Charcoal Activated

What it is and how it works

Activated charcoal is a highly porous form of carbon with a very large surface area that adsorbs many drugs and toxins in the gastrointestinal tract, preventing their absorption. Repeated doses can also enhance elimination of some drugs by interrupting enterohepatic circulation and ‘gut dialysis’.

Indications

Acute oral poisoning or overdose with substances adsorbed by charcoal, ideally within 1 hour of ingestion; multiple-dose therapy for selected drugs (e.g. carbamazepine, dapsone, phenobarbital, quinine, theophylline). Low-dose tablets are also used for flatulence and mild diarrhoea.

Dosage and administration (summary)

Poisoning (adults): single dose of 50 g (25–100 g) by mouth or nasogastric tube as an aqueous suspension; multiple-dose regimen typically 50 g every 4 hours or 25 g every 2 hours according to protocol.

Contraindications

Unprotected airway (reduced consciousness without intubation); gastrointestinal obstruction, perforation or ileus; ingestion of corrosives (acids, alkalis) or hydrocarbons with high aspiration risk.

Warnings and precautions

Ineffective for alcohols, glycols, iron, lithium, cyanide and other metals, strong acids and alkalis. Aspiration may cause serious pneumonitis; vomiting and constipation are common, and stools turn black. It adsorbs oral medicines and antidotes given concurrently (e.g. oral acetylcysteine) — separate administration.

Pregnancy

Not absorbed systemically; may be used in pregnancy when indicated.

Storage and supply

Store below 25 °C in a tightly closed container, away from strong odours and volatile substances.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.