Ipecacuanha, emetine, and dehydroemetine

General information

Ipecacuanha is an extract of the root of Psychotria ipecacuanha , also known as Cephaelis ipecacuanha , a member of the Rubiaceae. It contains the emetic alkaloids cephaeline and emetine. It has often been used as a home remedy for various purposes, and not only as an emetic. It is a traditional ingredient of some expectorants, since expectoration often accompanies vomiting. Misuse of ipecacuanha by patients with anorexia nervosa and bulimia has resulted in severe myopathy, lethargy, erythema, dysphagia, cardiotoxicity, and even death.

Emetine, once the drug of choice for the treatment of amebiasis, despite marked cardiotoxicity, has largely been replaced by metronidazole and related compounds for this indication. Large doses of emetine can damage the heart, liver, kidneys, intestinal tract, and skeletal muscle. Allergic reactions and tumor-inducing effects have not been described. Dehydroemetine is a little less toxic but also less effective than emetine; its adverse effects are similar [ ].

Gastrointestinal decontamination in acute toxic ingestion has been reviewed [ ]. Although ipecac generally seems to have a good safety profile, it can be associated with protracted vomiting. Other reported adverse reactions include drowsiness, agitation, abdominal cramps, diarrhea, aspiration pneumonia, cerebral hemorrhage, pneumoperitoneum, and pneumomediastinum. Its use is not currently recommended [ ].

Organs and systems