Activated Charcoal

Activated charcoal, also known as activated carbon, is used to absorb a variety of drugs and chemicals in the body by binding the drug or chemical to the activated charcoal. Desorption may occur unless the ratio of charcoal to toxin is extremely high.

• Activated charcoal is available under the following different brand names: Actidose-Aqua, charcoal (activated), CharcoalAid, Insta-Char, Liqui-Char, and Superchar.

Adult and pediatric dosages:

• 250 mg tablets
• 260 mg capsules
• 208 mg/ml liquid
• 25 g suspension
• 50 g suspension
• 25 mg pellets for suspension

Dosage Considerations

Adult poisoning

• 1 g/kg, 25-100 g orally.
• Alternatively 10 g charcoal/1 g drug ratio
• Minimum dose = 25 g

Commonly used with sorbitol 25 g; multiple-dose regimen 25 g orally every 2 hours or 50 g every 4 hours without sorbitol.

• Do not give sorbitol after the first dose due to the risk for severe diarrhea; use an aqueous solution.
• Dose cathartic once daily if used.
• Shake vigorously prior to use.

Administer in a closed container with straw; may place on ice to improve taste; mix 1:3 soda for pediatrics.

• Multiple doses are used with dapsone, carbamazepine, digitoxin and digoxin, phenobarbital, theophylline, meprobamate, and quinine.

Aqueous suspension

• Infants: 1 g/kg/dose orally, may repeat every 4-6 hours.
• Children: 1-2 g/kg/dose (or 25-50 g/dose) orally, may repeat every 4-6 hours.
• Adolescents: 5-10 times the estimated weight of drug/chemical ingested (or 50-100 g/dose) orally, may repeat every 4-6 hours.

Sorbitol suspension

• Infants and children: Not indicated; due to the risk for severe diarrhea associated with sorbitol suspension, the aqueous formulation is recommended.
• Adolescents: 50 g as a single dose orally; not recommended for multiple dosage regimens (use aqueous solutions for repeat dosing).

Side effects associated with the use of activated charcoal includes the following:

• black stool
• constipation

Rare side effects of activated charcoal include:

• slowing of the intestinal tract
• blockages in the intestinal tract
• regurgitation into the lungs
• dehydration

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Activated charcoal has moderate interactions with:
  • acetylcysteine
  • acetylcysteine (antidote)
  • citalopram
  • digoxin
  • dyphylline
  • methotrexate
  • theophylline
• Activated charcoal has mild interactions with:
  • acarbose
  • leflunomide
  • miglitol

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Warnings

• This medication contains activated charcoal. Do not take Actidose-Aqua, charcoal (activated), CharcoalAid, Insta-Char, Liqui-Char, and Superchar if you are allergic to activated charcoal or any ingredients contained in this drug.
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Do not use if there is intestinal obstruction, unprotected airway (aspiration may occur), or caustic ingestions.

Effects of Drug Abuse

• There are no effects of drug abuse with the use of activated charcoal.

Short-term Effects

• There are no short-term effects from the use of activated charcoal.

Long-term Effects

• There are no long-term effects from the use of activated charcoal.

Cautions

Consider the following cautions when using activated charcoal:

• vomiting may occur
• caution in patients with decreased peristalsis
• ipecac may decrease the effectiveness of activated charcoal
• sorbitol or other cathartics may increase the risk of significant electrolyte abnormalities
• capsules or tablets not recommended for treatment of poisoning
• a product containing sorbitol, not for use in patients with fructose intolerance
• note: activated charcoal is not effective with alcohols, caustics (contraindicated), iron, lithium, heavy metals, and mineral acids.

Pregnancy and Lactation

• Consult with your physician for use in pregnancy or when lactating.