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Toxicology – Ipecac
Indication
No routine indication. Syrup of ipecac was historically kept in homes to induce vomiting after accidental poison ingestion, especially in children. It is no longer recommended for routine prehospital management of poisoning.
Mechanism of Action
Ipecac is derived from the roots and rhizomes of the Cephaelis ipecacuanha plant.
It causes vomiting through two main effects:
- Direct irritation of the stomach and intestinal lining
- Stimulation of the central chemoreceptor trigger zone
Why It Is No Longer Recommended
Inducing vomiting has not been shown to reliably improve outcomes after poisoning and can create additional problems, including:
- Aspiration
- Delayed administration of more effective treatments
- Prolonged vomiting
- Difficulty giving activated charcoal or other therapies
Adverse Effects
Repeated or chronic use can cause significant toxicity, including:
- Persistent vomiting
- Electrolyte disturbances
- Muscle weakness
- Cardiomyopathy
Key Points
- Ipecac should not be used routinely after toxic ingestion.
- It has largely been replaced by supportive care and more selective decontamination strategies.
- Chronic misuse can cause serious cardiac toxicity.
- Poisoning exposures should be discussed with a poison control center or medical professional rather than treated by inducing vomiting at home.
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