Yes

Antidote

Treatment of acute oral drug overdosage and in certain poisonings

C

Do not use in unconscious patients when time elapsed since exposure is >1 hour, patients with no gag reflex; following ingestion of strong bases or acids, volatile oils; when seizures are likely

Do not confuse ipecac syrup with ipecac fluid extract, which is 14 times more potent; use with caution in patients with cardiovascular disease and bulimics; may not be effective in antiemetic overdose

1% to 10%:

Central nervous system: Lethargy

Gastrointestinal: Protracted vomiting, diarrhea

Neuromuscular & skeletal: Myopathy

Contains cardiotoxin; symptoms of overdose include tachycardia, CHF, atrial fibrillation, depressed myocardial contractility, myocarditis, diarrhea, persistent vomiting, hypotension

Treatment is activated charcoal, gastric lavage

Decreased effect: Activated charcoal, milk, carbonated beverages

Increased toxicity: Phenothiazines (chlorpromazine has been associated with serious dystonic reactions)

Irritates the gastric mucosa and stimulates the medullary chemoreceptor trigger zone to induce vomiting

Onset of action: Within 15-30 minutes

Duration: 20-25 minutes; can last longer, 60 minutes in some cases

Absorption: Significant amounts, mainly when it does not produce emesis

Elimination: Emetine (alkaloid component) may be detected in urine 60 days after excess dose or chronic use

Oral:

6-12 months: 5-10 mL followed by 10-20 mL/kg of water; repeat dose one time if vomiting does not occur within 20 minutes

1-12 years: 15 mL followed by 10-20 mL/kg of water; repeat dose one time if vomiting does not occur within 20 minutes

If emesis does not occur within 30 minutes after second dose, ipecac must be removed from stomach by gastric lavage

Adults: 15-30 mL followed by 200-300 mL of water; repeat dose one time if vomiting does not occur within 20 minutes

Milk, carbonated beverages may decrease effectiveness

May cause sedation

Combination with chlorpromazine has been associated with dystonic reactions

No information available to require special precautions

No effects or complications reported

The Poison Control Center should be contacted before administration. Take only as directed; do not take more than recommended or more often than recommended. Follow with 8 oz of water. If vomiting does not occur within 30 minutes, contact the Poison Control Center or emergency services again. Do not administer if vomiting. If vomiting occurs after taking, do not eat or drink until vomiting subsides. Breast-feeding precautions: Consult prescriber if breast-feeding.

Do not administer to unconscious patients; patients should be kept active and moving following administration of ipecac; if vomiting does not occur after second dose, gastric lavage may be considered to remove ingested substance

Syrup: 70 mg/mL (15 mL, 30 mL, 473 mL, 4000 mL)

Colletti RB and Wasserman RC, "Recurrent Infantile Vomiting Due to Intentional Ipecac Poisoning," J Pediatr Gastroenterol Nutr, 1989, 8(3):394-6.

Day L, Kelly C, Reed G, et al, "Fatal Cardiomyopathy: Suspected Child Abuse by Chronic Ipecac Administration," Vet Hum Toxicol, 1989, 31(3):225-7.

Klein-Schwartz W, Gorman RL, Oderda GM, et al, "Ipecac Use in the Elderly: The Unanswered Question," Ann Emerg Med, 1984, 13(12):1152-4.

Kunkel DB, "The Toxic Toll of Keeping Thin," Emerg Med, 1985, 17:176-80.

Manno BR and Manno JE, "Toxicology of Ipecac: A Review," J Toxicol Clin Toxicol, 1977, 10:221-42.

Moran DM, Crouch DC, Finkle BS, et al, "Absorption of Ipecac Alkaloids in Emergency Room Patients," Vet Hum Toxicol, 1983, 25:286.