Charcoal, activated

Definition

Activated charcoal is a fine black odorless and tasteless powder made from wood or other materials that have been exposed to high temperatures in an airless environment. The powder is treated (activated) with oxidizing gas or other chemicals to increase its ability to adsorb various substances. Activated charcoal is pure carbon that absorbs particles and gases in the body's digestive system.


Activated charcoal has been used since ancient times to cure various ailments and poisonings, and its healing effects have been documented since1550 B.C. by the Egyptians. In the 1980s, it was rediscovered as an oral treatment for poisoning and drug overdoses.



Description

Activated charcoal is not absorbed from the stomach or intestines and binds or adsorbs most drugs and poisons. Its most important use in humans is in treating drug overdose and poisoning. It is also sometimes used to treat diarrhea or excessive gas. It can be used to treat poisoned pets and animals. Other possible uses, in treating viruses, bacteria, bacterial toxic byproducts, snake venoms, and other substances, have not been supported by clinical studies. By adding water to the powder to make a paste, activated charcoal can be used as an external application to reduce pain and itching from bites and stings.

Poisons and drug overdoses

It is estimated that one million children accidentally overdose every year on medications, thinking they are candies, or eat, drink, or inhale poisonous household products. Infants and toddlers are at the greatest risk for accidental poisoning. Activated charcoal can absorb large quantities of poisons quickly in the intestines, is non-toxic, may be stored indefinitely, and can be conveniently administered at home. Charcoal binds irritating or toxic substances in the stomach and intestines, preventing their absorption, so they can be excreted in the stool. When poisoning is suspected, the local poison control center should always be contacted for instructions. They may recommend using activated charcoal, which should be available at home so that it can be immediately given to the poisoned child or pet. For severe poisoning, several doses of activated charcoal may be needed.

Activated charcoal is used in adults who have accidentally taken too much medication, or attempted suicide by intentionally taking a drug overdose.

Intestinal disorders

In the past, activated charcoal was a popular remedy for flatus (intestinal gas). But more recent studies have not shown its value. Other measures, like dietary changes or biofeedback training, are more effective in relieving patients' symptoms.

Charcoal has been used to treat other intestinal disorders like diarrhea, constipation, and cramps. There is little evidence to support these uses. Frequent use may decrease absorption of essential nutrients and cause constipation. So a laxative should be taken if several doses of charcoal are taken.

Other uses

Activated charcoal has been used to clean skin wounds and adsorb waste materials from the gastrointestinal tract.When used with other remedies such as aloe vera, acidophilus, and psyllium, charcoal helps keep symptoms of ulcerative colitis under control. While charcoal shows some anti-aging activity in rats, it is doubtful if it has the same effect in humans.

Apart from its medicinal applications, activated charcoal is used by biologists to cool cell suspensions; by public health physicians to filter disease organisms from drinking water; and by environmental scientists to remove organic pollutants from ocean sediments.

For poisoning

Activated charcoal is available without prescription. In cases of accidental poisoning or drug overdose, always call a poison control center for advice. If both syrup of ipecac and charcoal are recommended, ipecac should be given first to induce vomiting, and charcoal given only after vomiting stops. Activated charcoal may be mixed with a liquid and drunk, or put into a stomach tube. Activated charcoal is available as 1.1 oz (33 mL) and 0.5 oz (15mL) containers as pre-mixed slurries, or as containers to which water or soda pop can be added. It is a good idea to keep activated charcoal at home for the immediate treatment of poisonings.

For acute poisoning, the dosage is as follows:

  • Infants (under 1 year of age): 1 g/kg
  • Children (1-12 years of age): 15-30 g or 1-2 g/kg with at least 8 oz of water
  • Adults: 30-100 g or 1-2 g/kg with at least 8 oz of water

For diarrhea

Charcoal can be taken as tablets or capsules with water, or sprinkled onto foods. The dosage for treatment of diarrhea in adults is 520-975 mg after each meal and up to 5 g per day.

Precautions

Parents should keep activated charcoal on hand for emergencies. Charcoal should not be given together with syrup of ipecac as it will adsorb the ipecac. It should not be taken until after the vomiting from ipecac stops. Some activated charcoal products contain sorbitol, a sweetener and laxative that can cause nausea, vomiting, and diarrhea. These products should not be used in infants. Charcoal may interfere with the absorption of medications and nutrients such as vitamins or minerals. It should not be taken for at least two hours after other medications.

Charcoal should not be used to treat poisonings caused by lye or other corrosives, strong acids, or petroleum products like gasoline or cleaning fluids. In those cases, charcoal may cause treatment for the condition to be delayed. It is also not effective in lithium, cyanide, iron, ethanol, or methanol overdoses or poisonings. Chocolate syrup, sherbet, or ice cream may improve the taste of charcoal, but they may prevent it from working properly.

Activated charcoal may produce abdominal pain or swelling, and can complicate intestinal bleeding or obstruction. Charcoal may be less effective in people with slow digestion. Charcoal should not be given for more than three or four days for treatment of diarrhea, as it may interfere with normal nutrition. Charcoal should not be used in children under three years of age to treat diarrhea or gas. Activated charcoal should be kept out of reach of children.

Side effects

Charcoal may cause constipation when taken for a drug overdose or accidental poisoning. A laxative should be taken after the crisis is over. Activated charcoal normally causes stools to turn black. Patients should consult a doctor if they have pain or swelling of the stomach.

Interactions

Chocolate syrup, ice cream, or sherbet mixed may prevent charcoal from working properly.