Peringatan Keamanan

An overdose of an ipecac preparation may cause serious poisoning. If emesis is not provoked after two doses of ipecac, a gastric lavage is recommended.L2753 The overdose of the components such as emetine is reported to cause the onset of myopathy. Chronic use of this drug has been indicated to produce muscle weakness, waddling gait, dyspnea, left atrial enlargement and reduced left ventricular ejection fraction.T49

Ipecac

DB13293

small molecule approved withdrawn

Deskripsi

Ipecac is obtained from the plant Cephaelis ipecacuanha and contains a number of emetic alkaloids including emetine and cephaeline.L2753 Ipecac was approved by Health Canada as an OTC but all those products are now discontinued.L1113 The FDA does not have currently any approved product containing ipecac, however, ipecac as an ingredient is accepted to be sold over the counter in packages of 1 fluid ounce (30 ml) for the emergency use to cause vomiting in poisoning.L2752

Struktur Molekul 2D

Struktur tidak tersedia

Peta Jejaring Molekuler
Legenda: Obat • Target • Gen • Enzim • (Panah → menunjukkan arah efek / relasi) • Transporter • Carrier

Profil Farmakokinetik

Waktu Paruh (Half-Life) The effect of ipecac is done in about 20 minutes and the elimination of the little-absorbed dose is reported to be very rapid. Thus, the half-life is thought to be of about 0.5-1 hour.[T49]
Volume Distribusi The volume of distribution is thought to be large based on the prolonged excretion.[T49]
Klirens (Clearance) The urinary excretion of the main components of ipecac accounts for 75% of the administered dose 48 hours after initial administration.[T202]

Absorpsi

The main components of ipecac are rapidly absorbed from the GI tract, this absorption depends on the amount of emesis produced by the administered dose. The peak plasma concentration of 10-16 ng/ml is attained 20 minutes after first administration.T49 The bioavailability of ipecac is reduced over time from 67-11% after 5-60 minutes of administration.A33034

Metabolisme

The main components of ipecac have been shown in microsomal enzyme systems that emetine is converted to cephaeline and 9-O-demethylemetine by CYP2D6. On the other hand, CYP3A4 produces the transformation of emetine to 9-O-demethylemetine and 10-O-demethylemetine. In preclinical studies, it was shown that cephaline is conjugated with glucuronice to form cephaeline-6'-O-glucuronide for biliary excretion whereas emetine gets demethylated to cephaline and 9-O-demethylemetine before glucuronidation.T49

Rute Eliminasi

Due to the emetic function, even 76% of the administered dose is vomited. From the absorbed dose, the elimination from plasma is relatively rapid. In some clinical trials, the alkaloids were not observed in plasma 6 hours after administration. When the patient does not vomit any part of the administered dose, there could be traces in plasma after 24 hours. The component alkaloids are eliminated via the bile and urine as it has been observed a persistence in urine after chronic administration.T49 Biliary and urinary excretion of ipecac corresponds to 57.5% and 16.5% of the administered dose respectively. From the excreted dose, unchanged cephaeline accountd for 42.4% of the eliminated dose in feces.A33036

Interaksi Obat

1107 Data
Mirabegron The serum concentration of Ipecac can be increased when it is combined with Mirabegron.
Celecoxib The metabolism of Ipecac can be decreased when combined with Celecoxib.
Fluvoxamine The metabolism of Ipecac can be decreased when combined with Fluvoxamine.
Metoprolol The metabolism of Ipecac can be decreased when combined with Metoprolol.
Venlafaxine Venlafaxine may decrease the excretion rate of Ipecac which could result in a higher serum level.
Clobazam The serum concentration of Ipecac can be increased when it is combined with Clobazam.
Clozapine The serum concentration of Ipecac can be increased when it is combined with Clozapine.
Duloxetine The metabolism of Ipecac can be decreased when combined with Duloxetine.
Chlorpromazine The metabolism of Ipecac can be decreased when combined with Chlorpromazine.
Cimetidine The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Cimetidine is combined with Ipecac.
Chloroquine The metabolism of Ipecac can be decreased when combined with Chloroquine.
Nicardipine The metabolism of Ipecac can be decreased when combined with Nicardipine.
Primaquine The metabolism of Ipecac can be decreased when combined with Primaquine.
Fusidic acid The metabolism of Ipecac can be decreased when combined with Fusidic acid.
Cholecalciferol The metabolism of Ipecac can be decreased when combined with Cholecalciferol.
Tranylcypromine The metabolism of Ipecac can be decreased when combined with Tranylcypromine.
Perhexiline The metabolism of Ipecac can be decreased when combined with Perhexiline.
Tegaserod The metabolism of Ipecac can be decreased when combined with Tegaserod.
Abiraterone The metabolism of Ipecac can be decreased when combined with Abiraterone.
Panobinostat The metabolism of Ipecac can be decreased when combined with Panobinostat.
Vilazodone The metabolism of Ipecac can be decreased when combined with Vilazodone.
Sulfaphenazole The metabolism of Ipecac can be decreased when combined with Sulfaphenazole.
Phenylbutyric acid The metabolism of Ipecac can be decreased when combined with Phenylbutyric acid.
Manidipine The metabolism of Ipecac can be decreased when combined with Manidipine.
Rolapitant The metabolism of Ipecac can be decreased when combined with Rolapitant.
Asunaprevir The metabolism of Ipecac can be decreased when combined with Asunaprevir.
Rucaparib The metabolism of Ipecac can be decreased when combined with Rucaparib.
Ritanserin The metabolism of Ipecac can be decreased when combined with Ritanserin.
Rhein The metabolism of Ipecac can be decreased when combined with Rhein.
Quinine The metabolism of Ipecac can be decreased when combined with Quinine.
Terbinafine The metabolism of Ipecac can be decreased when combined with Terbinafine.
Lumefantrine The metabolism of Ipecac can be decreased when combined with Lumefantrine.
Cyclosporine The metabolism of Ipecac can be decreased when combined with Cyclosporine.
Imipramine The metabolism of Ipecac can be decreased when combined with Imipramine.
Darifenacin The metabolism of Ipecac can be decreased when combined with Darifenacin.
Desipramine The metabolism of Ipecac can be decreased when combined with Desipramine.
Dosulepin The metabolism of Ipecac can be decreased when combined with Dosulepin.
Lorcaserin The metabolism of Ipecac can be decreased when combined with Lorcaserin.
Berotralstat The metabolism of Ipecac can be decreased when combined with Berotralstat.
Thioridazine The metabolism of Ipecac can be decreased when combined with Thioridazine.
Paroxetine The metabolism of Ipecac can be decreased when combined with Paroxetine.
Cinacalcet The metabolism of Ipecac can be decreased when combined with Cinacalcet.
Bupropion The metabolism of Ipecac can be decreased when combined with Bupropion.
Orphenadrine The metabolism of Ipecac can be decreased when combined with Orphenadrine.
Propafenone The metabolism of Ipecac can be decreased when combined with Propafenone.
Halofantrine The metabolism of Ipecac can be decreased when combined with Halofantrine.
Methotrimeprazine The metabolism of Ipecac can be decreased when combined with Methotrimeprazine.
Glycerol phenylbutyrate The metabolism of Ipecac can be decreased when combined with Glycerol phenylbutyrate.
Cisapride The metabolism of Ipecac can be decreased when combined with Cisapride.
Quinidine The metabolism of Ipecac can be decreased when combined with Quinidine.
Pitolisant The serum concentration of Ipecac can be decreased when it is combined with Pitolisant.
Icosapent Icosapent may decrease the excretion rate of Ipecac which could result in a higher serum level.
Cefotiam Cefotiam may decrease the excretion rate of Ipecac which could result in a higher serum level.
Mesalazine Mesalazine may decrease the excretion rate of Ipecac which could result in a higher serum level.
Cefmenoxime Cefmenoxime may decrease the excretion rate of Ipecac which could result in a higher serum level.
Cefmetazole Cefmetazole may decrease the excretion rate of Ipecac which could result in a higher serum level.
Tenofovir disoproxil Tenofovir disoproxil may decrease the excretion rate of Ipecac which could result in a higher serum level.
Indomethacin Indomethacin may decrease the excretion rate of Ipecac which could result in a higher serum level.
Cidofovir Cidofovir may decrease the excretion rate of Ipecac which could result in a higher serum level.
Cefpiramide Cefpiramide may decrease the excretion rate of Ipecac which could result in a higher serum level.
Ceftazidime Ceftazidime may decrease the excretion rate of Ipecac which could result in a higher serum level.
Loracarbef Loracarbef may decrease the excretion rate of Ipecac which could result in a higher serum level.
Cefalotin Cefalotin may decrease the excretion rate of Ipecac which could result in a higher serum level.
Nabumetone Nabumetone may decrease the excretion rate of Ipecac which could result in a higher serum level.
Ketorolac Ketorolac may decrease the excretion rate of Ipecac which could result in a higher serum level.
Tenoxicam Tenoxicam may decrease the excretion rate of Ipecac which could result in a higher serum level.
Cefotaxime Cefotaxime may decrease the excretion rate of Ipecac which could result in a higher serum level.
Tolmetin Tolmetin may decrease the excretion rate of Ipecac which could result in a higher serum level.
Foscarnet Foscarnet may decrease the excretion rate of Ipecac which could result in a higher serum level.
Rofecoxib Rofecoxib may decrease the excretion rate of Ipecac which could result in a higher serum level.
Piroxicam Piroxicam may decrease the excretion rate of Ipecac which could result in a higher serum level.
Cephalexin Cephalexin may decrease the excretion rate of Ipecac which could result in a higher serum level.
Fenoprofen Fenoprofen may decrease the excretion rate of Ipecac which could result in a higher serum level.
Valaciclovir Valaciclovir may decrease the excretion rate of Ipecac which could result in a higher serum level.
Valdecoxib Valdecoxib may decrease the excretion rate of Ipecac which could result in a higher serum level.
Diclofenac Diclofenac may decrease the excretion rate of Ipecac which could result in a higher serum level.
Sulindac Sulindac may decrease the excretion rate of Ipecac which could result in a higher serum level.
Bacitracin Bacitracin may decrease the excretion rate of Ipecac which could result in a higher serum level.
Cephaloglycin Cephaloglycin may decrease the excretion rate of Ipecac which could result in a higher serum level.
Flurbiprofen Flurbiprofen may decrease the excretion rate of Ipecac which could result in a higher serum level.
Adefovir dipivoxil Adefovir dipivoxil may decrease the excretion rate of Ipecac which could result in a higher serum level.
Pentamidine Pentamidine may decrease the excretion rate of Ipecac which could result in a higher serum level.
Etodolac Etodolac may decrease the excretion rate of Ipecac which could result in a higher serum level.
Mefenamic acid Mefenamic acid may decrease the excretion rate of Ipecac which could result in a higher serum level.
Acyclovir Acyclovir may decrease the excretion rate of Ipecac which could result in a higher serum level.
Naproxen Naproxen may decrease the excretion rate of Ipecac which could result in a higher serum level.
Sulfasalazine Sulfasalazine may decrease the excretion rate of Ipecac which could result in a higher serum level.
Phenylbutazone Phenylbutazone may decrease the excretion rate of Ipecac which could result in a higher serum level.
Meloxicam Meloxicam may decrease the excretion rate of Ipecac which could result in a higher serum level.
Carprofen Carprofen may decrease the excretion rate of Ipecac which could result in a higher serum level.
Cefaclor Cefaclor may decrease the excretion rate of Ipecac which could result in a higher serum level.
Diflunisal Diflunisal may decrease the excretion rate of Ipecac which could result in a higher serum level.
Ceforanide Ceforanide may decrease the excretion rate of Ipecac which could result in a higher serum level.
Salicylic acid Salicylic acid may decrease the excretion rate of Ipecac which could result in a higher serum level.
Meclofenamic acid Meclofenamic acid may decrease the excretion rate of Ipecac which could result in a higher serum level.
Acetylsalicylic acid Acetylsalicylic acid may decrease the excretion rate of Ipecac which could result in a higher serum level.
Carboplatin Carboplatin may decrease the excretion rate of Ipecac which could result in a higher serum level.
Oxaprozin Oxaprozin may decrease the excretion rate of Ipecac which could result in a higher serum level.
Ketoprofen Ketoprofen may decrease the excretion rate of Ipecac which could result in a higher serum level.
Balsalazide Balsalazide may decrease the excretion rate of Ipecac which could result in a higher serum level.

Referensi & Sumber

Artikel (PubMed)
  • PMID: 19227966
    Lee MR: Ipecacuanha: the South American vomiting root. J R Coll Physicians Edinb. 2008 Dec;38(4):355-60.
  • PMID: 15504189
    Axelsson P, Thorn SE, Wattwil M: Betamethasone does not prevent nausea and vomiting induced by ipecacuanha. Acta Anaesthesiol Scand. 2004 Nov;48(10):1283-6.
  • PMID: 9365428
    Saincher A, Sitar DS, Tenenbein M: Efficacy of ipecac during the first hour after drug ingestion in human volunteers. J Toxicol Clin Toxicol. 1997;35(6):609-15.
  • PMID: 11996324
    Asano T, Watanabe J, Sadakane C, Ishihara K, Hirakura K, Wakui Y, Yanagisawa T, Kimura M, Kamei H, Yoshida T, Fujii Y, Yamashita M: Biotransformation of the ipecac alkaloids cephaeline and emetine from ipecac syrup in rats. Eur J Drug Metab Pharmacokinet. 2002 Jan-Mar;27(1):29-35.
Textbook
  • Barceloux D.G. (2012). Medical toxicology of drug abuse: Synthesized chemicals and psychoactive plants.. Wiley.
  • Benzoni T. and Gossman W. (2017). Ipecac. Treasure Island: StatPearls Publishing.

Contoh Produk & Brand

Produk: 6 • International brands: 0
Produk
  • Ipecac roots
    Stick • 50 kg/50kg • Not applicable • US
  • Ipecac Syrup
    Syrup • 140 mg / 100 mL • Oral • Canada • OTC • Approved
  • Ipecac Syrup 1.8gm/30ml USP
    Syrup • 1.8 g / 30 mL • Oral • Canada • OTC • Approved
  • PMS-ipecac Syrup
    Syrup • 7 % • Oral • Canada • Generic • OTC • Approved
  • Robol Tab
    Tablet • - • Oral • Canada • OTC • Approved
  • Trousse Antipoison Pour Enfants Liq
    Liquid • - • Oral • Canada • OTC • Approved

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