Ipecac Syrup

What is it?
Ipecac syrup is an herbal medicine made from the root of the Ipecacuanha plant. It is used mainly to cause people to vomit after an accidental poisoning. It has also been used to help loosen and bring up phlegm after coughing (as an expectorant).

Other names for Ipecac syrup include: Cephaelis ipecacuanha, and Cephaelis accuminata.

Ask your doctor, nurse, or pharmacist if you need more information about this medicine or if any information in this leaflet concerns you.

Before Using:
Tell your doctor if you

• are taking medicine or are allergic to any medicine (prescription or over-the-counter (OTC) or dietary supplement)
• are pregnant or plan to become pregnant while using this medicine
• are breastfeeding
• have any other health problems, such as high blood pressure or heart or blood vessel disease

Dosage:
Talk with your caregiver about how much Ipecac syrup you should take. The amount depends on the strength of the medicine and the reason you are taking Ipecac syrup. If you are using this medicine without instructions from your caregiver, follow the directions on the medicine bottle. Do not take more medicine or take it more often than the directions tell you to.

To store this medicine:
Keep all medicine locked up and away from children. Store medicine away from heat and direct light. Do not store your medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down and not work the way it should work. Throw away medicine that is out of date or that you do not need. Never share your medicine with others.

Warnings:

• Before taking Ipecac syrup, tell your doctor if you are pregnant or breastfeeding
• Do not give Ipecac to people who have eaten or drunk anything that is a strong acid or base, or anything that has petroleum or strychnine in it (examples: oil, kerosene, gasoline, or cleaning fluids) (1)
• Ipecac syrup should never be given to a person who is unconscious (not able to wake) or who is in shock (1,7)
• If you have a heart or blood vessel problem, call your doctor or poison center for advice before using Ipecac syrup (7)
• Do not use Ioecac fluid extract. It is stronger than Ipecac syrup and can cause death from overdose (7)

Side Effects:
Stop taking your medicine right away and talk to your doctor if you have any of the following side effects. Your medicine may be causing these symptoms which may mean you are allergic to it.

• Breathing problems or tightness in your throat or chest
• Chest pain
• Skin hives, rash, or itchy or swollen skin

Other Side Effects:
You may have the following side effects, but this medicine may also cause other side effects. Tell your doctor if you have side effects that you think are caused by this medicine.

• Using Ipecac for a long time can cause heart (8,9), stomach (10,11,12,13), and muscle problems (1,14,15,16).

References:
1. Product Information: Ipecac Syrup USP. Cumberland-Swan, Inc, Smyrna, TN; 2000.
2. Anon: Position statement: IPECAC syrup; American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. Clin Toxicol 1997; 35:699-709.
3. Spigiel RW, Abdorich I & Munn D: The effect of temperature of concurrently administered fluid on the onset of ipecac induced emesis. Clin Toxicol 1979; 14:281.
4. Uden DL, Davison GJ & Kohen DP: The effect of carbonated beverages on ipecac-induced emesis. Ann Emerg Med 1981; 10:79-81.
5. Gaudreault P, McCormick MA, Lacouture PG et al: Poisoning exposures and use of ipecac in children less than 1 year old. Ann Emerg Med 1986; 15:808-810.
6. Litovitz TL, Klein-Schwartz W, Oderda GM et al: Ipecac administration in children younger than 1 year of age. Pediatrics 1985; 76:761-764.
7. Reynolds JEF (ed): Martindale: The Extra Pharmacopoeia (electronic version). Micromedex Inc, Englewood, CO; 1997
8. Friedman EJ: Death from ipecac intoxication in a patient with anorexia nervosa. Am J Psychiatry 1984; 141:702-703.
9. Goebel J, Bremse DA 7 Artman M: Cardiomyopathy from ipecac administration in Muchausen syndrome by proxy. Pediatrics 1993; 92:601-603.
10. Tandberg D, Liechty EJ & Fishbein D: Mallory-Weiss syndrome: an un usual complication of ipecac-induced emesis. Ann Emerg Med 1981; 10:521.
11. Czajka PA & Russell SL: Nonemetic effect of ipecac syrup. Pediatrics 1985; 75:1101-1104.
12. Sutphen JL & Saulsbury FT: Intentional ipecac poisoning: Munchausen syndrome by proxy. Pediatrics 1988; 82:453-456.
13. Berkner P, Kastner T & Skolnick L: Chronic ipecac poisoning in infancy: a case report. Pediatrics 1988; 82:384-386.
14. Mateer JE, Farrell BJ, Chou SSM et al : Reversible ipecac myopathy. Arch Neurol 1985; 42:188-190.
15. Bennett HS, Spiro AJ, Pollack MA et al: Ipecac-induced myopathy simulating dermatomyositis. Neurology 1982; 32:91.
16. Brotman MC, Forbath N, Garfinkel PE et al: Myopahty due to ipecac-syrup poisoning in a pateint with anorexia nervosa. Can Med Assoc J 1981; 125:453.