Syrup of ipecac is an emetic made from the dried roots of the ipecacuanha plant.

Syrup of ipecac is used in certain cases of poisoning where vomiting is necessary to help remove the toxin. Ipecac should not be given except under the advice of the poison control center or physician because with some types of poisoning, the damage caused by the poison passing back through the throat is worse than leaving the poison in the stomach and using other agents to counteract or absorb the poison.

Unfortunately, ipecac is used by many who suffer eating disorders. Also unfortunately, ipecac is a poison which can weaken the heart and cause heart attacks, irregular heartbeats, chest pains, breathing problems, and rapid heart rate even after only one use (Karen Carpenter died of a heart attack due to casual ipecac use).
A typical dose of syrup of ipecac can take up to twenty minutes to "kick in," and once it does, it will not give up until the patient has thoroughly emptied their stomach, so it is rarely recommended to induce vomiting anymore.

A fully stocked professional first aid kit should have a bottle of ipecac syrup, and a bottle of activated charcoal. The latter does not induce vomiting, but will absorb most chemicals to make them more inert inside the stomach.

Contraindications to using this emetic agent:

  • where the airway protective reflexes may be compromised as in coma or seizure
  • ingestion of corrosives such as strong acids or alkalis
  • ingestion of petroleum, kerosene and other hydrocarbons or similar oil based substances
  • in any patient where inducing vomiting would do more harm than good

Dosage
The United States Pharmacopeia (USP DI, 1997) recommends the following oral dosage regimen for Ipecac Syrup, USP.

Children up to six months of age: Ipecac syrup should only be administered under the supervision of a physician;

Children 6-12 months of age: 5-10 mL preceded or followed by 120-240 mL of water;
Children 1-12 years of age: 15 mL preceded or followed by 120-240 mL of water;
Adolescents and adults: 15-30 mL followed immediately by 240 mL of water.

The dose may be repeated in all age groups if emesis does not occur in 20-30 minutes.

The ingestion of milk or a drug with antiemetic properties are not contraindications to the use of ipecac. The use of ipecac that has exceeded the expiration date is not a contraindication to its use.

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