Activated Charcoal

Other Name(s):

Activated Carbon, Animal Charcoal, Carbo Vegetabilis, Carbon, Carbón Activado, Charbon Actif, Charbon Activé, Charbon Animal, Charbon Médicinal, Charbon Végétal, Charbon Végétal Activé, Charcoal, Gas Black, Lamp Black, Medicinal Charcoal, Noir de Gaz, Noir de Lampe, Vegetable Carbon, Vegetable Charcoal.

Overview

Common charcoal is made from peat, coal, wood, coconut shell, or petroleum. “Activated charcoal” is similar to common charcoal, but is made especially for use as a medicine. To make activated charcoal, manufacturers heat common charcoal in the presence of a gas that causes the charcoal to develop lots of internal spaces or “pores.” These pores help activated charcoal “trap” chemicals.

Activated charcoal is used to treat poisonings, reduce intestinal gas (flatulence), lower cholesterol levels, prevent hangover, and treat bile flow problems (cholestasis) during pregnancy.

How does work?

Activated charcoal is good at trapping chemicals and prevents their absorption.

Uses

Likely Effective for...

  • Trapping chemicals to stop some types of poisoning when used as a part of standard treatment.

Insufficient Evidence to Rate Effectiveness for...

  • Lowering cholesterol levels. So far, research studies don't agree about the effectiveness of taking activated charcoal by mouth to lower cholesterol levels in the blood.
  • Decreasing gas (flatulence). Some studies show that activated charcoal is effective in reducing intestinal gas, but other studies don't agree. It's too early to come to a conclusion on this.
  • Treating reduced bile flow (cholestasis) during pregnancy. Taking activated charcoal by mouth seems to help treat cholestasis in pregnancy, according to some early research reports.
  • Preventing hangover. Activated charcoal is included in some hangover remedies, but some experts are skeptical about how well it might work. Activated charcoal doesn't seem to trap alcohol well.
  • Other conditions.
More evidence is needed to rate the effectiveness of activated charcoal for these uses.

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Side Effects

Activated charcoal is safe for most adults when used short-term. Side effects of activated charcoal include constipation and black stools. More serious, but rare, side effects are a slowing or blockage of the intestinal tract, regurgitation into the lungs, and dehydration.

Precautions

Pregnancy and breast-feeding: Activated charcoal might be safe when used short-term if you are pregnant or breast-feeding, but consult with your healthcare professional before using if you are pregnant.

Gastrointestinal (GI) blockage or slow movement of food through the intestine: Don't use activated charcoal if you have any kind of intestinal obstruction. Also, if you have a condition that slows the passage of food through your intestine (reduced peristalsis), don't use activated charcoal, unless you are being monitored by your healthcare provider.

Interactions


AlcoholInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Activated charcoal is sometimes used to prevent poisons from being absorbed into the body. Taking alcohol with activated charcoal might decrease how well activated charcoal works to prevent poison absorption.


Medications taken by mouth (Oral drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Activated charcoal absorbs substances in the stomach and intestines. Taking activated charcoal along with medications taken by mouth can decrease how much medicine your body absorbs, and decrease the effectiveness of your medication. To prevent this interaction, take activated charcoal at least one hour after medications you take by mouth.


Syrup of ipecacInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Activated charcoal can bind up syrup of ipecac in the stomach. This decreases the effectiveness of syrup of ipecac.

Dosing

The following doses have been studied in scientific research:

BY MOUTH:

  • For drug overdose or poisoning: 50 to 100 grams of activated charcoal is given at first, followed by charcoal every 2 to 4 hours at a dose equal to 12.5 grams per hour. For children, lower doses (10 to 25 grams) are used.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

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References

Anon. Position paper: Ipecac syrup. J Toxicol Clin Toxicol 2004;42:133-43. View abstract.

Anon. Position statement and practice guidelines on the use of multi-dose activated charcoal in the treatment of acute poisoning. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. J Toxicol Clin Toxicol 1999;37:731-51. View abstract.

Bond GR. The role of activated charcoal and gastric emptying in gastrointestinal decontamination: a state-of-the-art review. Ann Emerg Med 2002;39:273-86. View abstract.

Hall RG Jr, Thompson H, Strother A. Effects of orally administered activated charcoal on intestinal gas. Am J Gastroenterol 1981;75:192-6. View abstract.

Hoegberg LC, Angelo HR, Christophersen AB, Christensen HR. Effect of ethanol and pH on the adsorption of acetaminophen (paracetamol) to high surface activated charcoal, in vitro studies. J Toxicol Clin Toxicol 2002;40:59-67. View abstract.

Hoekstra JB, Erkelens DW. No effect of activated charcoal on hyperlipidaemia. A double-blind prospective trial. Neth J Med 1988;33:209-16.

Kaaja RJ, Kontula KK, Raiha A, Laatikainen T. Treatment of cholestasis of pregnancy with peroral activated charcoal. A preliminary study. Scand J Gastroenterol 1994;29:178-81. View abstract.

Neuvonen PJ, Kuusisto P, Vapaatalo H, Manninen V. Activated charcoal in the treatment of hypercholesterolaemia: dose-response relationships and comparison with cholestyramine. Eur J Clin Pharmacol 1989;37:225-30. View abstract.

Park GD, Spector R, Kitt TM. Superactivated charcoal versus cholestyramine for cholesterol lowering: a randomized cross-over trial. J Clin Pharmacol 1988;28:416-9. View abstract.

Suarez FL, Furne J, Springfield J, Levitt MD. Failure of activated charcoal to reduce the release of gases produced by the colonic flora. Am J Gastroenterol 1999;94:208-12. View abstract.