Charcoal, Activated

May decrease absorption of and therapeutic response to other orally administered drugs.102 106 107 a Drugs other than those used for GI decontamination or antidotes for ingested toxins should not be given within 2 hours of activated charcoal; if necessary, concomitant drug therapy can be given parenterally.102 107

Specific Drugs

Storage

Oral

Well-closed glass or metal containers.a

• Importance of calling poison control center (800-222-1222), physician, or emergency department before administration.107

• Shake liquid well, drink, then rinse container with water, shake again, and drink to get full dose.107

• Administer only after vomiting has ceased.107

• Importance of not mixing with milk, ice cream, or sherbet.107

• Importance of taking oral drugs not used for poisoning at least 2 hours before or after administration of activated charcoal.107

• Importance of informing patients of other important precautionary information. (See Cautions.)

• Activated Carbon
• Activated Charcoal
• Adsorbent Charcoal
• Liquid Antidote
• Medicinal Carbon
• Medicinal Charcoal

Acute poisoning: Oral, NG: Note: Some products may contain sorbitol; coadministration of a cathartic, including sorbitol, is not recommended due to the potential risk of severe dehydration and electrolyte imbalance, especially in children. Some clinicians still recommend dosing activated charcoal in a 10:1 (charcoal:poison) ratio for optimal efficacy (Gude 2009); however, the amount of poison ingested is commonly unknown, which makes this approach challenging and often impractical (Chyka 2005).

Single dose (Chyka 2005):

Infants <1 year: 10 to 25 g; Note: Although dosing by body weight is reported in children (0.5 to 1 g/kg) and published in many resources, there are no data or scientific rationale to support this recommendation.

Children 1 to 12 years: 25 to 50 g

Children >12 years: Refer to adult dosing.

Multidose: Initial dose: 25 to 50 g; followed by multiple doses of 10 to 25 g every 4 hours

Powder: Dilute with at least 8 mL of water per 1 g of charcoal, or mix in a charcoal to water ratio of 1:4 to 1:8; mix vigorously to form a slurry (eg, mix 25 g with sufficient tap water to create a 4-ounce slurry or mix 50 g with sufficient tap water to create an 8-ounce slurry).

Leflunomide: Charcoal, Activated may decrease serum concentrations of the active metabolite(s) of Leflunomide. Management: Unless using this combination to intentionally enhance leflunomide elimination, consider an alternative to charcoal when possible. Separating drug administration is not likely to be effective at avoiding this interaction. Consider therapy modification

Teriflunomide: Charcoal, Activated may decrease the serum concentration of Teriflunomide. Management: Unless using this combination to intentionally enhance teriflunomide elimination, consider an alternative to charcoal when possible. Separating drug administration is not likely to be effective at avoiding this interaction. Consider therapy modification

Frequency not defined.

Gastrointestinal: Abdominal distention, appendicitis, constipation, dental discoloration (black; temporary), fecal discoloration (black), intestinal obstruction, mouth discoloration (black; temporary), vomiting

Ophthalmic: Corneal abrasion (with direct contact)

Respiratory: Aspiration, respiratory failure

The product is a mixture of Activated Charcoal, Sorbitol, and water with a unique preservative system. Activated charcoal is a fine black, odorless and tasteless powder which has been treated by various agents to enhance its adsorptive powers. The treatment is referred to as activation; the agents remove substances previously adsorbed on the charcoal, and in some instances, break down the granules of carbon into smaller ones having a greater total surface area, thus a greater number of adsorption sites on the charcoal molecule. Sorbitol reduces the gritty sensation associated with activated charcoal, imparts a sweet taste which enhances patient compliance and may produce a cathartic effect.