activated charcoal (OTC)

Brand and Other Names:Actidose-Aqua, charcoal (activated), more...CharcoalAid, Insta-Char, Liqui-Char, Superchar
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablets

  • 250mg

capsules

  • 260mg

liquid

  • 208 mg/mL

suspension

  • 25g
  • 50g

pellets for suspension

  • 25mg

Overdose, Poisoning

1 g/kg, 25-100 g PO

Alternatively 10 g charcoal/1 g drug ratio

Minimum dose = 25 g

Commonly used with sorbitol 25 g; multiple dose regimen 25 g PO q2hr or 50 g q4hr without sorbitol

DO NOT give sorbitol after first dose due to risk for severe diarrhea; use aqueous solution

Dose cathartic once daily if used

Shake vigorously prior to use

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

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

Dosage Forms & Strengths

tablets

  • 250mg

capsules

  • 260mg

liquid

  • 208 mg/mL

suspension

  • 25g
  • 50g

pellets for suspension

  • 25mg

Poisoning

Aqueous suspension

  • Infants: 1 g/kg/ dose PO; may repeat q4-6hr
  • Children: 1-2 g/kg/dose (or 25-50 g/dose) PO; may repeat q4-6hr
  • Adolescents: 5-10 times the estimated weight of drug/chemical ingested (or 50-100 g/dose) PO; may repeat q4-6hr

Sorbitol suspension

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

Interaction Checker

and activated charcoal

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        Significant - Monitor Closely

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                Monitor Closely (6)

                • acetylcysteine

                  activated charcoal decreases effects of acetylcysteine by Other (see comment). Use Caution/Monitor. Comment: Conflicting reports exist; however, charcoal administration does not preclude acetylcysteine administration for acetaminophen overdose .

                • acetylcysteine (Antidote)

                  activated charcoal decreases effects of acetylcysteine (Antidote) by Other (see comment). Use Caution/Monitor. Comment: Conflicting reports exist; however, charcoal administration does not preclude acetylcysteine administration for acetaminophen overdose .

                • citalopram

                  activated charcoal decreases effects of citalopram by pharmacodynamic antagonism. Use Caution/Monitor. Charcoal can reduce absorption of citalopram, resulting in decreased efficacy.

                • digoxin

                  activated charcoal decreases levels of digoxin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                • methotrexate

                  activated charcoal will decrease the level or effect of methotrexate by Other (see comment). Use Caution/Monitor. Charcoal can reduce absorption of methotrexate and remove it from systemic circulation. Depending on the clinical situation, this will reduce the effectiveness or toxicity of methotrexate.

                • theophylline

                  activated charcoal decreases levels of theophylline by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                Minor (3)

                • acarbose

                  activated charcoal decreases levels of acarbose by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                • leflunomide

                  activated charcoal decreases levels of leflunomide by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                • miglitol

                  activated charcoal decreases levels of miglitol by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

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                Adverse Effects

                Frequency Not Defined

                Common

                • Black stool
                • Constipation

                Rare

                • Slowing of intestinal tract
                • Blocking of intestinal tract
                • Regurgitation into the lungs
                • Dehydration
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                Warnings

                Contraindications

                Intestinal obstruction

                Unprotected airway (aspiration may occur)

                Caustic ingestions

                Cautions

                Vomiting may occur

                Caution in patients with decreased peristalsis

                Ipecac may decrease effectiveness of activated charcoal

                Sorbitol or other cathartics may increase risk of significant electrolyte abnormalities

                Capsules or tablets not recommended for treatment of poisoning

                Product containing sorbitol not for use in patients with fructose intolerance

                Note: not effective with alcohols, caustics (contraindicated), iron, lithium, heavy metals, mineral acids

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                Pharmacology

                Mechanism of Action

                Adsorbs a variety of drugs and chemicals (eg, physical binding of a molecule to the surface of charcoal particles); desorbtion of bound particals may occur unless the ratio of charcoal to toxin is extremely high

                Pharmacokinetics

                Absorption: None

                Metabolism: None

                Excretion: Unchanged in feces

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                Images

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                Patient Handout

                Patient Education
                activated charcoal oral

                NO MONOGRAPH AVAILABLE AT THIS TIME

                USES: Consult your pharmacist.

                HOW TO USE: Consult your pharmacist.

                SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Consult your pharmacist.

                DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

                OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

                NOTES: No monograph available at this time.

                MISSED DOSE: Consult your pharmacist.

                STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

                Information last revised July 2016. Copyright(c) 2021 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.