 1984;141(5):702-703. View abstract.
Goebel, J., Gremse, D. A., and Artman, M. Cardiomyopathy from ipecac administration in Munchausen syndrome by proxy. Pediatrics 1993;92(4):601-603. View abstract.
Halbig, L., Gutmann, L., Goebel, H. H., Brick, J. F., and Schochet, S. Ultrastructural pathology in emetine-induced myopathy. Acta Neuropathol. 1988;75(6):577-582. View abstract.
Hall, R. C., Blakey, R. E., and Hall, A. K. Bulimia nervosa. Four uncommon subtypes. Psychosomatics 1992;33(4):428-436. View abstract.
Ho, P. C., Dweik, R., and Cohen, M. C. Rapidly reversible cardiomyopathy associated with chronic ipecac ingestion. Clin.Cardiol. 1998;21(10):780-783. View abstract.
Izaddoost, M. and Robinson, T. Synergism and antagonism in the pharmacology of alkaloidal plants. Herbs Spices Med Plants 1986;2:137-58.
Johnson, J. E., Carpenter, B. L., Benton, J., Cross, R., Eaton, L. A., Jr., and Rhoads, J. M. Hemorrhagic colitis and pseudomelanosis coli in ipecac ingestion by proxy. J.Pediatr.Gastroenterol.Nutr. 1991;12(4):501-506. View abstract.
Kendrick, D., Smith, S., Sutton, A., Watson, M., Coupland, C., Mulvaney, C., and Mason-Jones, A. Effect of education and safety equipment on poisoning-prevention practices and poisoning: systematic review, meta-analysis and meta-regression. Arch Dis.Child 2008;93(7):599-608. View abstract.
Klein-Schwartz, W., Gorman, R. L., Oderda, G. M., Wedin, G. P., and Saggar, D. Ipecac use in the elderly: the unanswered question. Ann.Emerg.Med. 1984;13(12):1152-1154. View abstract.
Knight, K. M. and Doucet, H. J. Gastric rupture and death caused by ipecac syrup. South.Med.J. 1987;80(6):786-787. View abstract.
Kornberg, A. E. and Dolgin, J. Pediatric ingestions: charcoal alone versus ipecac and charcoal. Ann.Emerg.Med 1991;20(6):648-651. View abstract.
Kulig, K., Bar-Or, D., Cantrill, S. V., Rosen, P., and Rumack, B. H. Management of acutely poisoned patients without gastric emptying. Ann.Emerg.Med 1985;14(6):562-567. View abstract.
Kuntzer, T., Bogousslavsky, J., Deruaz, J. P., Janzer, R., and Regli, F. Reversible emetine-induced myopathy with ECG abnormalities: a toxic myopathy. J Neurol. 1989;236(4):246-248. View abstract.
Lachman, M. F., Romeo, R., and McComb, R. B. Emetine identified in urine by HPLC, with fluorescence and ultraviolet/diode array detection, in a patient with cardiomyopathy. Clin Chem. 1989;35(3):499-502. View abstract.
Lacomis, D. Case of the month. June 1996--anorexia nervosa. Brain Pathol. 1996;6(4):535-536. View abstract.
Lee, M. R. Ipecacuanha: the South American vomiting root. J R.Coll.Physicians Edinb. 2008;38(4):355-360. View abstract.
Lewis, R. K. and Paloucek, F. P. Assessment and treatment of acetaminophen overdose. Clin Pharm 1991;10(10):765-774. View abstract.
Litovitz, T., Clancy, C., Korberly, B., Temple, A. R., and Mann, K. V. Surveillance of loperamide ingestions: an analysis of 216 poison center reports. J.Toxicol.Clin.Toxicol. 1997;35(1):11-19. View abstract.
Lohr, K. M. Rheumatic manifestations of diseases associated with substance abuse. Semin.Arthritis Rheum. 1987;17(2):90-111. View abstract.
Luczynska, C. M., Marshall, P. E., Scarisbrick, D. A., and Topping, M. D. Occupational allergy due to inhalation of ipecacuanha dust. Clin.Allergy 1984;14(2):169-175. View abstract.
MacLean, W. C., Jr. A comparison of ipecac syrup and apomorphine in the immediate treatment of ingestion of poisons. J.Pediatr. 1973;82(1):121-124. View abstract.
Mateer, J. E., Farrell, B. J., Chou, S. S., and Gutmann, L. Reversible ipecac myopathy. Arch.Neurol. 1985;42(2):188-190. View abstract.
McClung, H. J., Murray, R., Braden, N. J., Fyda, J., Myers, R. P., and Gutches, L. Intentional ipecac poisoning in children. Am.J.Dis.Child 1988;142(6):637-639. View abstract.
McNamara, R. M., Aaron, C. K., Gemborys, M., and Davidheiser, S. Efficacy of charcoal cathartic versus ipecac in reducing serum acetaminophen in a simulated overdose. Ann.Emerg.Med 1989;18(9):934-938. View abstract.
Meadows-Oliver, M. Syrup of ipecac: new guidelines from the AAP. J.Pediatr.Health Care 2004;18(2):109-110. View abstract.
Merigian, K. S., Woodard, M., Hedges, J. R., Roberts, J. R., Stuebing, R., and Rashkin, M. C. Prospective evaluation of gastric emptying in the self-poisoned patient. Am J Emerg.Med 1990;8(6):479-483. View abstract.
Mofenson, H. C. and Caraccio, T. R. Benefits/risks of syrup of ipecac. Pediatrics 1986;77(4):551-552. View abstract.
Moldawsky, R. J. Myopathy and ipecac abuse in a bulimic patient. Psychosomatics 1985;26(5):448-449. View abstract.
Neuvonen, P. J., Vartiainen, M., and Tokola, O. Comparison of activated charcoal and ipecac syrup in prevention of drug absorption. Eur.J.Clin.Pharmacol. 1983;24(4):557-562. View abstract.
Olsen, K. M., Ma, F. H., Ackerman, B. H., and Stull, R. E. Low-volume whole bowel irrigation and salicylate absorption: a comparison with ipecac-charcoal. Pharmacotherapy 1993;13(3):229-232. View abstract.
Palmer, E. P. and Guay, A. T. Reversible myopathy secondary to abuse of ipecac in patients with major eating disorders. N.Engl.J.Med. 12-5-1985;313(23):1457-1459. View abstract.
Parks, B. R. and Fischer, R. G. Misuse of syrup of ipecac. Pediatr.Nurs. 1987;13(4):261. View abstract.
Persson, C. G. Ipecacuanha asthma: more lessons. Thorax 1991;46(6):467-468. View abstract.
Phillips, S., Gomez, H., and Brent, J. Pediatric gastrointestinal decontamination in acute toxin ingestion. J Clin Pharmacol 1993;33(6):497-507. View abstract.
Pond, S. M., Lewis-Driver, D. J., Williams, G. M., Green, A. C., and Stevenson, N. W. Gastric emptying in acute overdose: a prospective randomised controlled trial. Med J Aust 10-2-1995;163(7):345-349. View abstract.
Rashid, N. Medically unexplained myopathy due to ipecac abuse. Psychosomatics 2006;47(2):167-169. View abstract.
Robertson, W. O. Syrup of ipecac associated fatality: a case report. Vet.Hum.Toxicol. 1979;21(2):87-89. View abstract.
Rodgers, G. C., Jr. and Matyunas, N. J. Gastrointestinal decontamination for acute poisoning. Pediatr Clin North Am 1986;33(2):261-285. View abstract.
Rosenberg, N. L. and Ringel, S. P. Myopathy from surreptitious ipecac ingestion. West J.Med. 1986;145(3):386-388. View abstract.
Saincher, A., Sitar, D. S., and Tenenbein, M. Efficacy of ipecac during the first hour after drug ingestion in human volunteers. J.Toxicol.Clin.Toxicol. 1997;35(6):609-615. View abstract.
Scharman, E. J., Hutzler, J. M., Rosencrance, J. G., and Tracy, T. S. Single dose pharmacokinetics of syrup of ipecac. Ther.Drug Monit. 2000;22(5):566-573. View abstract.
Schiff, R. J., Wurzel, C. L., Brunson, S. C., Kasloff, I., Nussbaum, M. P., and Frank, S. D. Death due to chronic syrup of ipecac use in a patient with bulimia. Pediatrics 1986;78(3):412-416. View abstract.
Schneider, D. J., Perez, A., Knilamus, T. E., Daniels, S. R., Bove, K. E., and Bonnell, H. Clinical and pathologic aspects of cardiomyopathy from ipecac administration in Munchausen's syndrome by proxy. Pediatrics 1996;97(6 Pt 1):902-906. View abstract.
Schneider, M. Bulimia nervosa and binge-eating disorder in adolescents. Adolesc.Med 2003;14(1):119-131. View abstract.
Schofferman, J. A. A clinical comparison of syrup of ipecac and apomorphine use in adults. JACEP. 1976;5(1):22-25. View abstract.
Seaton, A. Ipecacuanha asthma: an old lesson. Thorax 1990;45(12):974. View abstract.
Silber, T. J. Ipecac syrup abuse, morbidity, and mortality: isn't it time to repeal its over-the-counter status? J Adolesc.Health 2005;37(3):256-260. View abstract.
Steffen, K. J., Mitchell, J. E., Roerig, J. L., and Lancaster, K. L. The eating disorders medicine cabinet revisited: a clinician's guide to ipecac and laxatives. Int J Eat.Disord. 2007;40(4):360-368. View abstract.
Stewart, J. J. Effects of emetic and cathartic agents on the gastrointestinal tract and the treatment of toxic ingestion. J Toxicol.Clin Toxicol. 1983;20(3):199-253. View abstract.
Stiell, I. G. Activated charcoal alone versus activated charcoal & ipecac. Ann.Emerg.Med. 1990;19(10):1202-1204. View abstract.
Sutphen, J. L. and Saulsbury, F. T. Intentional ipecac poisoning: Munchausen syndrome by proxy. Pediatrics 1988;82(3 Pt 2):453-456. View abstract.
Tandberg, D. and Murphy, L. C. The knee-chest position does not improve the efficacy of ipecac-induced emesis. Am.J.Emerg.Med. 1989;7(3):267-270. View abstract.
Tandberg, D., Diven, B. G., and McLeod, J. W. Ipecac-induced emesis versus gastric lavage: a controlled study in normal adults. Am.J.Emerg.Med. 1986;4(3):205-209. View abstract.
Tandberg, D., Liechty, E. J., and Fishbein, D. Mallory-Weiss syndrome: an unusual complication of ipecac-induced emesis. Ann.Emerg.Med. 1981;10(10):521-523. View abstract.
Tenenbein, M., Cohen, S., and Sitar, D. S. Efficacy of ipecac-induced emesis, orogastric lavage, and activated charcoal for acute drug overdose. Ann.Emerg.Med. 1987;16(8):838-841. View abstract.
Thyagarajan, D., Day, B. J., Wodak, J., Gilligan, B., and Dennett, X. Emetine myopathy in a patient with an eating disorder. Med J Aust. 12-6-1993;159(11-12):757-760. View abstract.
Timberlake, G. A. Ipecac as a cause of the Mallory-Weiss syndrome. South.Med.J. 1984;77(6):804-805. View abstract.
Uldry, P. A. and Regli, F. [Muscular diseases in relation to drug consumption]. Schweiz.Rundsch.Med Prax. 6-6-1989;78(23):671-673. View abstract.
Veltri, J. C. and Temple, A. R. Telephone management of poisonings using syrup of ipecac. Clin.Toxicol. 1976;9(3):407-417. View abstract.
Wagner, C. and Bowers, W. Cardiomyopathy in a child induced by intentional ipecac poisoning. Air Med J 2006;25(6):236-237. View abstract.
Wax, P. M., Cobaugh, D. J., and Lawrence, R. A. Should home ipecac-induced emesis be routinely recommended in the management of toxic berry ingestions? Vet.Hum.Toxicol. 1999;41(6):394-397. View abstract.
Wolowodiuk, O. J., McMicken, D. B., and O'Brien, P. Pneumomediastinum and retropneumoperitoneum: an unusual complication of syrup-of-ipecac-induced emesis. Ann.Emerg.Med. 1984;13(12):1148-1151. View abstract.
Yamashita, M., Yamashita, M., and Azuma, J. Urinary excretion of ipecac alkaloids in human volunteers. Vet.Hum.Toxicol. 2002;44(5):257-259. View abstract.
Young, W. F., Jr. and Bivins, H. G. Evaluation of gastric emptying using radionuclides: gastric lavage versus ipecac-induced emesis. Ann.Emerg.Med. 1993;22(9):1423-1427. View abstract.
Anon. Position paper: Ipecac syrup. J Toxicol Clin Toxicol 2004;42:133-43. View abstract.
Burnham TH, ed. Drug Facts and Comparisons, Updated Monthly. Facts and Comparisons, St. Louis, MO.
Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
Ipecac for the home treatment of poisonings. Pharmacist's Letter/Prescriber's Letter 2003;19(12):191201.