Activated Charcoal

Indications
 Oral
Acute oral poisoning
Adult: 25-100 g as a single dose. For multiple-dose treatment: 50-100 g as an initial dose followed by not <12.5 g every hr. Alternatively, 25 mg every 2 hr or 50 mg every 4 hr.
Child: <1 yr: 1 g/kg/dose; 1-12 yr: 25-50 g/dose.
Oral
Gastrointestinal disorders
Adult: 0.975 - 3.9 g tid.
Contraindications
 Cyanide, mineral acids, caustic alkalis, organic solvents, iron, ethanol, methanol poisoning; lithium, methionine; intestinal obstruction, anatomically-broken GI tract, haemorrhage or GI perforation. Concomitant use of charcoal with sorbitol: Patients with fructose intolerance; Childn <1 yr.
Warnings / Precautions
 Decreased peristalsis: administer within 1 hr of ingestion. Induce vomiting of ipecac syr before admin of charcoal to prevent adsorption of ipecac. Petroleum distillate, caustic ingestions may harm gastric lining upon induction of vomiting by charcoal. Limit admin of charcoal in sorbitol doses to prevent loss of fluid and electrolyte. Monitor for active bowel sounds before administering charcoal. Pregnancy.
Adverse Reactions
 Vomiting, constipation, diarrhoea, black stools, swelling of abdomen, bowel obstruction; platelet aggregation, charcoal embolism, thrombocytopenia, haemorrhage, hypoglycaemia, hypocalcaemia, hypothermia, hypotension (haemoperfusion with activated charcoal); blackening of teeth and mouth; hypernatraemia, hypokalaemia, hypermagnesemia (with concomitant admin with cathartics).
Drug Interactions
 Reduces absorption of most drugs from GI tract. Decreases effectiveness of methionine via adsorption. Decreases ipecac effect.
See Below for More charcoal, activated Drug Interactions
Food Interactions
 Milk products eg, milk, ice crm or sherbet, marmalade reduces charcoal effect. Food, nutritional supplements or herbs must not be taken within two hr of ingestion of charcoal.
Mechanism of Actions
 Charcoal due to its large surface area, inhibits the GI absorption of toxic substances or irritants eg, aromatic or benzenoid-type substances through adsorption. As a laxative, the addition of sorbitol provides hyperosmotic environment thus causing catharsis. Moreover, charcoal interferes with the enterohepatic circulation of bile acids resulting to a lower cholesterol level.
Absorption: Unabsorbed via the GI tract.
Metabolism: Unmetabolised.
Excretion: Via faeces (as unchanged form).
Administration
 Should be taken on an empty stomach (i.e. At least one hour before food or two hours after food). (Take on an empty stomach w/ plenty of liqd. Allow to disintegrate in water w/ stirring or take whole w/ liqd. Take at least 2 hr before or 2 hr after other medications. Avoid milk, ice cream & cocoa.)
Available As
  • Activated Charcoal 20 mg
  • Activated Charcoal 200 mg
  • Activated Charcoal 250 mg
  • Activated Charcoal 400 mg
  • Activated Charcoal 50 mg
  • Activated Charcoal 500 mg
  • Activated Charcoal 75 mg

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