Activated charcoal

Indications

1. Drug ingested is adsorbed by charcoal and has significant potential for toxicity, and
2. One of the following:
   1. Time since ingestion is less than 1-2 hours
   2. The drug has significant enterohepatic circulation
3. The drug delays gastric emptying AND time since ingestion is less than 4 hours
4. The drug is in a controlled release preparation AND time since ingestion is less than 12-18 hours

Dose

1. 1g/kg PO
2. Mixed with water (sorbitol no longer recommended)

Administration

1. PO (at least 50 g of charcoal within 20 minutes)
   1. It is NOT necessary for charcoal to be administered by a nasogastric or orogastric tube
   2. Improved taste if activated charcoal is chilled
   3. In children, may mix with juice, yogurt or ice-cream
2. See also Gastric Lavage

Complications

1. Aspiration
2. Bowel obstruction

See Also

Gastric Lavage