Activated charcoal

Identification

Summary

Activated charcoal is a gastric decontamination agent used in emergency clinical settings as a antidote to treat poisonings following excessive oral ingestion of certain medications or poisons.

Brand Names
Actidose, Insta-char
Generic Name
Activated charcoal
DrugBank Accession Number
DB09278
Background

Activated charcoal, or activated carbon, is an amorphous form of carbon prepared from incomplete combustion of carbonaceous organic matter. It is activated by an oxidizing gas flow at high temperature passed over its surface to make a fine network of pores, producing a material with large surface area and high affinity for various substances. It is used as a gastric decontaminant and emergency medication to treat poisonings following excessive oral ingestion of certain medications or poisons by absorbing most drugs and toxins. However its effects is rendered poor on some compounds including strong acids or bases, methanol and substances with limited absorptive capacity (including iron, lithium, arsenic). It works by binding to the poison in the gastric contents in a reversible fashion thus may be adminstered together with a cathartic to reduce the small intestine transit time. The clinical applications of activated charcoal occured in the early 1800's. While this management for acute poisoning is considered fairly invasive, it is on the World Health Organization's List of Essential Medicines that includes the most important medications needed in a basic health system.

Type
Small Molecule
Groups
Approved
Structure
Thumb
Weight
Average: 12.011
Monoisotopic: 12.0
Chemical Formula
C
Synonyms
  • Activated carbon
  • Carbo activates
  • Carbo activatus
  • Carbo vegetabilis
  • Carbon
  • Carbón activado
  • Carbon, Activated
  • Carbon, decolorizing
  • carbono
  • Charcoal activated
  • Charcoal-activated
  • Charcoal, Activated
  • Charcoal,activated
  • Medicinal carbon
  • Medicinal charcoal
External IDs
  • AST 120
  • AST-120
  • GC BM-3

Pharmacology

Indication

Used as a antidote to treat poisonings following excessive oral ingestion of certain medications or poisons.

Pharmacology
Reduce drug development failure rates
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Associated Conditions
Contraindications & Blackbox Warnings
Contraindications
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Pharmacodynamics

Activated charcoal is used as a gastric decontamination agent in emergency clinical settings in case of poison or medication overdose. Studies show that early administration of one dose of activated charcoal can adsorb poison in the stomach and reduce absorption while it also works long after ingestion, by interruption of enterohepatic and enterovascular cycling of poison.

Mechanism of action

Active charcoal acts by binding to the pharmaceutical drugs or poisons such as organophosphates and decreasing the systemic absorption of toxic agents. Molecules with large volume of distribution, thus likely having higher lipid solubility, tends to bind have better absorptive binding to activated charcoal. Following the administration of activated charcoal, cathartics are indicated to evacuate the charcoal-poison bonded complex from the gastrointestinal tract. Activated charcoal may also have an effect on systemic drug levels by lowering the serum levels of already absorbed drugs or toxins. Many absorbed drugs that undergo significant hepatic metabolism and conjugation are eliminated via bile into the small intestines. When they reach the small intestines, drug conjugates can undergo hydrolysis and return to the enterohepatic circulation. Activated charcoal interferes with this process and binds to the conjugated drug before hydrolysis or the free deconjugated drug before reabsorption.

Absorption

No evidence of systemic absorption of activated charcoal

Volume of distribution

Not Available

Protein binding

Not Available

Metabolism
Not Available
Route of elimination

Fecal excretion.

Half-life

Not Available

Clearance

Not Available

Adverse Effects
Adverseeffects
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Toxicity

Adverse effects from the treatment include aspiration into the lungs and possibly pneumonitis, black stools, vomiting, and constipation or diarrhea. The oral LD50 value in rats is 15400mg/kg.

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
DigoxinActivated charcoal may increase the excretion rate of Digoxin which could result in a lower serum level and potentially a reduction in efficacy.
LeflunomideActivated charcoal can cause a decrease in the absorption of Leflunomide resulting in a reduced serum concentration and potentially a decrease in efficacy.
OlanzapineThe serum concentration of Olanzapine can be decreased when it is combined with Activated charcoal.
TeriflunomideActivated charcoal can cause a decrease in the absorption of Teriflunomide resulting in a reduced serum concentration and potentially a decrease in efficacy.
Interactions
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Food Interactions
  • Take with or without food. Give a higher dose of activated charcoal if it is administered after a large meal.

Products

Products2
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dosage, form, labeller, route of administration, and marketing period.
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Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
ActidoseSuspension208 mg/1mLOralPaddock Laboratories, LLC1983-10-01Not applicableUS flag
Actidose AquaSuspension208 mg/1mLOralPaddock Laboratories, LLC1984-01-01Not applicableUS flag
Activated CharcoalSuspension208 mg/1mLOralHF Acquisition Co LLC, DBA HealthFirst2018-12-22Not applicableUS flag
Char-flo Aqueous Base - Sus Orl 208mg/mlSuspension208 mg / mLOralBallard Medical Products1997-08-202004-08-04Canada flag
Charcodote-aqueous Sus 200mg/mlSuspension200 mg / mLOralPharmascience Inc1997-03-172019-01-17Canada flag
Over the Counter Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
ActidoseSuspension208 mg/1mLOralPaddock Laboratories, LLC.2020-12-05Not applicableUS flag
Actidose AquaSuspension208 mg/1mLOralPaddock Laboratories, LLC.2020-11-10Not applicableUS flag
Activated CharcoalCapsule225 mgOralJamp Pharma CorporationNot applicableNot applicableCanada flag
Activated CharcoalCapsule225 mgOralLaboratoire Leo Desilets M.H. Inc1998-10-07Not applicableCanada flag
Activated Charcoal 260mgCapsule260 mgOralExzell Pharma Inc1998-12-07Not applicableCanada flag
Activated Charcoal Cap 280mgCapsule280 mg / capOralNutrition Professionals Inc.1988-12-311997-02-27Canada flag
Activated Charcoal Cap 280mgCapsule280 mg / capOralNature's Way Of Canada Ltd.1984-12-312010-07-27Canada flag
Activated Charcoal CapsulesCapsule250 mgOralWn Pharmaceuticals Ltd.Not applicableNot applicableCanada flag
Activated Charcoal CapsulesCapsule250 mgOralNatural Factors Nutritional Products Ltd.Not applicableNot applicableCanada flag
Activated Charcoal PowderPowder, for solution1 g / 1 gOralLaboratoire Leo Desilets M.H. Inc1999-04-082013-06-18Canada flag
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
CarbosylaneActivated charcoal (140 mg) + Dimethicone (45 mg)CapsuleOralLaboratoires Grimberg1990-12-31Not applicableCanada flag
Char-flo With Sorbitol - SusActivated charcoal (208 mg / mL) + Sorbitol (400 mg / mL)SuspensionOralBallard Medical Products1997-08-202004-08-04Canada flag
EUCARBON TABLETActivated charcoal (180 mg) + Octasulfur (50 mg) + Rhubarb (25 mg) + Senna leaf (105 mg)TabletOralANTAH PHARMA SDN. BHD.2020-09-08Not applicableMalaysia flag
EUCARBON TABLET, 100 ADETActivated charcoal (180 mg) + Octasulfur (50 mg) + Rhubarb (25 mg) + Sennosides (105 mg)TabletOralSANTA FARMA İLAÇ SAN. A.Ş.2020-08-14Not applicableTurkey flag
FARMA CARBON TABLET, 100 ADETActivated charcoal (180 mg) + Octasulfur (50 mg) + Rhubarb (25 mg) + Sennosides (105 mg)TabletOralSANTA FARMA İLAÇ SAN. A.Ş.2020-08-14Not applicableTurkey flag
Flat-eezeActivated charcoal (250 mg) + Simethicone (80 mg)TabletOralSeaford Pharmaceuticals Inc1998-03-202003-09-08Canada flag
INTESTAL ENTERIK KAPLI ,120 DRAJEActivated charcoal (71.1 mg) + Ox bile extract (21.3 mg) + Pancrelipase (59.4 mg)Tablet, coatedOralFARMAKO ECZACILIK A.Ş.2020-08-14Not applicableTurkey flag
INTESTAL ENTERIK KAPLI DRAJEActivated charcoal (71.1 mg) + Ox bile extract (21.3 mg) + Pancrelipase (59.4 mg)Tablet, coatedOralFARMAKO ECZACILIK A.Ş.2020-08-14Not applicableTurkey flag
INTESTINOL DRAJE, 120 ADETActivated charcoal (71.7 mg) + Ox bile extract (21.3 mg) + Pancrelipase (59.4 mg)Tablet, coatedOralKOÇAK FARMA İLAÇ VE KİMYA SAN. A.Ş.2020-08-14Not applicableTurkey flag
INTESTINOL TABLET, 60 ADETActivated charcoal (71.7 mg) + Ox bile extract (21.3 mg) + Pancrelipase (59.4 mg)TabletOralKOÇAK FARMA İLAÇ VE KİMYA SAN. A.Ş.2020-08-14Not applicableTurkey flag
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
ActidoseActivated charcoal (208 mg/1mL)SuspensionOralPaddock Laboratories, LLC1983-10-01Not applicableUS flag
Actidose AquaActivated charcoal (208 mg/1mL)SuspensionOralPaddock Laboratories, LLC1984-01-01Not applicableUS flag
Activated CharcoalActivated charcoal (208 mg/1mL)SuspensionOralHF Acquisition Co LLC, DBA HealthFirst2018-12-22Not applicableUS flag
AQUA-CARBO 50 G/240 ML KULLANIMA HAZIR SULU AKTIF KARBON ICEREN SUSPANSIYONActivated charcoal (50 g/240ml)SuspensionOralAVİCENNA FARMA DIŞ TİC. VE PAZ. A.Ş.2020-08-14Not applicableTurkey flag
Charcoal ActivatedActivated charcoal (1000 mg/1g)PowderOralWoodward Pharma Services Llc2018-06-01Not applicableUS flag
Humco Charcoal ActivatedActivated charcoal (1000 mg/1g)PowderOralHumco Holding Group. Inc.2008-01-01Not applicableUS flag
Miracle Sos BlackActivated charcoal (0.7 g/100g) + Moringa oleifera leaf (33.8 g/100g)SoapTopicalDdoruroo Co., Ltd.2017-05-01Not applicableUS flag
W Lab Sebum Out Peel Off PackActivated charcoal (2 g/100mL)GelTopicalWow Ventures2016-08-012017-08-28US flag

Categories

ATC Codes
A07BA51 — Medicinal charcoal, combinationsA07BA01 — Medicinal charcoal
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as organic compounds. These are compounds that contain at least one carbon atom, excluding isocyanide/cyanide and their non-hydrocarbyl derivatives, thiophosgene, carbon diselenide, carbon monosulfide, carbon disulfide, carbon subsulfide, carbon monoxide, carbon trioxide, carbon suboxide, and dicarbon monoxide.
Kingdom
Organic compounds
Super Class
Not Available
Class
Not Available
Sub Class
Not Available
Direct Parent
Organic compounds
Alternative Parents
Not Available
Substituents
Aliphatic acyclic compound / Organic compound
Molecular Framework
Aliphatic acyclic compounds
External Descriptors
nonmetal atom, carbon group element atom (CHEBI:27594)
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
4XYU5U00C4
CAS number
64365-11-3
InChI Key
OKTJSMMVPCPJKN-UHFFFAOYSA-N
InChI
InChI=1S/C
IUPAC Name
carbon
SMILES
[C]

References

General References
  1. Shimoishi K, Anraku M, Kitamura K, Tasaki Y, Taguchi K, Hashimoto M, Fukunaga E, Maruyama T, Otagiri M: An oral adsorbent, AST-120 protects against the progression of oxidative stress by reducing the accumulation of indoxyl sulfate in the systemic circulation in renal failure. Pharm Res. 2007 Jul;24(7):1283-9. Epub 2007 Mar 27. [Article]
  2. Eddleston M, Juszczak E, Buckley NA, Senarathna L, Mohamed F, Dissanayake W, Hittarage A, Azher S, Jeganathan K, Jayamanne S, Sheriff MR, Warrell DA: Multiple-dose activated charcoal in acute self-poisoning: a randomised controlled trial. Lancet. 2008 Feb 16;371(9612):579-87. doi: 10.1016/S0140-6736(08)60270-6. [Article]
  3. Zawahir S, Gawarammana I, Dargan PI, Abdulghni M, Dawson AH: Activated charcoal significantly reduces the amount of colchicine released from Gloriosa superba in simulated gastric and intestinal media. Clin Toxicol (Phila). 2017 May 23:1-5. doi: 10.1080/15563650.2017.1325897. [Article]
  4. Ronowicz J, Kupcewicz B, Palkowski L, Krysinski J: Development and optimization of the activated charcoal suspension composition based on a mixture design approach. Acta Pharm. 2015 Mar;65(1):83-90. doi: 10.1515/acph-2015-0005. [Article]
  5. Moon J, Chun B, Song K: An exploratory study; the therapeutic effects of premixed activated charcoal-sorbitol administration in patients poisoned with organophosphate pesticide. Clin Toxicol (Phila). 2015 Feb;53(2):119-26. doi: 10.3109/15563650.2014.1001516. Epub 2015 Jan 22. [Article]
  6. Yousefi G, Bizhani M, Jamshidzadeh A, Gholamzadeh S: Comparison of activated charcoal and sodium polystyrene sulfonate resin efficiency on reduction of amitriptyline oral absorption in rat as treatments for overdose and toxicities. Iran J Basic Med Sci. 2017 Jan;20(1):46-52. doi: 10.22038/ijbms.2017.8092. [Article]
  7. Derlet RW, Albertson TE: Activated charcoal--past, present and future. West J Med. 1986 Oct;145(4):493-6. [Article]
  8. Spector R, Park GD: New roles for activated charcoal. West J Med. 1986 Oct;145(4):511-2. [Article]
  9. Guss DA: Emergency medicine: activated charcoal-the first-line agent in cases of overdose. West J Med. 1989 Jul;151(1):63. [Article]
  10. Neuvonen PJ: Clinical pharmacokinetics of oral activated charcoal in acute intoxications. Clin Pharmacokinet. 1982 Nov-Dec;7(6):465-89. [Article]
  11. World Health Organization Model List of Essential Medicines (19th List) [Link]
  12. World Health Organization Model Formulary2008 [Link]
KEGG Drug
D03251
PubChem Compound
297
PubChem Substance
347827832
ChemSpider
4575370
RxNav
272
ChEBI
27594
ChEMBL
CHEMBL2106049
Wikipedia
Activated_charcoal_(medication)
MSDS
Download (52.3 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4CompletedTreatmentAST-120 / Chronic Kidney Disease (CKD)1
4CompletedTreatmentChronic Kidney Disease (CKD)1
4CompletedTreatmentLoss of Solute Clearance1
4Unknown StatusTreatmentAnticoagulants; Circulating, Hemorrhagic Disorder1
4Unknown StatusTreatmentRenal Failure, Chronic Renal Failure1
3CompletedTreatmentChronic Kidney Disease (CKD)2
3CompletedTreatmentFecal Incontinence1
3CompletedTreatmentInflammatory Bowel Diseases (IBD) / Intestinal Fistula1
3CompletedTreatmentMultiple Sclerosis1
2CompletedTreatmentHepatic Encephalopathy (HE)1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
SuspensionOral208 mg/1mL
CapsuleOral225 mg
CapsuleOral280 mg / cap
CapsuleOral250 mg
Powder, for solutionOral1 g / 1 g
PowderOral100 %
CapsuleOral170 mg
SuspensionOral
TabletOral
TabletOral300 mg
TabletOral500 mg
CapsuleOral
SuspensionOral208 mg / mL
SuspensionOral
SuspensionOral222 mg / mL
SuspensionOral50 g / 225 mL
SuspensionOral200 mg / mL
SuspensionOral50 g / 250 mL
TabletOral230 mg
CapsuleOral162 mg
PowderOral1000 mg/1g
TabletOral
PelletOral25 g/25g
LiquidOral50 g / 250 mL
LiquidOral15 g / 120 mL
SuspensionOral50 g/240mL
Tablet, coatedOral
Capsule, coatedOral
SoapTopical
CapsuleOral
CapsuleOral280 mg
Granule, for suspensionOral
GranuleOral
TabletOral150 mg
SuspensionOral20 g
LiquidOral
GelTopical2 g/100mL
CapsuleOral260 mg
Tablet
TabletOral250 mg
TabletOral325 mg
Prices
Not Available
Patents
Not Available

Properties

State
Solid
Experimental Properties
PropertyValueSource
water solubilityInsolubleMSDS
Predicted Properties
PropertyValueSource
Water Solubility0.0 mg/mLALOGPS
logP-1.3ALOGPS
logP0ChemAxon
logS1.08ALOGPS
Physiological Charge0ChemAxon
Hydrogen Acceptor Count0ChemAxon
Hydrogen Donor Count0ChemAxon
Polar Surface Area0 Å2ChemAxon
Rotatable Bond Count0ChemAxon
Refractivity13.11 m3·mol-1ChemAxon
Polarizability1.51 Å3ChemAxon
Number of Rings0ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterNoChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET Features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSNot Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available

Drug created on October 29, 2015 14:53 / Updated on September 25, 2021 23:53