June 4, 2001: Please address the following questions regarding the use of activated charcoal.

1.         What are the 5 most common poisonings in which there is evidence it is effective?

The administration of a single dose of activated charcoal following ingestion is controversial.  There is no evidence that single dose activated charcoal changes outcome (ie. is "effective"). MTPC does not recommend the routine use of activated charcoal. 

Multiple dose activated charcoal (MDAC) is used to perform gastric dialysis, ie, the drug is actually pulled from the blood into the gut and absorbed onto the activated charcoal.  Charcoal is administered every 3-4 hours.  There is evidence that administration of  MDAC to patients with the following poisonings decreases the serum concentration of these drugs:  salicylate, carbamazepine (Tegretol), phenobarbital, dapsone, quinnine, and  theophylline.


2.         How it is to be used including doses for age or weight and for how long? 

If one chooses to administer charcoal, the recommended dose of charcoal is 1g/kg in children up to one year of age, 25-50 g in children 1-12 years old, and 25-100 g in adolescents and adults.  In practice, it should be the maximum amount tolerated.


3.         What is the tradename and source of the irrigant in whole bowel irrigation?

Whole Bowel Irrigation (WBI)  consists of administration of a polyethylene glycol electrolyte solution (PEG-ES) also known as Go-Lytely.  It is administered following ingestion of sustained release preparations, ions (lithium, iron) and packets.