Cephaelis ipecacuanha

Related Terms

Cephaeline, Cephaelisipecacuanha, cephaline, emetamine, emetine, Euphorbiaipecacuanhae, Ipeca?, ipecacuana, ipecacuanha, ipecacuanha Syrup APF, ipecacuanhic acid, ipecacuanhin, isoquinoline alkaloids, o-methylpsychotrine, protoemetine, Pure-Pak?, Psychotriaipecacuanha, psychotrine, Rubiaceae, Tithymalopsisipecacuanhae.

Background

Syrup of ipecac, used medicinally since the 1500s, is made from the dried root and rhizome (underground stem) of the ipecacuanha plant (Cephaelis ipecacuanha). This plant grows in Brazilian rainforests and other locations in Central and South America. Ipecac's primary medicinal use is to cause vomiting after a person takes in a toxic substance. The induced vomiting reportedly removes toxic substances from the stomach, hinders their absorption, and speeds recovery. Currently, many experts recommend abandoning ipecac use in both home and clinical settings and employing other therapies such as activated charcoal, which has been shown to be effective and lacking in potential for abuse.
Another ipecac use is to treat gastrointestinal infections caused by amoeba. While ipecac is active against the amoebic form of dystentery (diarrhea), it is ineffective against bacterial dysentery.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


In several studies, ipecac was shown to be effective in reducing acetaminophen (e.g., Tylenol?) concentration when administered within 30 minutes or less after acetaminophen overdose.

C


In several studies, ipecac was shown to be effective in reducing acetaminophen (e.g., Tylenol?) concentration when administered within 30 minutes or less after acetaminophen overdose.

C


Ipecac has been used as an antidote to poisoning because it is inexpensive, easy to administer, and can be used in a home setting. Its effectiveness depends on how quickly it is given after poison ingestion and on the particular poison.
Because of its disadvantages, including a lack of effectiveness for all poisons and potential for abuse, it is being replaced by other treatments, especially activated charcoal.

 C


Ipecac has been used as an antidote to poisoning because it is inexpensive, easy to administer, and can be used in a home setting. Its effectiveness depends on how quickly it is given after poison ingestion and on the particular poison.
Because of its disadvantages, including a lack of effectiveness for all poisons and potential for abuse, it is being replaced by other treatments, especially activated charcoal.

 C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Dosing

Adults (18 years and older)
To induce vomiting, 30-50 milliliters of syrup of ipecac (total alkaloids: 123-157 milligrams per 100 milliliters) followed by 200-600 milliliters of water has been taken by mouth and repeated after 30 minutes if no vomiting occurs. For treatment of amoeba infection, emetine (a component of ipecac) has been given by mouth at significantly lower doses than are used to produce vomiting; however, specific dosage and duration of therapy are not available. Sixty milligrams of ipecac has been given daily by injection under the skin (site not specified) for no more than 10 or 12 doses.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Interactions

Interactions with Drugs
Ipecac may increase the amount of drowsiness caused by some drugs. Examples include benzodiazepines such as lorazepam (Ativan?) or diazepam (Valium?), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, CNS depressants, and alcohol. Caution is advised while driving or operating machinery.
Vomiting produced by ipecac administration may reduce the effects of many drugs if given within one hour of taking the drug.
Antiemetics (drugs that inhibit vomiting) decrease the incidence of vomiting in patients who have taken ipecac. Activated charcoal reduces the emetic effect of ipecac. Therefore, activated charcoal is often not given until vomiting has stopped. Bismuth subsalicylate may reduce vomiting following ipecac.
Ipepac may also interact with marijuana and serotonin receptor antagonists.

Attribution

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

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