Charcoal

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Charcoal Brand Names

Actidose With Sorbitol | Actidose-Aqua | Charcoal Plus DS | CharcoCap | EZ Char | Kerr INSTA-CHAR

What is Charcoal

Activated charcoal is the residue obtained from destructive distillation of various organic materials (generally wood pulp or vegetables, but also sucrose, lactose, bone, blood, and industrial wastes), which is subsequently treated to increase its adsorptive capacity.

Steam, air, CO2, O2, zinc chloride, sulfuric acid, or phosphoric acid at temperatures of 500—900 degrees F “activate” the residue.

This process removes previously adsorbed substances and can break down granules to even smaller ones, thereby increasing their effective surface area.

Activated charcoal was approved by the FDA in 1940, but its adsorbent properties were first described in 1791.

In 1830, Touery, a French pharmacist, conclusively demonstrated the protective ability of charcoal by ingesting several times the lethal dose of strychnine together with 15 g of charcoal with no ill effects.

However, as recently as 1975, charcoal was not recognized as a drug, and commercial formulations specified that it not be used in humans.

In 1979, Neuvonen described the use of charcoal to prevent absorption of various drugs, and in 1982, the ability of charcoal to accelerate systemic clearance of phenobarbital and theophylline was reported.

The adsorptive properties of activated charcoal make it an effective general purpose antidote.

Indications

  1. diarrhea
  2. flatulence
  3. overdose
  4. phenobarbital toxicity
  5. poisoning
  6. theophylline toxicity

For treatment of flatulence† or for the treatment of non-infectious diarrhea† associated with indigestion and intestinal gas (as an adsorbent)

NOTE: The FDA has not evaluated activated charcoal for these purposes; these products are not intended to diagnose, treat, cure, or prevent any disease.

NOTE: Available in a variety of strengths from many manufacturers of nutritional supplements. Consumers should also note that rigid quality control standards are not required and substantial variability can occur in both the potency and the purity of these products.

Side Effects

  1. abdominal pain
  2. constipation
  3. diarrhea
  4. stool discoloration
  5. tongue discoloration

The principal adverse reactions associated with activated charcoal administration are gastrointestinal in nature and include vomiting, constipation, diarrhea, and tongue discoloration and stool discoloration. Abdominal pain or distention may also occur but are less frequent. Such side effects are more likely to occur with multiple-dose, chronic administration; adverse events are usually negligable when charcoal is administered acutely for GI decontamination in overdose. Patients who ingest activated charcoal in non-overdose situations for flatulence or other purposes should be aware that the effectiveness of other regularly taken medications (e.g., digoxin, oral contraceptives) may be decreased.

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • acid ingestion
  • alkali ingestion
  • breast-feeding
  • children
  • coma
  • constipation
  • dehydration
  • diarrhea
  • electrolyte imbalance
  • ethanol intoxication
  • gag reflex depression
  • GI disease
  • GI obstruction
  • ileus
  • pregnancy
  • quinidine hypersensitivity
  • quinine hypersensitivity
  • seizures
  • surgery
  • vomiting

Interactions

  • Acarbose
  • Acetaminophen
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Acetylcysteine
  • Alpha-glucosidase Inhibitors
  • Aripiprazole
  • Atenolol
  • Atenolol; Chlorthalidone
  • Bendroflumethiazide; Nadolol
  • Benzhydrocodone; Acetaminophen
  • Carbamazepine
  • Cardiac glycosides
  • Chenodiol
  • Chlorpromazine
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Dapsone
  • Dextromethorphan; Promethazine
  • Digitoxin
  • Digoxin
  • Ethanol
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Hydantoins
  • Ipecac
  • Leflunomide
  • Meperidine; Promethazine
  • Mesoridazine
  • Miglitol
  • Mycophenolate
  • Nadolol
  • Olanzapine
  • Oral Contraceptives
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenothiazines
  • Phenylephrine; Promethazine
  • Pindolol
  • Prochlorperazine
  • Promethazine
  • Sotalol
  • Teriflunomide
  • Theophylline, Aminophylline
  • Thiethylperazine
  • Thioridazine
  • Thiothixene
  • Trifluoperazine
  • Ursodeoxycholic Acid, Ursodiol

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