| CHARCOAL, ACTIVATED (LIQUID ANTIDOTE)
Actidose, CharcoAid, Charcocaps, Charcodote, Insta-Char
Classifications: antidote; adsorbent; Therapeutic: antidote
Pregnancy Category: C
208 mg/mL, 15 g, 30 g, 50 mg liquid/suspension
Activated charcoal (carbon) is a chemically inert, odorless, tasteless, fine black powder with wide spectrum of adsorptive
activity. Acts by binding (adsorbing) toxic substances, thereby inhibiting their GI absorption, enterohepatic circulation,
and thus bioavailability.
Action appears to result from drug diffusion from plasma into GI tract where it is adsorbed by activated charcoal. Effectively
adsorbs toxins in the gut preventing their systemic absorption and impact.
General purpose emergency antidote in the treatment of poisonings by most drugs and chemicals. Gastric dialysis (repetitive
doses) in uremia to adsorb various waste products from GI tract; severe acute poisoning. Has been used to adsorb intestinal
gases in treatment of dyspepsia, flatulence, and distension (value in these conditions not established). Sometimes used
topically as a deodorant for foul-smelling wounds and ulcers.
Reportedly not effective for poisonings by cyanide, mineral acids, caustic alkalis, organic solvents, iron, ethanol, methanol;
gag reflex depression, coma; GI obstruction; quinidine or quinine hypersensitivity; pregnancy (category C).
Route & Dosage
Adult: PO 30100 g in at least 180240 mL (68 oz) of water or 1 g/kg
Child (112 y): PO 12 g/kg or 1530 g in at least 68 oz of water
Infant (<1 y): PO 1 g/kg
Adult: PO 2040 g q6h for 1 or 2 d
Adult: PO 520975 mg p.c. up to 5 g/d
- Activated charcoal tablets or capsules are less adsorptive and thus less effective than powder or liquid form; therefore,
they are not recommended in treatment of acute poisoning.
- Drug is most effective when administered as soon as possible after acute poisoning (preferably within 30 min).
- In an emergency, dose may be approximated by stirring sufficient activated charcoal into tap water to make a slurry the
consistency of soup (about 2030 g in at least 240 mL of water).
- Activated charcoal can be swallowed or given through a nasogastric tube. If administered too rapidly, patient may vomit.
- If necessary, palatability may be improved by adding a small amount of concentrated fruit juice or chocolate powder to the
slurry. Reportedly, these agents do not appreciably alter adsorptive activity.
- To prevent adsorption of gases from the air, store in tightly covered container.
Adverse Effects (≥1%)GI:
Vomiting (rapid ingestion of high doses), constipation
, diarrhea (from sorbitol).
May decrease absorption of all other oral medicationsadminister at least 2 h apart.
Not absorbed. Elimination:
Assessment & Drug Effects
- Record appearance, color, consistency, frequency, and relative amount of stools. Inform patient that activated charcoal
will color feces black.