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ipecacuanha

R05CA04

Forms & Strengths

Oral syrup 2% (20 mg/mL ipecac alkaloids)
Oral tablets 5% (50 mg/tablet)
Dissolvable powder for reconstitution 10%

Adult Dosing

20‑30 mL syrup (≈0.5‑1.5 g ipecac) single dose; repeat once after 15‑30 min if emesis incomplete
If tablets used, 2‑3 tablets (≈100‑150 mg) single dose; repeat once

Pediatric Dosing

Infants >6 kg: 5‑10 mL syrup (≈0.25‑0.5 g) single dose; repeat once after 15‑30 min if needed
Children >12 kg: 10‑15 mL syrup (≈0.5‑0.75 g) single dose; repeat once

Indications

Acute oral poisoning when activated charcoal unavailable or contraindicated
Ingestion of substances amenable to emesis (e.g., iron, aspirin, certain hydrocarbons)

Mechanism of Action

Direct gastric mucosal irritation triggers vagal afferents
Stimulates chemoreceptor trigger zone → central emesis pathway

Contraindications

GI obstruction, perforation, or recent abdominal surgery
Known cardiac disease, severe hypertension, or arrhythmias
Hyperthyroidism, epilepsy, or seizure disorders
Pregnancy, lactation
Hypersensitivity to ipecac or its constituents

Adverse Reactions

Nausea, vomiting, abdominal cramps
Aspiration pneumonia if vomitus not cleared
Electrolyte loss (hypokalemia, metabolic alkalosis)
Tachycardia, hypertension, ventricular arrhythmias (emetine toxicity)
Mucosal irritation, sore throat

Drug Interactions

May potentiate cardiotoxicity of quinidine, digitalis, or other QT‑prolonging agents
Reduced emetic efficacy with anticholinergics (e.g., scopolamine)
Concurrent CNS depressants may mask emesis and increase aspiration risk

Curated Content: Needs Vetting Before Put to Clinical Use