Ipecac syrup is an emetic that patients with bulimia nervosa may ingest to induce vomiting; small, chronic doses have caused cumulative, fatal toxicity in a few patients [106]. Although it is no longer available over the counter or as a prescription drug in several countries, it appears that it is possible to obtain the drug through internet purchases [121].
One component of ipecac is emetine, which accumulates in cardiac muscle cells and is toxic. Signs and symptoms of cardiotoxicity include precordial chest pain, dyspnea, hypotension, prolonged QT, pulmonary congestion, and cardiac arrest [121]. Chronic use damages muscle cells including the myocardium, that could lead to cardiomyopathy which may be irreversible [110]. Recovery may be prolonged
One component of ipecac is emetine, which accumulates in cardiac muscle cells and is toxic. Signs and symptoms of cardiotoxicity include precordial chest pain, dyspnea, hypotension, prolonged QT, pulmonary congestion, and cardiac arrest [121]. Chronic use damages muscle cells including the myocardium, that could lead to cardiomyopathy which may be irreversible [110]. Recovery may be prolonged