Activated Charcoal Oral: Poisoning Guidance

Therapeutic action

Adsorbent.

Indications

• Poisoning by drugs, in particular paracetamol, aspirin, ibuprofen, chloroquine, quinine, dapsone, phenobarbital, carbamazepine, and digoxin.
• Poisoning by other toxic substances such as certain plants and certain domestic, industrial, or agricultural chemicals.

Forms and strengths

• Granules for oral suspension, in 50 g bottle, to be reconstituted with 250 ml of water.

Dose and duration

The dose of charcoal has to be administered as soon as possible, preferably within one hour after ingestion of the toxic compound, and swallowed within a limited period such as 15 to 20 minutes.

If the dose is not entirely swallowed, or the toxic substance was ingested in large quantities or over 2 hours beforehand, follow treatment for 24 hours after poisoning by administering half or a quarter of the initial dose every 4 or 6 hours depending on tolerance and cooperation.

• Child under 1 year: 1 g per kg.
• Child from 1 to 12 years: 25 g.
• Child over 12 years and adult: 50 g.

Contra-indications, adverse effects, precautions

• Do not administer in poisoning by caustic or foaming products, or hydrocarbons, because of the risk of aggravating lesions, aspiration pneumonia, or airway obstruction.
• Charcoal is ineffective in poisoning by alcohols, organophosphorus and carbamate insecticides, and metals such as lithium or iron salts.
• May cause black colouring of stools, which is normal, constipation, and vomiting if large quantities are administered rapidly.
• Do not administer charcoal simultaneously with other oral drugs. Administer 2 hours apart.
• Pregnancy: no contra-indication.
• Breast-feeding: no contra-indication.