What is Ipecac?
Ipecac is the dried root and rhizome of the tropical plant Carapichea ipecacuanha that belongs to the madder family (Rubiaceae). The scientific name for ipecac is Ipecacuanha. The medicinal use of ipecac has been prevalent since ancient times. It is used for treating poisoning by inducing vomiting and nausea. This drug is known as the ipecac syrup or ipecacuanha syrup or syrup of ipecac. Although it was earlier used as an emetic this practice has now been stopped in Western medicine with the discovery of more effective treatment options.
Ipecac Syrup
Ipecac vomit inducing properties help in treating poisoning when used in a syrup form. Ipecac medicine acts as a treatment for poisoning as it induces vomiting and brings out the poison through it. Ipecac Tincture of Ipecac Fluidextract should not be used as they may cause serious side effects resulting in death since their dosage forms are very strong.
Ipecac use as medicine to treat poisoning should not be applied if the patient has ingested any strong acids or corrosives such as alkalies (lye), strychnine, or petroleum distillates such as gasoline, kerosene, fuel oil, coal oil, cleaning fluid, or paint thinner. If given to such a patient, it may cause additional injury to the throat, seizures, or pneumonia.
Patients suffering from diseases like anorexia, bulimia, and the likes must not use ipecac to cause vomiting for losing weight. When regularly used for inducing vomit, ipecac may cause serious heart problems or even death in some cases.
Dosage
More than a one-ounce dosage of Ipecac syrup can be obtained only with a doctor's prescription. It can be obtained in 1 and ½- -ounce bottles without a prescription. Before using ipecac syrup as a medicine, one must consult the doctor or a poison control centre, or an emergency room for any medical assistance or advice.
The dose of ipecac medicine is different for different patients and it must be taken in the dosage prescribed by a doctor or as per the instructions given on the medicine label. The dosage information given below states only the average doses of this medicine and if it is different from the one prescribed by a doctor, one must follow the doctor’s prescription.
The strength of the medicine decides its dosage. The number of doses to be taken each day, the time gap between each dose and the duration for taking the medicine are decided by the medical problem for which ipecac is being taken.
Oral Dosage Form (Ipecac Syrup)
For Poisoning Treatment:
For Adults and Teenagers: The regular dose is 15 to 30 millilitres (mL) (1 to 2 tablespoonful).
For Children Between 1 - 12 Years of Age: The regular medicine dose is 15 mL (1 tbsp).
For Children Between 6 Months- 1 Year of Age: The regular ipecac medicine dose is 5 to 10 mL (1 to 2 tsp)
The dose should be immediately followed by 1 glass (240 mL) of water and can be repeated one more time after 20-30 minutes if vomiting does not happen.
For Infants Up to 6 Months of Age: Infants must be given Ipecac only when and after it has been prescribed and under the guidance of a doctor.
Precautions
Ipecac medicine should not be given to the unconscious or people in a drowsy state as when the medicine will induce vomit, it may enter the lungs, causing pneumonia.
The dosage of this medicine must always be followed by water so that it can induce vomit. 1 full glass (8 ounces) of water should be given to adults and ½ to 1 full glass (4 to 8 ounces) of water should be given to children right after a dose of ipecac. In the case of children, water can also be given before the medicine dose, to soothe the child.
Ipecac should not be consumed with carbonated beverages, milk, or milk products as these may disrupt the effect of the medicine and may cause swelling in the stomach. The second dose of the medicine can be taken if vomit does not occur 20-30 minutes after taking the first dose. If the second dose also fails to induce vomit, the patient must be taken to a doctor immediately.
If this medicine is given along with activated charcoal to treat the poisoning, activated charcoal should not be given until after this medicine has been given for causing vomiting and the vomiting has stopped.
FAQs on Ipecac
1. What is Ipecac and where does it come from?
Ipecac is a medicine derived from the dried roots and rhizome of the Carapichea ipecacuanha plant, which is native to Central and South America. It is primarily known for its ability to induce vomiting.
2. How exactly does Ipecac make a person vomit?
Ipecac works through a two-step process. First, its active compounds, primarily alkaloids like emetine and cephaline, directly irritate the lining of the stomach. Second, they are absorbed into the bloodstream and stimulate the part of the brain responsible for triggering the vomiting reflex, known as the chemoreceptor trigger zone.
3. What were the main uses of Ipecac in medicine?
The primary use of Ipecac syrup was to induce vomiting in individuals who had swallowed certain types of poisons. In smaller, controlled doses, it was also used for other purposes, such as:
- As an expectorant to help clear mucus from the airways in conditions like bronchitis.
- To treat amoebic dysentery, a severe type of diarrhoea.
- In some cases, to stimulate appetite when taken in very small amounts.
4. Are there significant side effects or risks associated with Ipecac?
Yes, Ipecac can have serious side effects, especially if used improperly or for a long time. The main risks include severe heart problems, such as irregular heartbeats and heart muscle damage, as well as muscle weakness, stomach cramps, and breathing difficulties. These risks are a major reason its use has declined.
5. Why do doctors no longer recommend Ipecac syrup for at-home use during poisoning?
Medical guidelines changed because studies showed Ipecac wasn't as effective as once believed. It often doesn't remove enough of the poison to make a difference. Furthermore, the induced vomiting can delay or interfere with more effective treatments like activated charcoal and can cause additional harm if the person becomes drowsy or has swallowed a corrosive substance.
6. What is the difference between Ipecac's use in standard medicine versus in homeopathy?
In standard medicine, Ipecac is used in material doses to cause a direct physiological effect, specifically vomiting. In homeopathy, it is used in extremely diluted forms where the original substance is minimal or non-existent. Homeopathic Ipecacuanha is typically given to treat symptoms of persistent nausea and vomiting based on the principle of "like cures like," without actually inducing vomiting.
