Medications and Pharmacology: What is an example of an emetic?

October 9, 2025 •

4 min read

Decades ago, having a bottle of syrup of ipecac in your home medicine cabinet for accidental poisoning was standard advice, recommended by medical authorities like the American Academy of Pediatrics. In response to the question, 'What is an example of an emetic?', syrup of ipecac is the classic answer, but its use has been largely abandoned in favor of safer, more effective treatments due to evidence that it is often ineffective and carries significant risks.

Quick Summary

Emetics are substances that induce vomiting, but their routine use for poisoning is no longer recommended. Syrup of ipecac is a classic example, though modern medical practice favors activated charcoal for decontamination. This article explores the history, pharmacology, and risks of emetics, detailing why safer alternatives are now the standard of care. It also differentiates emetics from antiemetics.

Key Points

Syrup of Ipecac is a classic emetic example: Historically used for accidental poisoning, it was derived from the root of the Carapichea ipecacuanha plant.
Modern medicine has abandoned emetics: Health experts no longer recommend using emetics for poisoning due to their low efficacy and high risk of serious complications.
Activated charcoal is the modern alternative: For most oral poisonings, activated charcoal is the preferred treatment, as it effectively adsorbs toxins in the digestive tract.
Emetics carry significant risks: Potential side effects of inducing vomiting include aspiration pneumonia, esophageal damage, severe electrolyte imbalance, and in cases of ipecac abuse, cardiotoxicity.
Apomorphine is another emetic, primarily for veterinary use: This drug stimulates dopamine receptors to induce vomiting and is safely used under veterinary supervision for certain poisonings in dogs.
Call poison control immediately: If poisoning is suspected, the most important step is to call a poison control center for expert guidance, not to induce vomiting at home.

The Classic Example: Syrup of Ipecac

Syrup of ipecac, derived from the roots of the Carapichea ipecacuanha plant, was once the most common example of an emetic. It was historically used as an emergency first-aid treatment for oral poisoning. Its mechanism of action is twofold:

Local Irritation: The active alkaloids, primarily emetine and cephaeline, irritate the stomach lining, which helps to trigger the vomiting reflex.
Central Stimulation: The alkaloids are also absorbed into the bloodstream and stimulate the chemoreceptor trigger zone (CTZ) in the brain's medulla, a key area for controlling the vomiting reflex.

While ipecac was widely used, particularly for childhood poisonings, evidence later emerged showing that it was largely ineffective at removing a significant amount of ingested poison, especially if more than an hour had passed since ingestion. Furthermore, the uncontrolled and often prolonged vomiting it caused could delay more effective treatments and led to dangerous complications. Production of ipecac syrup ceased in 2010 after it was officially no longer recommended for routine use.

Another Pharmacological Emetic: Apomorphine

Another notable example of an emetic is apomorphine, a morphine derivative that does not bind to opioid receptors but acts as a potent dopamine agonist. It works centrally by stimulating dopamine D2 receptors in the chemoreceptor trigger zone, which is particularly effective for inducing vomiting in dogs. Due to species differences, apomorphine is not consistently effective in cats, which have fewer dopamine receptors in their chemoreceptor trigger zone. In dogs, it is a reliable and fast-acting emetic, but its use requires veterinary supervision to manage potential side effects such as sedation or protracted vomiting. An antiemetic like naloxone can be used to reverse the sedative effects without inhibiting the vomiting.

The Shift to Modern Gastrointestinal Decontamination

With the recognized limitations and risks of emetics, modern toxicology has shifted towards more effective and safer methods for gastric decontamination. The current standard of care almost always involves contacting a poison control center immediately for guidance on the best course of action.

Activated Charcoal

For many types of poisoning, activated charcoal is the preferred treatment. This porous substance works by binding to toxic compounds in the stomach and intestines, preventing them from being absorbed into the bloodstream. Activated charcoal is safe, highly effective for a wide range of substances, and does not require the risky and often incomplete process of inducing vomiting.

Gastric Lavage

Gastric lavage, or 'stomach pumping,' is a procedure where a tube is inserted into the stomach to wash out its contents. This is reserved for specific cases where a life-threatening amount of a substance has been ingested and the patient presents soon after. Unlike emetics, this controlled procedure is performed in a hospital setting where a patient's airway can be protected to prevent aspiration.

Whole-Bowel Irrigation

In some situations, particularly after the ingestion of sustained-release medications or heavy metals, whole-bowel irrigation is used. This involves flushing the entire gastrointestinal tract with a large volume of an electrolyte solution until the rectal effluent is clear.

Emetics vs. Antiemetics: A Crucial Distinction

It is important to understand the fundamental difference between these two classes of drugs:

Emetics induce vomiting, with the goal of expelling toxic substances from the stomach.
Antiemetics prevent or alleviate nausea and vomiting. They are commonly used to manage chemotherapy side effects, motion sickness, or post-operative nausea. Examples include ondansetron (Zofran) and promethazine (Phenergan).

Serious Risks and Contraindications of Emetics

Inducing vomiting is not a benign process and carries significant risks, which is a major reason for the decline in emetic use. These risks include:

Aspiration Pneumonia: If a person is unconscious or has an altered mental status, they can inhale the vomit into their lungs, leading to severe pneumonia.
Esophageal and GI Damage: Vomiting corrosive substances like strong acids or alkalis will cause further burns to the esophagus and throat on the way back up.
Cardiotoxicity: The emetine in ipecac can accumulate with repeated, chronic use (often associated with eating disorders like bulimia), leading to irreversible heart muscle damage and potentially death.
Delay of Treatment: The time it takes for an emetic to work (up to 30 minutes for ipecac) can delay the administration of more effective treatments, like activated charcoal.
Electrolyte Imbalance and Dehydration: Prolonged vomiting can cause a serious imbalance of electrolytes and severe dehydration.

Comparison: Emetics vs. Modern Decontamination


Feature	Emetics (e.g., Ipecac)	Modern Treatments (e.g., Activated Charcoal)
Mechanism	Irritates stomach lining and stimulates chemoreceptor trigger zone to force vomiting.	Adsorbs toxins in the gastrointestinal tract, preventing absorption.
Effectiveness	Highly variable; removes only a small, unpredictable amount of poison, especially after one hour.	Highly effective for a wide range of substances; adsorption reduces overall toxic load.
Risks	Aspiration pneumonia, esophageal damage, cardiotoxicity, dehydration, delayed treatment.	Generally safe, with rare side effects like constipation; risk is low compared to poisoning.
Application	Outdated; no longer recommended for routine management of poisoning.	The standard of care for most oral poisonings under medical supervision.
Contraindications	Corrosive poisons, hydrocarbons, reduced consciousness, cardiac/epileptic conditions.	Contraindicated for corrosive substances, iron, and some other ingestions; requires medical guidance.

Conclusion

While syrup of ipecac serves as a classic example of an emetic, its role in modern medicine has been superseded by safer and more effective methods for managing poisoning. Emetics carry significant risks and are no longer recommended for routine use in emergency settings. Activated charcoal, gastric lavage, and other methods provide more reliable and safer means of managing toxic ingestions when directed by a poison control center or medical professional. If you suspect poisoning, the first and most critical step is to call a poison control center immediately, not to attempt to induce vomiting at home.

Frequently Asked Questions

The most common example of an emetic was syrup of ipecac. It was historically kept in home medicine cabinets to induce vomiting in cases of accidental poisoning, but it is no longer recommended by medical professionals.

No, it is not safe to induce vomiting for poisoning at home. Medical experts now advise against it due to the significant risks, which include aspiration of stomach contents into the lungs, and the fact that it is often ineffective in removing a substantial amount of poison.

Activated charcoal works by a process called adsorption, where it binds to toxins and chemicals in the stomach and intestines. This prevents the poison from being absorbed into the bloodstream, and the charcoal-toxin complex is then safely passed out of the body.

Serious risks include aspiration pneumonia (inhaling vomit into the lungs), esophageal tearing, electrolyte imbalances, and cardiotoxicity (heart damage), especially with chronic misuse. For corrosive substances, vomiting can cause further damage to the esophagus.

Antiemetics are the opposite of emetics. While emetics are used to induce vomiting, antiemetics are medications prescribed to prevent or stop nausea and vomiting. Common antiemetics include medications like ondansetron and promethazine.

Ipecac was misused by some individuals with eating disorders like bulimia to induce vomiting for weight loss. The repeated, chronic abuse of ipecac was particularly dangerous and led to severe, often irreversible, heart damage due to the accumulation of the alkaloid emetine.

Immediately contact your local poison control center for expert guidance. Their number in the US is 1-800-222-1222. Do not attempt to induce vomiting unless instructed to do so by a medical professional.