What is it?

Activated charcoal is used when accidental poisoning has occurred. The charcoal helps absorb the poison and carry it out of the body. It is also used to treat diarrhea, upset stomach, and gas.

Other names for activated charcoal include: active carbon, adsorbent charcoal, carbo activatus, carbon active, carbon attivo, decolorizing charcoal, and medicinal charcoal.

Ask your doctor, nurse, or pharmacist if you need more information about this medicine or if any information in this leaflet concerns you.

Before Using:

Tell your doctor if you

• are taking medicine or are allergic to any medicine (prescription or over-the-counter (OTC) or dietary supplement).
• are pregnant or plan to become pregnant while using this medicine.
• are breastfeeding.
• have any other health problems, such as high blood pressure or heart or blood vessel disease.

Dosage:

Talk with your caregiver about how much activated charcoal you should take. The amount depends on the strength of the medicine and the reason you are taking activated charcoal. If you are using this medicine without instructions from your caregiver, follow the directions on the medicine bottle. Do not take more medicine or take it more often than the directions tell you to.

To store this medicine:

Keep all medicine locked up and away from children. Store medicine away from heat and direct light. Do not store your medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down and not work the way it should work. Throw away medicine that is out of date or that you do not need. Never share your medicine with others.

Drug and Food Interactions:

Since charcoal has such a strong ability to absorb material, it may cause problems with any medicine you may be taking by reducing how much gets absorbed by your body. This has the potential to be life threatening. If you are taking any drugs, check with your health care giver before taking activated charcoal. The following have been studied and are not well absorbed when taken with charcoal:

• Acarbose (Precose(R)) (4)
• Carbamazepine (Tegretol(R), Carbatrol(R)) (20)
• Digoxin (Lanoxin(R), Digitek(R)) (6,20)
• Furosemide (Lasix(R)) (20)
• Leflunomide (Arava(TM)) (8)
• Miglitol (Glyset(R)) (10)
• Olanzapine (Zyprexa(R)) (12)
• Mycophenolic acid (CellCept(R), Myfortic(R)) (21)

Warnings:

• Before taking activated charcoal, tell your doctor if you are pregnant or breastfeeding or if you have any problems with your digestive system.
• Some forms of this product contain sorbitol (an artificial sweetener), so make sure your doctor knows if you cannot have fructose (fruit sugar) (22).
• Do not use this medicine to treat poisoning unless you are told to do so by a doctor or poison control center. This product can be dangerous if used incorrectly when treating poisoning (22).

Side Effects:

Call your doctor right away if you have any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hand, swelling or tingling in your mouth or throat, chest tightness, trouble breathing, or rash

Other Side Effects:

You may have the following side effects, but this medicine may also cause other side effects. Tell your doctor if you have side effects that you think are caused by this medicine.

• Dark stools (BMs) (16,17,18)
• Upset stomach (16,17,18)
• Throwing up (16,17,18)

References:

1. Anon: USPDI: Drug Information for the Health Care Professional, 17th ed. US Pharmacopeial Convention Inc, Rockville, MD; 1997.

2. Anon: American Academy of Clinical Toxicology; European Association of Poison Centers and Clinical Toxicologists: Position statement: single-dose activated charcoal. J Toxicol Clin Toxicol 1997; 35:721-741.

3. FDA: Poison treatment drug product for over-the-counter human use; tentative final monograph. Fed Register 1985; 50:2244-2262

4. Product information: Precose(R), acarbose. Bayer Corporation, West Haven, CT; 1998

5. North DS, Peterson RG & Krenzelok EP: Effect of activated charcoal administration on acetylcysteine serum levels in humans. Am J Hosp Pharm 1981; 38:1022-1024.

6. Neuvonen PJ, Elfving SM & Elonen E: Reduction of absorption of digoxin, phenytoin and aspirin by activated charcoal in man. Eur J Clin Pharmacol 1978; 13:213-218.

7. Product Information: Ipecac syrup. Eli Lilly and Company, Indianapolis, IN; 1989

8. Product information: Arava(TM), leflunomide. Hoechst Marion Roussel, Inc, Kansas City, MO; 1998

9. El-Bahie N, Allen EM, Williams J et al: The effect of activated charcoal and hyoscine butylbromide alon and in combination on the absorption of mefenamic acid. Br J Clin Pharmacol 1985; 19:836-838.

10. Product information: Glyset(TM), miglitol. Bayer Corporation, West Haven, CT; 1999.

11. Karkkainen S & Neuvonin PJ: Effect of oral charcoal and urine pH on dextropropoxyphene pharmacokinetics. Int J Clin Pharmacol Ther Toxicol 1985; 23:219-225

12. Product information: Zyprexa(TM), olanzapine. Eli Lilly and Company, Indianapolis, IN; 1999.

13. GrebWH, Buscher G, Dierdorf HD et al: Ability of charcoal to prevent absorption of paroxetine. Acta Psychiatr Scand 1989; 80 (suppl 350):156-157.

14. Bachrach WH & Hofmann AF: Ursodeocycholic acid in the treatment of cholesterol cholelithiasis (Part I). Dig Dis Sci 1982; 27:737-761.

15. Product information: Charcocaps(R), activated charcoal. Requa,Inc, Greenwich, CT; 1997.

16. Minocha A, Wiley SH, Chabbra DR et al: Superior efficacy of sorbitol cathartics in poisoned patients. AAPCC/AACT/AMBT/CAPCC Annual Scientific Meeting, Santa Fe, New Mexico, September 25-30 1986b, Abstract 112.

17. Watson WA, Guy JC & Leighton J: The incidence of emesis after activated charcoal in emergency room patients. AAPCC/AACT/ABMT/CAPCC Annual Scientific Meeting, Santa Fe, New Mexico, September 25-30, Abstract 132.

18. Dockstrader LL, Lawrence RA & Bresnick HL: Home administration of activated charcoal: feasibility and acceptance. AAPCC/AACT/ABMT/CAPCC Annual Scientific Meeting, Santa Fe, New Mexico, September 25-30, 1986, Abstract 1.

19. Mauro LS, Nawarskas JJ & Mauro VF: Misadventures with activated charcoal and recommendations for safe use. Ann Pharmacother 1994; 28:915-924.

20. Neuvonen PJ, Kivisto K & Hirvisalo EL: Effects of resins and activated charcoal on the absorption of digoxin, carbamazepine and frusemide. Br J Clin Pharmacol 1988; 25:229-233.

21. Product Information: Myfortic(R), mycophenolic acid delayed-release tablets. Novartis Pharmaceuticals Corporation, East Hanover, NJ, 02/2004.

22. Actidose-Aqua(TM), activated charcoal suspension. Paddock Laboratories, Inc. Minneapolis, MN 2004.