Ipecac

Also indexed as: Ipecacuanha Emetic Mixture

Ipecac syrup is a drug used to induce vomiting in the treatment of drug overdoses and in certain poisonings. In addition, people with eating disorders, such as bulimia and anorexia nervosa, occasionally abuse ipecac to avoid weight gain. In emergency situations, a local poison control centre should be contacted before ipecac is given.

Summary of Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about the summarized interactions.

Beneficial May be Beneficial: Side effect reduction/prevention—Taking these supplements may help reduce the likelihood and/or severity of a potential side effect caused by the medication.

Potassium
Avoid Avoid: Reduced drug absorption/bioavailability—Avoid these supplements when taking this medication since the supplement may decrease the absorption and/or activity of the medication in the body.

Activated charcoal

Carbonated beverages

Milk
Depletion or interference

None known
Supportive interaction

None known
Adverse interaction

None known

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Dietary Supplements

Potassium
In order to lose weight, some individuals who are overly zealous, as well as those with eating disorders, occasionally induce vomiting with ipecac. However, chronic abuse of ipecac can result in low blood levels of potassium,1 which might result in an irregular heart rhythm. Though avoidance of this behaviour is the best form of prevention, individuals who abuse ipecac should supplement with potassium or high-potassium foods to prevent potassium deficiency.

Interactions with Foods and Other Compounds

Milk and carbonated beverages
Some references have suggested that taking ipecac along with milk or carbonated beverages might reduce the effectiveness of the drug.2 However, controlled studies have shown that drinking neither milk3 nor carbonated beverages4 inhibits the action of ipecac. Consequently, ipecac can be given with or without milk or carbonated beverages.

Activated charcoal
In the treatment of certain poisonings, activated charcoal is used to reduce the amount of poison absorbed into the body. Some references have suggested that people avoid giving ipecac and activated charcoal together.5 However, controlled studies have shown that activated charcoal may not completely block the effects of ipecac,6 and that the combination is effective when activated charcoal is given ten minutes after ipecac treatment.7 Until more information is available, individuals should probably wait to give activated charcoal until after the ipecac-induced vomiting stops.

References

1. Sansone RA. Complications of hazardous weight-loss methods. Am Fam Physician 1984;30:141–6 [review].

2. Olin BR, ed. Miscellaneous Products, Antidotes. In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 2695.

3. Klein-Schwartz W, Litovitz T, Oderda GM, et al. The effect of milk on ipecac-induced emesis. J Toxicol Clin Toxicol 1991;29:505–11.

4. Uden DL, Davison GJ, Kohen DP. The effect of carbonated beverages on ipecac-induced emesis. Ann Emerg Med 1981;10:79–81.

5. Olin BR, ed. Miscellaneous Products, Antidotes. In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 2695.

6. Krenzelok EP, Freeman GE, Pasternak S. Preserving the emetic effect of syrup of ipecac with concurrent activated charcoal administration: a preliminary study. J Toxicol Clin Toxicol 1986;24:159–66.

7. Freeman GE, Pasternak S, Krezelok EP. A clinical trial using syrup of ipecac and activated charcoal concurrently. Ann Emerg Med 1987;16:164–6.