Dosing & Uses
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)
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (0)
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.
Adverse Effects
Frequency Not Defined
Common
- Black stool
- Constipation
Rare
- Slowing of intestinal tract
- Blocking of intestinal tract
- Regurgitation into the lungs
- Dehydration
Warnings
Contraindications
Intestinal obstruction
Unprotected airway (aspiration may occur)
Caustic ingestions
Use of cathartic if patient has significant fluid or electrolyte abnormalities
Infants
Cathartic doses of sorbitol in young children (unless hospitalized and under immediate care of physician)
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
For use in a supervised medical facility or under direction of a physician or poison control center
Actidose with Sorbitol and Actidose-Aqua are adjuncts in the management of poisoning emergencies; prior to use, proper basic life support measures must be implemented as well as appropriate gastric emptying technique if indicated
When used to treat a poisoning emergency, patient and health care providers should be aware that activated charcoal will produce black stools that may be diarrhetic and may persist for several hours
When used with a cathartic, it may produce a profound cathartic effect; proper attention should be given to patient’s fluid and electrolyte needs; use cautiously in patients receiving multiple-dose activated charcoal; if used with cathartic at each dosage interval, profound catharsis may develop which could result in dehydration, hypotension and significant electrolyte and fluid abnormalities
Gastrointestinal obstruction from activated charcoal may occur as a consequence of toxin-induced antiperistaltic effects; administer cautiously in patients who have been exposed to toxins that interfere with gastrointestinal tract peristalsis (eg, anticholinergics, opioids, etc); bowel sounds should be frequently monitored to assess peristaltic action, especially in patients undergoing multiple-dose activated charcoal therapy
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
Images
Patient Handout
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) 2023 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.
