Products
Activated carbon is commercially available in the form of tablets, capsules, as a suspension, and pure powder, among others (e.g., Carbolevure, Norit, Carbovit, Hänseler Carbo activatus).
Structure and properties
Medicinal charcoal is composed of carbon and exists as a light, odorless, tasteless, jet-black powder that is free of granular particles. It is insoluble in most solvents and is therefore prepared as a suspension. The substance is obtained from plant materials by suitable carbonization and activation processes, which give it high adsorption capacity. It has a large internal surface area of about 1000 m2 per gram. Heated to red heat, it burns slowly without flame.
Effects
Medicinal charcoal (ATC A07BA01) has adsorbent properties. It binds a wide variety of organic and inorganic substances, bacteria, bacterial toxins, and toxins to itself and passes them for excretion through the stool. It prevents the absorption of unwanted substances into the bloodstream. Activated charcoal is effective only locally in the digestive tract and is not absorbed into the organism. With the subsequent administration of the laxative sodium sulfate, the excretion of bound toxins can be accelerated and constipation prevented. Some products also contain sorbitol.
Indications
Activated charcoal is mainly used medically for diarrhea, flatulence and for poisoning. Medical charcoal can be used to accelerate the elimination of drugs that are subject to enterohepatic circulation (e.g., antiepileptic drugs, theophylline). Activated charcoal can also be used to remove dental discoloration.
Dosage
According to the SmPC. Preparations for the treatment of diarrhea are usually taken by adults three times a day. In case of poisoning, the dose is higher and depends on body weight (generally 1g/kg bw). Administration should be done as soon as possible after poisoning. Dosage according to the antidote list of the Federal Office of Public Health:
- Adults: initially 50 to 100 g, then 25 to 50 g every 2 to 4 hours.
- Children: Initial 1 to 2 g/kg, then 0.25 to 0.5 g/kg every 2 to 4 hours.
The intake should be under medical supervision or in consultation with a specialist (Tox Info Suisse, telephone number 145).
Abuse
Activated carbon can be misused for the manufacture of black powder.
Contraindications
In cases of diarrhea:
- Hypersensitivity, diarrhea with fever, intestinal obstruction, acute abdominal pain, ulcerative collitis.
For poisoning:
- Poisoning with irritating substances (acids, bases), limited consciousness because of the risk of aspiration.
Charcoal is not effective against all poisons, for example, not against potassium cyanide and other cyanides, iron, lithium, electrolytes, solvents and various alcohols such as methanol and ethanol. For complete precautions, see the drug label.
Interactions
Other medications – this includes antidotes – should not be taken at the same time, but at least two hours apart, or loss of effect may occur. Activated charcoal may also accelerate the elimination of agents that are subject to enterohepatic circulation (see above). This effect is independent of the time of ingestion.
Adverse effects
Activated charcoal may cause a nonhazardous black discoloration of the stool and, in high doses, may cause vomiting, constipation, and intestinal obstruction.
