ACTIVATED CHARCOAL

Posology If the dose of poison that has been ingested is known, a ratio of 10:1 (activated charcoal: toxin) may be used to determine the optimal dose of activated charcoal, subject to the limits of practicality. In the absence of any information regarding the amount of poison ingested, the following doses are recommended: Adults (including the Elderly) and children over 12 years One full bottle (250 ml; equivalent to 50 g activated charcoal), repeated, if necessary, taken as soon as possible after ingestion of poison.

For multiple dose therapy, the dose may be repeated every 4-6 hours. Children aged under 12 years Half of one bottle (125 ml; equivalent to 25 g activated charcoal), repeated, if necessary, taken as soon as possible after ingestion of the poison.

If a large quantity of toxicants has been ingested, and where there is a risk to life. In these circumstances, the administration of the full 50 g dose is indicated. For multiple dose therapy, the dose may be repeated every 4-6 hours.

Children under 1 year of age:

For single dose therapy, 1 g or 5 ml per kg bodyweight taken as soon as possible after ingestion of poison. For multiple dose therapy, the dose may be repeated every 4-6 hours. Method of Administration Activated Charcoal should be given as soon as possible after the ingestion of the potential poison.

The suspension is then taken orally or given by intragastric tube. Induction of emesis is not recommended because there is no evidence that it affects absorption, and it may increase the risk of aspiration. If gastric lavage is being used to facilitate stomach evacuation a single dose of Activated Charcoal may be administered early in the procedure.

This has the advantage of prompt administration of activated charcoal, but the gastric lavage returns will be black which may make it difficult to evaluate what the patient ingested by visual examination. Activated Charcoal may be effective even when several hours have elapsed after ingestion of the poison if gastrointestinal motility is reduced by the toxin or if the drug is subject to enterohepatic or enter enteric recycling.

When ipecac syrup is used to induce emesis, it is recommended that Activated Charcoal be administered only after vomiting has been induced and completed, since ipecac syrup is adsorbed by the charcoal thus preventing emesis.

Adverse drug reactions (ADRs) are listed below by MedDRA system organ class and by frequency. Frequencies are defined as: very common (≥1/10), common (≥1/100 to <1/10), uncommon (≥1/1000 to <1/100), rare (≥1/10,000 to <1/1000), very rare (<1/10,000) and not known (cannot be estimated from the available data).

4). 2 Associated with the use of multiple dose activated charcoal therapy. Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product.

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Activated Charcoal is not recommended for patients who have ingested corrosive agents such as strong acids or alkalis since the activated charcoal may obscure endoscopic visualisation of oesophageal and gastric lesions produced by the toxin.

Activated Charcoal is of little or no value in the treatment of poisoning with cyanides, alcohols, iron salts, malathion and DDT. Activated Charcoal is an adjunct in the management of poisoning emergencies. Prior to its use, proper basic life support measures must be implemented where required as well as the appropriate gastric emptying technique if indicated.

g. anticholinergics, opioids). Bowel sounds should be monitored frequently to assess peristaltic action, especially in patients undergoing multiple doses activated charcoal therapy. 8 ‘Undesirable effects’). A laxative may be given concurrently to accelerate the removal of the activated charcoal- toxin complex but should be used with caution and only intermittently during multiple doses activated charcoal therapy since profuse and protracted diarrhoea may lead to fluid and electrolyte imbalance.

8 ‘Undesirable effects’).

Use of Activated Charcoal is contra-indicated in persons who are not fully conscious.