ACTIVATED CHARCOAL

OTHER NAME(S):

Activated Carbon, Animal Charcoal, Carbo Vegetabilis, Carbon, Carbón Activado, Charbon Actif, Charbon Activé, Charbon Animal, Charbon Médicinal, Charbon Végétal, Charbon Végétal Activé, Charcoal, Gas Black, Lamp Black, Medicinal Charcoal, Noir de Gaz, Noir de Lampe, Vegetable Carbon, Vegetable Charcoal.<br/><br/>

Overview

Overview Information

Common charcoal is made from peat, coal, wood, coconut shell, or petroleum. “Activated charcoal” is similar to common charcoal, but is made especially for use as a medicine. To make activated charcoal, manufacturers heat common charcoal in the presence of a gas that causes the charcoal to develop lots of internal spaces or “pores.” These pores help activated charcoal “trap” chemicals.

Orally, activated charcoal is used to treat poisonings, reduce phenytoin levels, reduce intestinal gas (flatulence), lower cholesterol levels, prevent diarrhea caused by the cancer drug irinotecan, reduce phosphate levels in dialysis, prevent hangover, calm upset stomach and treat bile flow problems (cholestasis) during pregnancy. Activated charcoal is also used topically in bandages for helping heal wounds and to improve the appearance of skin.

How does it work?

Activated charcoal is good at trapping chemicals and prevents their absorption.

Uses

Uses & Effectiveness?

Possibly Effective for

  • Poisoning. Activated charcoal is useful for trapping chemicals to stop some types of poisoning when used as part of standard treatment. Activated charcoal should be given within 1 hour after a poison has been ingested. It does not seem to be beneficial if given for 2 or more hours after some types of poisoning.

Insufficient Evidence for

  • Lowering cholesterol levels. So far, research studies don’t agree about the effectiveness of taking activated charcoal by mouth to lower cholesterol levels in the blood.
  • Diarrhea caused by the cancer drug irinotecan. Irinotecan is a cancer drug known to cause diarrhea. Early research shows that taking activated charcoal during treatment with irinotecan decreases diarrhea, including severe diarrhea, in children taking this drug.
  • Decreasing gas (flatulence). Some studies show that activated charcoal is effective in reducing intestinal gas, but other studies don’t agree. It’s too early to come to a conclusion on this.
  • Indigestion. Some early research shows that taking certain combination products containing activated charcoal and simethicone, with or without magnesium oxide, can reduce pain, bloating, and feelings of fullness in people with indigestion. It’s unclear if taking activated charcoal by itself will help.
  • Treating reduced bile flow (cholestasis) during pregnancy. Taking activated charcoal by mouth seems to help treat cholestasis in pregnancy, according to some early research reports.
  • Lowering phophate levels in people on dialysis. Early research shows that taking activated charcoal daily for 24 weeks might reduce phosphate levels in people on hemodialysis who have high phosphate levels.
  • Preventing hangover. Activated charcoal is included in some hangover remedies, but some experts are skeptical about how well it might work. Activated charcoal doesn’t seem to trap alcohol well.
  • Toxic effects from the antiseizure drug phenytoin. Some early research shows that activated charcoal can help remove phenytoin from the body, bringing the phenytoin levels back to a normal range.
  • Wound healing. Some early research shows that using bandages with activated charcoal does not help with wound healing in people with long-term wounds such as pressure ulcers.
  • Other conditions.
More evidence is needed to rate the effectiveness of activated charcoal for these uses.

Side Effects

Side Effects & Safety

Activated charcoal is safe for most adults when used short-term. Side effects of activated charcoal include constipation and black stools. More serious, but rare, side effects are a slowing or blockage of the intestinal tract, regurgitation into the lungs, and dehydration.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Activated charcoal might be safe when used short-term if you are pregnant or breast-feeding, but consult with your healthcare professional before using if you are pregnant.

Gastrointestinal (GI) blockage or slow movement of food through the intestine: Don’t use activated charcoal if you have any kind of intestinal obstruction. Also, if you have a condition that slows the passage of food through your intestine (reduced peristalsis), don’t use activated charcoal, unless you are being monitored by your healthcare provider.

Interactions

Interactions?

Major Interaction

Do not take this combination

!
  • Syrup of ipecac interacts with ACTIVATED CHARCOAL

    Activated charcoal can bind up syrup of ipecac in the stomach. This decreases the effectiveness of syrup of ipecac.

Moderate Interaction

Be cautious with this combination

!
  • Alcohol interacts with ACTIVATED CHARCOAL

    Activated charcoal is sometimes used to prevent poisons from being absorbed into the body. Taking alcohol with activated charcoal might decrease how well activated charcoal works to prevent poison absorption.

  • Medications taken by mouth (Oral drugs) interacts with ACTIVATED CHARCOAL

    Activated charcoal absorbs substances in the stomach and intestines. Taking activated charcoal along with medications taken by mouth can decrease how much medicine your body absorbs, and decrease the effectiveness of your medication. To prevent this interaction, take activated charcoal at least one hour after medications you take by mouth.

Dosing

Dosing

The following doses have been studied in scientific research:

ADULTS

BY MOUTH:

  • For drug overdose or poisoning: 50-100 grams of activated charcoal is given at first, followed by charcoal every 2-4 hours at a dose equal to 12.5 grams per hour. Sometimes a single-dose of 25-100 grams of activated charcoal may be used.
CHILDREN

BY MOUTH:
  • For drug overdose or poisoning: Activated charcoal 10-25 grams is recommended for children up to one year of age, while activated charcoal 25-50 grams is recommended for children 1-12 years of age. Activated charcoal 10-25 grams is recommended if multiple-doses of activated charcoal are needed.

View References

REFERENCES:

  • Anon. Position paper: Ipecac syrup. J Toxicol Clin Toxicol 2004;42:133-43. View abstract.
  • Anon. Position statement and practice guidelines on the use of multi-dose activated charcoal in the treatment of acute poisoning. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. J Toxicol Clin Toxicol 1999;37:731-51. View abstract.
  • Bond GR. The role of activated charcoal and gastric emptying in gastrointestinal decontamination: a state-of-the-art review. Ann Emerg Med 2002;39:273-86. View abstract.
  • Brahmi N, Kouraichi N, Thabet H, Amamou M. Influence of activated charcoal on the pharmacokinetics and the clinical features of carbamazepine poisoning. Am J Emerg Med 2006;24(4):440-3. View abstract.
  • Chyka PA, Seger D, Krenzelok EP, et al. Position paper: single-dose activated charcoal. Clin Toxicol (Phila) 2005;43(2):61-87. View abstract.
  • Coffin B, Bortolloti C, Bourgeouis O, Denicourt L. Efficacy of a simethicone, activated charcoal and magnesium oxide combination (Carbosymag) in functional dyspepsia: results of a general practice-based randomized trial. Clin Res Hepatol Gastroenterol 2011;35(6-7):494-9.View abstract.
  • Cooper GM, Le Couteur DG, Richardson D, Buckley NA. A randomized clinical trial of activated charcoal for the routine management of oral drug overdose. QJM 2005;98(9):655-60. View abstract.
  • Eddleston M, Juszczak E, Buckley NA, et al. Multiple-dose activated charcoal in acute self-poisoning: a randomised controlled trial. Lancet 2008;371(9612):579-87. View abstract.
  • Gude AB, Hoegberg LC, Angelo HR, Christensen HR. Dose-dependent adsorptive capacity of activated charcoal for gastrointestinal decontamination of a simulated paracetamol overdose in human volunteers. Basic Clin Pharmacol Toxicol 2010;106(5)406-10. View abstract.
  • Hall RG Jr, Thompson H, Strother A. Effects of orally administered activated charcoal on intestinal gas. Am J Gastroenterol 1981;75:192-6. View abstract.
  • Hoegberg LC, Angelo HR, Christophersen AB, Christensen HR. Effect of ethanol and pH on the adsorption of acetaminophen (paracetamol) to high surface activated charcoal, in vitro studies. J Toxicol Clin Toxicol 2002;40:59-67. View abstract.
  • Hoekstra JB, Erkelens DW. No effect of activated charcoal on hyperlipidaemia. A double-blind prospective trial. Neth J Med 1988;33:209-16.
  • Kaaja RJ, Kontula KK, Raiha A, Laatikainen T. Treatment of cholestasis of pregnancy with peroral activated charcoal. A preliminary study. Scand J Gastroenterol 1994;29:178-81. View abstract.
  • Kerihuel JC. Charcoal combined with silver for the treatment of chronic wounds. Wounds UK 2009;5(3):87-93.
  • Kerihuel JC. Effect of activated charcoal dressings on healing outcomes of chronic wounds. J Wound Care. 2010;19(5):208,210-2,214-5. View abstract.
  • Lecuyer M, Cousin T, Monnot MN, Coffin B. Efficacy of an activated charcoal-simethicone combination in dyspeptic syndrome: results of a randomized prospective study in general practice. Gastroenterol Clin Biol 2009;33(6-7):478-84. View abstract.
  • Mullins M, Froelke BR, Rivera MR. Effect of delayed activated charcoal on acetaminophen concentration after simulated overdose of oxycodone and acetaminophen. Clin Toxicol (Phila) 2009;47(2):112-5. View abstract.
  • Neuvonen PJ, Kuusisto P, Vapaatalo H, Manninen V. Activated charcoal in the treatment of hypercholesterolaemia: dose-response relationships and comparison with cholestyramine. Eur J Clin Pharmacol 1989;37:225-30. View abstract.
  • Park GD, Spector R, Kitt TM. Superactivated charcoal versus cholestyramine for cholesterol lowering: a randomized cross-over trial. J Clin Pharmacol 1988;28:416-9. View abstract.
  • Roberts DM, Southcott E, Potter JM, et al. Pharmacokinetics of digoxin cross-reacting substances in patients with acute yellow oleander (Thevetia peruviana) poisoning, including the effect of activated charcoal. Ther Drug Monit 2006;28(6):784-92. View abstract.
  • Sergio GC, Felix GM, Luis JV. Activated charcoal to prevent irinotecan-induced diarrhea in children. Pediatr Blood Cancer 2008;51(1):49-52. View abstract.
  • Skinner CG, Chang AS, Matthews AS, Reedy SJ, Morgan BW. Randomized controlled study on the use of multiple-dose activated charcoal in patients with supratherapeutic phenytoin levels. Clin Toxicol (Phila) 2012;50(8):764-9. View abstract.
  • Suarez FL, Furne J, Springfield J, Levitt MD. Failure of activated charcoal to reduce the release of gases produced by the colonic flora. Am J Gastroenterol 1999;94:208-12. View abstract.
  • Wananukul W, Klaikleun S, Sriapha C, Tongpoo A. Effect of activated charcoal in reducing paracetamol absorption at supra-therapeutic dose. J Med Assoc Thai 2010;93(10):1145-9. View abstract.
  • Wang X, Mondal S, Wang J, et al. Effect of activated charcoal on apixaban pharmacokinetics in healthy subjects. Am J Cardiovasc Drugs 2014;14(2):147-54. View abstract.
  • Wang Z, Cui M, Tang L, et al. Oral activated charcoal suppresses hyperphosphataemia in haemodialysis patients. Nephrology (Carlton) 2012;17(7):616-20. View abstract.

More Resources for ACTIVATED CHARCOAL

CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

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