(ipecac syrup) dosing, indications, interactions, adverse effects, and more

Sections

Sections ipecac syrup
Dosing & Uses
Adverse Effects
Warnings
Pregnancy
Pharmacology
Images
Patient Handout
Formulary

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

oral syrup

Overdose/Poisoning

No longer recommended for poisonings; activated charcoal is the treatment of choice

15-30 mL PO once; may repeat once with 15 mL if vomiting does not occur within 20-30 min

If vomiting does not occur within 30-45 min after second dose, perform gastric lavage

Give with 3-4 glasses of water

Dosage Forms & Strengths

oral syrup

Overdose/Poisoning

Currently not recommended as an emetic for childhood poisonings; activated charcoal is the treatment of choice

<6-12 months: 5-10 mL PO once with 4-8 ounces of water; give only under medical supervision

1-12 years: 15 mL PO once with 1-2 glasses of water; may repeat once with 15 mL once if vomiting does not occur within 20-30 min

>12 years: As adults; 5-30 mL PO once with 3-4 glasses of water; may repeat once with 15 mL once if vomiting does not occur within 20-30 min

If vomiting does not occur within 30-45 min after second dose, perform gastric lavage

Frequency Not Defined

Prolonged vomiting

Aspiration

CNS depression

Mallory-Weiss tear

Delay of other therapy (charcoal/N-acetylcysteine)

Pneumomediastinum

May cause vomiting-induced vagal bradycardia

Contraindications

Lethargy

Absent gag reflex

Coma

Short time between ingestion of poison and charcoal administration/lavage

History of ingestion of substence that causes CNS depression or seizures

Ingestion of caustics, volatile liquids, or sharp objects

Cautions

May not work on empty stomach

Do not confuse ipecac syrup with ipecac fluid extract (14 times stronger)

Not indicated if patient had spontaneous vomiting

Falling out of favor with many poison control centers; may delay gastric lavage if vomiting prolonged

Milk or carbonated beverages may decrease effect

Abuse may occur in patients with bulimia or anorexia nervosa; associated with cardiomyopathies and death in patients with eating disorder

May be cardiotoxic if not vomited and allowed to be absorbed; emetine absorption may result in heart conduction disturbances

Pregnancy & Lactation

Pregnancy Category: C

Lactation: Unknown if excreted in breast milk; caution advised

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

Mechanism of Action

Gastric irritant and stimulates chemoreceptor trigger zone in CNS by alkaloids emetine and cephaeline to produce vomiting

Pharmacokinetics

Effective within 30 min post ingestion

Absorption: Significant when emesis not produced

Images

No images available for this drug.

Patient Handout

A Patient Handout is not currently available for this monograph.

Formulary

FormularyPatient Discounts

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

View explanations for tiers and restrictions

Tier	Description
1	This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2	This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC	NOT COVERED – Drugs that are not covered by the plan.

Code	Definition
PA	Prior Authorization Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL	Quantity Limits Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST	Step Therapy Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR	Other Restrictions Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.

Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.

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