Charcoal

Common Name(s): Activated charcoal, Animal charcoal, Charcoal, Gas black, Lamp black, Oral charcoal adsorbent

Medically reviewed by Drugs.com. Last updated on Sep 21, 2021.

Clinical Overview

Use

Activated charcoal's main use is as an antidote in poisoning. It is promoted for use as an antiflatulent and in dyslipidemia, and has demonstrated benefit in wound healing, kidney disease, and diarrhea; however, clinical studies to support these uses are lacking.

Dosing

Acute poisoning antidote: In the management of poisonings, refer to local protocols. The recommended dosing of activated charcoal is as follows:

Children 1 year and younger: 10 to 25 g, or 0.5 to 1 g/kg.

Children 1 to 12 years: 25 to 50 g, or 0.5 to 1 g/kg.

Adolescents and adults: 25 to 100 g.

Flatulence: As an antiflatulent, a dose range of 520 to 975 mg has been suggested, to be taken after meals or at the first sign of discomfort and repeated as needed up to 4.16 g daily.

Contraindications

The American Academy of Pediatrics does not recommend administration of activated charcoal in the home, especially in cases of acute poisoning in children.

Charcoal is contraindicated in individuals with unprotected airways and decreased levels of consciousness if not intubated; ingestion of acids or alkalis; cases in which the risk or severity of aspiration is increased; or isolated ingestions of lithium, iron, heavy metals, or ethanol.

Caution should be used in those at risk of gastric hemorrhage or perforation, or in those who have ingested a substance that increases the risk of sudden onset of seizures or sudden decreases in mental status.

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

None well documented.

Adverse Reactions

Emesis is the most common adverse reaction. Use in poisoning is associated with a risk of aspiration and subsequent chemical pneumonitis. GI obstruction can develop in patients receiving repeated doses.

Toxicology

Minimal toxicity is associated with the use of charcoal in hemoperfusion.

Source

Charcoal is produced by pyrolysis and high temperature oxidation of organic materials. Animal charcoal is obtained from items such as charred bones, meat, and blood. Activated charcoal is obtained from charred wood or vegetable matter and treated with various substances to increase its adsorptive power. Amorphous carbons (or charcoals) are taken from the incomplete combustion of natural gas, fats, oils, or resins.Lapus 2007

History

Charcoal has been used for medicinal purposes for thousands of years. Ancient Egyptian papyri document use of charcoal as early as 1500 BC for the adsorption of odor from rotting wounds. Hindu documents from 450 BC record the use of charcoal and sand filters for the purification of drinking water. Hippocrates and Pliny describe the use of charcoal to treat epilepsy, chlorosis, and anthrax.

In 1773, the German-Swedish pharmaceutical chemist Carl Scheele recognized the specific adsorptive powers of charcoal with various gases. At a meeting of the French Academy of Sciences in 1831, a pharmacist ingested several times the lethal dose of strychnine with equal amounts of charcoal and survived. However, the Academy members were unimpressed by this demonstration, and charcoal continued to be used primarily for industrial purposes.

In 1911, the first industrially activated charcoal was made in Austria. Shortly afterward, the use of toxic gases in World War I drove the mass production of activated charcoal suitable for respirators. However, it was not until 1963, after a review article was published in th...