Activated charcoal (medication)

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Activated charcoal
Activated charcoal for medical use
Trade namesCharcoAid, others
Clinical data
Main usesCertain poisonings[1]
Side effectsVomiting, black stools, diarrhea, constipation[2]
Routes of
By mouth, nasogastric tube
Defined daily dose5 gm[3]
Typical dose50 gm[1]
External links

Activated charcoal, also known as activated carbon, is a medication used to treat poisonings that occurred by mouth.[2] To be effective it must be used within a short time of the poisoning occurring, typically an hour.[2][4] It does not work for poisonings by cyanide, corrosive agents, iron, lithium, alcohols, or malathion.[4] It may be taken by mouth or given by a nasogastric tube.[5] Other uses include inside hemoperfusion machines.[2]

Common side effects include vomiting, black stools, diarrhea, and constipation.[2] The more serious side effect, pneumonitis, may result if aspirated into the lungs.[2][4] Gastrointestinal obstruction and ileus are less common but serious adverse effects.[2] Use in pregnancy and breastfeeding is safe.[5] Activated charcoal works by adsorbing the toxin.[2]

While charcoal has been used since ancient times for poisonings, activated charcoal has been used since the 1900s.[6][7] It is on the World Health Organization's List of Essential Medicines.[8] The wholesale costs in the developing world is between US$0.46 and US$0.86 per dose.[9] In the United States a course of treatment costs less than US$25.[5] In the UK, a single dose costs around £12.[10]

Medical uses

Poison ingestion

Activated charcoal is used to treat many types of oral poisonings such as phenobarbital and carbamazepine.[11] It is not effective for a number of poisonings including: strong acids or bases, iron, lithium, arsenic, methanol, ethanol or ethylene glycol.[11]

No randomized controlled trials have shown activated charcoal improves outcomes and routine use is not recommended.[11] In a study of acute poisonings from agricultural pesticides and yellow oleander seeds, the administration of activated carbon did not affect survival rates.[12]

Gastrointestinal tract-related issues

Charcoal biscuits were sold in England starting in the early 19th century, originally as remedy to flatulence and stomach trouble.[13]

Tablets or capsules of activated carbon are used in many countries as an over-the-counter drug to treat diarrhea, indigestion, and flatulence.[14] There is some evidence of its effectiveness to prevent diarrhea in cancer patients who have received irinotecan.[15] It can interfere with the absorption of some medications, and lead to unreliable readings in medical tests such as the guaiac card test.[16] Activated carbon is also used for bowel preparation by reducing intestinal gas content before abdominal radiography to visualize bile and pancreatic and renal stones. A type of charcoal biscuit has also been marketed as a pet care product.[citation needed]


Claims that activated charcoal will do things such as whiten teeth, cure alcohol-induced hangovers, and prevent bloating, are not supported by evidence.[17][18] Activated charcoal cleanses also lack evidence and are considered pseudoscience.[19]


The defined daily dose is 5 grams (by mouth).[3] In people over 12 years of age the typical dose is 50 grams, while in those 1 to 12 years old the dose is 25 grams.[1] Under 1 year old it is 1 gram per kilogram of body weight.[1]

Side effects

Incorrect application (e.g. into the lungs) results in pulmonary aspiration which can sometimes be fatal if immediate medical treatment is not initiated.[20] The use of activated carbon is contraindicated when the ingested substance is an acid, an alkali, or a petroleum product.[citation needed]

Mechanism of action

In cases of suspected poisoning, medical personnel administer activated carbon on the scene or at a hospital's emergency department. In rare situations, it may also be used in a hemoperfusion system to remove toxins from the blood stream of poisoned patients. Activated carbon has become the treatment of choice for many poisonings, and other decontamination methods such as ipecac-induced emesis or stomach pumping are now used rarely.[citation needed]

Society and culture


A single dose of 50g costs the NHS in the UK around £12.[21]


  1. 1.0 1.1 1.2 1.3 "Activated CHARCOAL oral - Essential drugs". Archived from the original on 27 August 2021. Retrieved 26 August 2020.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 "Charcoal, Activated". The American Society of Health-System Pharmacists. Archived from the original on 21 December 2016. Retrieved 8 December 2016.
  3. 3.0 3.1 "WHOCC - ATC/DDD Index". Archived from the original on 1 July 2021. Retrieved 19 September 2020.
  4. 4.0 4.1 4.2 World Health Organization (2009). Stuart MC, Kouimtzi M, Hill SR (eds.). WHO Model Formulary 2008. World Health Organization. p. 57. hdl:10665/44053. ISBN 9789241547659.
  5. 5.0 5.1 5.2 Hamilton, Richart (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 469. ISBN 9781284057560.
  6. Cecen, Ferhan; Aktas, Özgür (2011-09-19). "1". Activated Carbon for Water and Wastewater Treatment: Integration of Adsorption and Biological Treatment. John Wiley & Sons. ISBN 9783527639458. Archived from the original on 2016-12-20.
  7. Tascón, J. M. D. (2012). Novel Carbon Adsorbents. Elsevier. p. 640. ISBN 9780080977447. Archived from the original on 2016-12-20.
  8. World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  9. "Charcoal, Activated". International Drug Price Indicator Guide. Archived from the original on 22 January 2018. Retrieved 13 August 2015.
  10. Hitchings, Andrew; Lonsdale, Dagan; Burrage, Daniel; Baker, Emma (2019). The Top 100 Drugs: Clinical Pharmacology and Practical Prescribing (2nd ed.). Elsevier. pp. 32–33. ISBN 978-0-7020-7442-4. Archived from the original on 2021-05-22. Retrieved 2021-11-09.
  11. 11.0 11.1 11.2 "Charcoal, Activated". The American Society of Health-System Pharmacists. Archived from the original on 22 May 2014. Retrieved 23 April 2014.
  12. Eddleston M, Juszczak E, Buckley NA, et al. (2008). "Multiple-dose activated charcoal in acute self-poisoning: a randomised controlled trial". Lancet. 371 (9612): 579–87. doi:10.1016/S0140-6736(08)60270-6. PMC 2430417. PMID 18280328.
  13. Rolland, Jacques L. (2006). The Food Encyclopedia: Over 8,000 Ingredients, Tools, Techniques and People. Robert Rose. p. 148. ISBN 0-7788-0150-0.
  14. Stearn, Margaret (2007). Warts and all: straight talking advice on life's embarrassing problems. London: Murdoch Books. p. 333. ISBN 978-1-921259-84-5. Archived from the original on 2017-09-10. Retrieved 2009-05-03.
  15. Michael M, Brittain M, Nagai J, et al. (Nov 2004). "Phase II study of activated charcoal to prevent irinotecan-induced diarrhea". J Clin Oncol. 22 (21): 4410–7. doi:10.1200/JCO.2004.11.125. PMID 15514383.
  16. Gogel HK, Tandberg D, Strickland RG (Sep 1989). "Substances that interfere with guaiac card tests: implications for gastric aspirate testing". Am J Emerg Med. 7 (5): 474–80. doi:10.1016/0735-6757(89)90248-9. PMID 2787993.
  17. Brooks, JK; Bashirelahi, N; Reynolds, MA (September 2017). "Charcoal and charcoal-based dentifrices: A literature review". Journal of the American Dental Association. 148 (9): 661–670. doi:10.1016/j.adaj.2017.05.001. PMID 28599961.
  18. "Can activated charcoal help with hangovers?". WebMD. Archived from the original on 29 March 2019. Retrieved 13 March 2019.
  19. Medlin, Sophie (12 June 2018). "Activated charcoal doesn't detox the body – four reasons you should avoid it". The Conversation. Archived from the original on 13 June 2018. Retrieved 26 November 2019.
  20. Elliott C, Colby T, Kelly T, Hicks H (1989). "Charcoal lung. Bronchiolitis obliterans after aspiration of activated charcoal". Chest. 96 (3): 672–4. doi:10.1378/chest.96.3.672. PMID 2766830.
  21. BNF (80 ed.). BMJ Group and the Pharmaceutical Press. September 2020 – March 2021. p. 1438. ISBN 978-0-85711-369-6.{{cite book}}: CS1 maint: date format (link)

External links

  • "Activated charcoal". Drug Information Portal. U.S. National Library of Medicine. Archived from the original on 2021-08-27. Retrieved 2020-01-19.