What is ipecacuana? Exploring the History, Dangers, and Discontinuation of Ipecac

October 7, 2025 •

3 min read

For decades, syrup of ipecac was a household medicine cabinet staple recommended for accidental poisoning, but its widespread medical use has since been formally discontinued. This change reflects growing evidence that challenged the perceived benefits and highlighted the potential risks associated with using ipecacuana as an emetic.

Quick Summary

The plant ipecacuanha is the source of syrup of ipecac, a once-common over-the-counter emetic for accidental poisoning. It has since been discontinued due to its limited efficacy, risk of side effects, and the availability of superior treatments.

Key Points

Source of Ipecac Syrup: The plant Carapichea ipecacuanha is the botanical source of the alkaloids emetine and cephaeline, which were used to make syrup of ipecac.
Mechanism of Action: Ipecac induces vomiting by irritating the stomach lining and stimulating the brain's chemoreceptor trigger zone.
Discontinuation of Medical Use: Ipecac is no longer recommended by major medical organizations like the AACT and AAP due to its inconsistent efficacy and significant risks.
Serious Dangers: Side effects can include prolonged vomiting, aspiration pneumonia, esophageal tears, and cardiotoxicity, particularly with chronic misuse.
Modern Alternatives: Activated charcoal is a more effective method for gastrointestinal decontamination in many cases and is administered by medical professionals.
Poisoning Emergency Protocol: The correct action for suspected poisoning is to immediately call a poison control center or 9-1-1 for professional guidance, not to induce vomiting at home.

What is Ipecacuana? The Plant and Its Medical History

Ipecacuanha refers to the plant Carapichea ipecacuanha, a slow-growing shrub native to rainforests in Central and South America. The dried roots and rhizomes of this plant contain alkaloids, primarily emetine and cephaeline, which have emetic (vomit-inducing) properties. These active ingredients were the basis for syrup of ipecac, a medicinal product once widely used to induce vomiting following oral ingestion of poisons.

Historically, ipecacuanha was used for dysentery in the 17th century, and by the 1800s, its emetic properties from alkaloids were recognized. Syrup of ipecac became a common over-the-counter poisoning treatment in the mid-20th century.

The Mechanism of Action

Syrup of ipecac causes vomiting through two mechanisms: irritating the stomach lining and stimulating the brain's vomiting center via absorbed alkaloids. Vomiting usually starts within 15-30 minutes.

The Fall from Grace: Why Is Ipecac No Longer Recommended?

Starting in the late 1990s, medical bodies like the AACT and EAPCCT began to question the routine use of ipecac. Position statements based on clinical findings led to its discontinuation. Key reasons included its ineffectiveness in consistently removing poisons and improving patient outcomes, the risk of delaying more effective treatments like activated charcoal, and potential serious risks like aspiration pneumonia, esophageal tears, and cardiotoxicity with chronic misuse. Based on this evidence, organizations including the AAP withdrew their recommendations. Production of syrup of ipecac ceased by late 2010.

Comparison of Gastrointestinal Decontamination Methods


Method	Mechanism	Effectiveness	Risks	Current Medical Recommendation
Ipecac Syrup	Local gastric irritation and central stimulation of the vomiting reflex.	Variable; removes inconsistent and often insignificant amounts of poison.	Aspiration pneumonia, esophageal tears, potential for cardiotoxicity with chronic use.	No longer recommended for routine use.
Activated Charcoal	Adsorbs toxins to its surface, preventing absorption from the gastrointestinal tract.	Highly effective for many substances when administered promptly. Ineffective for corrosive agents, metals (e.g., iron), and alcohols.	Less effective if delayed; cannot be used in unconscious patients due to aspiration risk.	Standard of care for many poisonings, administered by medical professionals.
Gastric Lavage	"Stomach pumping"; involves inserting a tube to wash out the stomach.	Can be effective, but often difficult, poorly tolerated, and carries risks.	Esophageal trauma, aspiration, delayed activated charcoal administration.	Used rarely and only in specific, time-critical situations under medical supervision.
Whole-Bowel Irrigation	Flushing the entire GI tract with a large volume of liquid.	Effective for substances not adsorbed by charcoal, extended-release formulations, and “body packers”.	Not for all patients (e.g., unconscious patients, bowel obstruction) and can be time-consuming.	Administered by medical professionals for specific types of poisoning.

Modern Recommendations for Suspected Poisoning

Current guidelines strongly advise against using ipecac for suspected poisoning. The critical first step is to immediately contact a poison control center. The National Poison Control Center hotline (1-800-222-1222) offers 24/7 expert advice.

If the person is unconscious, having a seizure, or difficulty breathing, call 9-1-1. Do not wait for symptoms. Only induce vomiting if explicitly told to do so by medical professionals or poison control.

Critical Actions Following Poisoning

Ensure breathing and consciousness, initiate CPR if needed, and if safe, identify the substance. Note substance, amount, time, and patient's state for poison control and implement instructions from poison control or emergency responders. For more information on poison prevention, consult {Link: American Association of Poison Control Centers https://www.aapcc.org}.

Conclusion

Ipecacuanha and its derivative, syrup of ipecac, are no longer medically recommended for poisoning due to their lack of proven effectiveness, significant risks, and the availability of better treatments. Modern medical consensus dictates that in a poisoning emergency, contacting a poison control center for expert, evidence-based guidance is the safest and most effective course of action.

Frequently Asked Questions

Doctors stopped recommending ipecac because clinical studies showed it was not effective at improving patient outcomes in poisoning cases and could delay the administration of more beneficial treatments like activated charcoal.

Key risks included the possibility of prolonged vomiting, aspiration pneumonia (inhaling vomit into the lungs), esophageal tears, and cardiotoxicity (damage to the heart muscle) with chronic or high-dose use.

Yes, activated charcoal is generally considered superior because it adsorbs toxins throughout the gastrointestinal tract and does not carry the same risks associated with forced vomiting. It is a standard treatment administered by medical professionals.

Chronic misuse of ipecac, often associated with eating disorders, is particularly dangerous. The active component, emetine, can accumulate in the body and cause severe muscle damage, especially to the heart, leading to serious medical complications or death.

If you suspect someone has been poisoned, immediately call the National Poison Control Center hotline at 1-800-222-1222. If the person is unconscious or having severe symptoms, call 9-1-1.

No, you cannot. Following the medical community's recommendations, the last remaining manufacturer of ipecac syrup in the US ceased production in 2010, and it is no longer available over-the-counter or by prescription.

Ipecacuanha is the name of the plant (Carapichea ipecacuanha) from which ipecac is derived. Ipecac typically refers to the medicinal preparation, syrup of ipecac, made from the plant's roots and rhizomes.