Ipecac

Ipecac/Drug Interactions:

  • GeneralGeneral: The emesis produced by ipecac administration can reduce the effects of many drugs if administered within one hour of ingestion. Also, any antiemetic will decrease the incidence of vomiting in a patient who has ingested ipecac.
  • Bismuth subsalicylateBismuth subsalicylate: Based on human and animal study, bismuth subsalicylate reduced vomiting following ipecac (88).
  • CannabinoidsCannabinoids: Based on human study, use of marijuana reduced queasiness and slightly reduced vomiting in healthy volunteers who had used ipecac (89).
  • CharcoalCharcoal: A number of human studies have reported that activate charcoal reduces the emetic effect of ipecac (41; 90). Therefore, activated charcoal is often not administered until vomiting has ceased. This protocol may delay administration of activated charcoal, which can adsorb toxic substances for up to one hour. Furthermore, in many situations, activated charcoal is the preferred decontamination method.
  • CNS depressantsCNS depressants: Based on a human study, ipecac might potentiate the effect of sedatives (85).
  • Serotonin receptor antagonistsSerotonin receptor antagonists: Based on human and animal study, zatosetron maleate reduced nausea following ipecac (91).

    • Ipecac/Herb/Supplement Interactions:

  • GeneralGeneral: The emesis produced by ipecac administration can reduce the effects of many herbs and supplements if administered within one hour of ingestion. Also, any antiemetic will decrease the incidence of vomiting in a patient who has ingested ipecac.
  • Activated charcoalActivated charcoal: A number of human studies have reported that activate charcoal reduces the emetic effect of ipecac (41; 90). Therefore, activated charcoal is often not administered until vomiting has ceased. This protocol may delay administration of activated charcoal, which can adsorb toxic substances for up to one hour. Furthermore, in many situations, activated charcoal is the preferred decontamination method.
  • SedativesSedatives: Based on human study, ipecac might potentiate the effect of sedatives (85).

    • Ipecac/Food Interactions:

  • Carbonated beveragesCarbonated beverages: Carbonated beverages have been reported to interfere with ipecac's absorption and efficacy (92; 93). Therefore, water is the only recommended liquid to be administered after ipecac ingestion.
  • MilkMilk: Milk has been reported to interfere with ipecac's absorption and efficacy (92; 93). Therefore, water is the only recommended liquid to be administered after ipecac ingestion.

    • Ipecac/Lab Interactions:

  • Arterial pHArterial pH: Based on information from reviews, ipecac-induced emesis can raise the arterial pH, resulting in alkalosis (10; 87).
  • Creatine kinaseCreatine kinase: Based on a case report, ipecac abuse has been reported to significantly decrease the serum enzyme levels of creatine kinase (56).
  • Lactase dehydrogenaseLactase dehydrogenase: Based on a case report, ipecac abuse has been reported to significantly decrease the serum enzyme levels of lactate dehydrogenase (56).
  • PotassiumPotassium: Based on information from reviews, ipecac-induced emesis resulted in loss of electrolytes. In particular, emesis can lower serum potassium (significant amount of potassium can be found in vomitus) (10; 87).
  • Serum electrolytesSerum electrolytes: Based on information from reviews, ipecac-induced emesis results in loss of electrolytes. In particular, emesis can lower serum potassium (significant amount of potassium can be found in vomitus) (10; 87).