Position Paper: Single-Dose Activated Charcoal

  title={Position Paper: Single-Dose Activated Charcoal},
  author={American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinic},
  journal={Clinical Toxicology},
  pages={61 - 87}
Single-dose activated charcoal therapy involves the oral administration or instillation by nasogastric tube of an aqueous preparation of activated charcoal after the ingestion of a poison. Volunteer studies demonstrate that the effectiveness of activated charcoal decreases with time. Data using at least 50 g of activated charcoal, showed a mean reduction in absorption of 47.3%, 40.07%, 16.5% and 21.13%, when activated charcoal was administered at 30 minutes, 60 minutes, 120 minutes and 180… 
Should activated charcoal be given after tramadol overdose?
Balancing the hazards of tramadol poisoning versus the potential risks of charcoal administration is important for answering the question of whether AC should be administrated to patients with tramadols overdose.
The effect of activated charcoal on drug exposure following intravenous administration: A meta‐analysis
The results offer a possible and plausible rationale for the previously observed effects of single‐dose activated charcoal beyond the timeframe where ingested drug is present in the gastro‐intestinal tract.
An exploratory study; the therapeutic effects of premixed activated charcoal–sorbitol administration in patients poisoned with organophosphate pesticide
It was demonstrated that the administration of AC–sorbitol was not associated with outcome measures for effectiveness and did not significantly increase either aspiration pneumonia or electrolyte imbalances during hospitalization and further qualified trials with a sufficient number of patients are needed.
Activated Charcoal and Poisoning: Is It Really Effective?
The use of activated charcoal in poisoned patients may not provide sufficient clinical benefits, and clinical studies with strong evidence levels are needed to determine activated charcoal's clinical efficacy, which is still used as a universal antidote.
Dose Determination of Activated Charcoal in Management of Amitriptyline-Induced Poisoning by Reversed-Phase High-Performance Liquid Chromatography
The proposed RP-HPLC method enables determination of amitriptyline with good separation and resolution of the chromatographic peaks and revealed that the method is sensitive, accurate and selective.
Fundaments of Toxicology-Approach to the Poisoned Patient.
Hemodialysis is the most inexpensive, widely available, and most commonly used method of extracorporeal drug removal in the treatment of poisoning.
ExposiÁies tÛxicas agudas em crianÁas: um panorama Acute toxic exposure in children: an overview
There is no evidence that gastrointestinal decontamination and multiple-dose activated charcoal improve the outcome of poisoned patients, and Ipecac syrup and cathartics should not be administered on a routine basis in acute toxic exposures in outpatient treatment.
Antidotes in Poisoning
  • B. Chacko, J. Peter
  • Chemistry, Biology
    Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
  • 2019
An overview of the role of antidotes in poisoning is provided and drugs such as N-acetyl cysteine and sodium thiocyanate reduce the formation of toxic metabolites in paracetamol and cyanide poisoning respectively.
First aid interventions by laypeople for acute oral poisoning.
The collected evidence was mostly of low to very low certainty, often downgraded for indirectness, risk of bias or imprecision due to low numbers of events.
General Management of the Poisoned Patient
  • B. Corbett
  • Medicine
    Behavioral Emergencies for Healthcare Providers
  • 2021


Activated charcoal alone or after gastric lavage: a simulated large paracetamol intoxication.
It is suggested that combination treatment may be no better than activated charcoal alone in patients presenting early after large overdoses, and the effect of activated charcoal given 2 h post ingestion is substantially less than at 1 h, emphasizing the importance of early intervention.
Factors influencing the clinical efficacy of activated charcoal.
  • W. Watson
  • Medicine
    Drug intelligence & clinical pharmacy
  • 1987
Variables that may alter the efficacy of charcoal therapy include the preparation and dose of charcoal used, the intoxicants involved, stomach contents, the gastrointestinal pH, concurrently administered materials, and time from toxin ingestion to charcoal administration.
How Long After Drug Ingestion Is Activated Charcoal Still Effective?
The data do not support the administration of activated charcoal as a gastrointestinal decontamination strategy beyond 1 hour after drug overdose.
Oral Activated Charcoal in the Treatment of Intoxications
In addition to increasing the elimination of many drugs and toxins even after their systemic absorption, repeated doses of charcoal also reduce the risk of desorbing from the charcoal-toxin complex as the complex passes through the gastrointestinal tract.
Effect of activated charcoal administration on acetylcysteine serum levels in humans.
The data suggest that acetylcysteine absorption is not impaired by activated charcoal administration, which conflicts with previously published in vitro data; therefore, it is recommended that activated charcoal should not be administered concomitantly with acetyl Cysteine as a usual procedure until more data are available.
Optimal antidotal dose of activated charcoal.
Effect of charcoal-drug ratio on antidotal efficacy of oral activated charcoal in man.
  • K. Olkkola
  • Medicine
    British journal of clinical pharmacology
  • 1985
To minimize the possibility of saturation of the adsorption capacity of charcoal in acute intoxications where the amount and type of drug taken is usually unknown, large doses (50-100 g) of activated charcoal should be used.
Adverse effects of superactivated charcoal administered to healthy volunteers.
Superactivated charcoal consumption is associated with significant adverse effects in some healthy volunteers, which may impede a drug overdose patient's ability to willingly drink charcoal slurry in a reasonable period of time.
Effect of activated charcoal on the pharmacokinetics of pholcodine, with special reference to delayed charcoal ingestion.
It is concluded that activated charcoal is effective in preventing the absorption of pholcodine, and its administration can be beneficial even several hours after phol codine ingestion.
Concomitant use of activated charcoal and N-acetylcysteine.