activated charcoal

Action and Spectrum

Action:

The main mode of action of activated charcoal is the physiological process of adsorption in which the substance forms a film over the charcoal particles to bind and prevent the substances in the gastrointestinal tract from being absorbed into the systemic circulation. This can in turn lower the systemic availability of many drugs, toxins, and chemicals; thus, inflammation and its related toxicities are lowered.

Spectrum:

Activated charcoal requires further study to elucidate the various forms of activity, however, it has been used in such conditions as drug overdose, toxic ingestions, and in chemical poisonings. Nonetheless, it has its drawbacks, and it is not appropriate for all types of solutions, including highly concentrated ones, such as strong acids and strong alkalis, and some gases.

Drug Interaction

Adverse Reaction

Frequency not defined:  

Rare 

Blocking of the intestinal tract

Regurgitation into the lungs

Slowing of the intestinal tract

Dehydration

Common

Constipation

Black stool

Black Box Warning

Black box warning: 

None  

Contraindication / Caution

Contraindications/caution:

Contraindications 

Blockage in the gastrointestinal tract

Low consciousness or unconsciousness

Recent oral administration of certain medications

Intact gut mucosa

Presence of certain substances in the gut

Caution 

Decreased kidney or liver function

Dehydration

Presence of other medical conditions

Pregnancy or breastfeeding

Elderly populations

Pregnancy / Lactation

Pregnancy/Lactation 

Pregnancy consideration:  

AU TGA pregnancy category: B2

Lactation: Excretion of the drug in human breast milk is unknown

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.
• Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
• Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
• Category N: There is no data available for the drug under this category

Pharmacology

Pharmacology:

In the digestive system, it adsorbs poisons, chemicals, and medications. This way the amount of the substance or nutrient that is left to be absorbed into the blood stream is lowered therefore concentration of the substance or nutrient in the body and hence its toxicity is lowered.

Pharmacodynamics:

It was found that the extent of activated charcoal in the removal of a particular substance depends with the dose and nature of the substance as well as the activated charcoal and also the time of administration with relation to the intake of the substance.

In the gastrointestinal system, activated charcoal adsorbs chemicals and finally leaves the body through excretion. It is not absorbed into the circulation.

Pharmacokinetics:

Absorption

It is not absorbed into the bloodstream and remains in the gastrointestinal tract.

Distribution

It is not distributed throughout the body because it is not absorbed into the bloodstream.

Metabolism

It is not metabolized in the body.

Elimination/Excretion

It is eliminated from the body primarily in the feces. The elimination half-life of activated charcoal is short and depends on the dose, form, and timing of administration.

Adminstartion

Administration:

Oral Administration: It is prescribed for oral use. The dosing regimen and the forms are defined by the indication and the product used in the therapy.

Nasogastric tube administration: It can be administered orally, but in the cases where this is impossible it may be administered through a nasogastric tube.

Activated charcoal is contraindicated in anybody who cannot protect their airway due to loss of consciousness and they may cause aspiration and lung injury. Finally, it is crucial to avoid the use of activated charcoal in some of the following conditions: Toxicity is likely to be aggravated in cases involving corrosive agents or petroleum products.

Patient Information Leaflet

Patient Information Leaflet 

Generic Name: activated charcoal

Pronounced: [CHAR-coal]

Why do we use activated charcoal? 

It acts as an antidote to poisoning or drug overdose. It stops medications from being absorbed into the circulation by adsorbing them in the gastrointestinal system.
It could cleanse the digestive system of harmful toxins.
It cures ailments including indigestion, gas, and diarrhea.
It has been demonstrated to lower blood cholesterol levels.
It is used in water filtration systems to purge contaminants and enhance drinking water’s flavour.