Activated Charcoal: Benefits, Dosage, Contraindications

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Vegetable activated charcoal is a carbon-rich, porous material obtained by calcining wood (or other materials) heated to a very high temperature in the absence of air. The charcoal is then activated by increasing the number of pores, which increases its surface area. This is achieved by heating it to high temperature in the presence of steam or carbon dioxide, or with an activating agent such as phosphoric acid or zinc chloride. Activated charcoal is widely used to treat drug overdoses and poisonings. Activated charcoal can be prepared from vegetable by-products such as coconut shells, cherry pits, olive pits, or date pits. The adsorption power of activated charcoals is mainly attributed to its porosity and specific surface area (surface area per unit mass, expressed in m²/g), representing the area available to adsorb a monolayer of molecules. The surface developed by activated charcoal is significant: 1 g of activated charcoal has a specific surface area between 400 and 2,500 m²/g. Activated charcoal demonstrated its ability to prevent toxicity when two of its pioneers, Bertrand (1813) and Touéry (1831), publicly ingested arsenic and strychnine, respectively, with activated charcoal and survived. Subsequent researchers demonstrated in vitro the action of activated charcoal on a wide range of toxins, including morphine, barbiturates, salicylates, and other medications. In addition to its role in neutralizing toxins, it has been demonstrated that activated charcoal adsorbs gases, suggesting it may play a role in reducing flatulence. Due to its adsorbing nature (meaning to attract substances to the surface of the material), activated charcoal can help treat liver and kidney disorders. Oral intake of activated charcoal may lower cholesterol levels and reduce high bile acid levels.

Other name(s) 

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Scientific name(s)

Carbo vegetabilis

Family or group: 

Super Food


Indications

Rating methodology

EFSA approval.

Several clinical trials (> 2) randomized controlled with double blind, including a significant number of patients (>100) with consistently positive outcomes for the indication.
Several clinical trials (> 2) randomized controlled with double blind, and including a significant number of patients (>100) with positive outcomes for the indication.
One or more randomized studies or multiple cohorts or epidemiological studies with positive outcomes for the indication.
Clinical studies exist but are uncontrolled, with conclusions that may be positive or contradictory.
Lack of clinical studies to date that can demonstrate the indication.


Detoxification
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Oral intake of activated charcoal appears to be effective when part of the standard treatment for certain acute poisonings. Single doses of activated charcoal, from 25 to 100 g in adults (10 to 50 g in children, depending on age), are effective in preventing the absorption of certain drugs if taken within an hour of ingestion.

Posologie

posologieOrally

posologie10 g


Diarrhea
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Preliminary clinical research conducted in children treated with irinotecan (chemotherapy) shows that taking 250 mg of activated charcoal the day before the first infusion, and then every 8 hours until the end of the cycle, reduces the risk of diarrhea by 60% compared to no treatment. Activated charcoal also appears to reduce the risk of severe diarrhea by 92% and the discontinuation of chemotherapy by 87% among these patients.

Posologie

posologieOrally

posologie250 mg


Digestive Disorders
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A preliminary clinical study conducted in adults with functional dyspepsia shows that taking a specific combination containing 280 mg of activated charcoal, 90 mg of simethicone (medication), and 180 mg of magnesium oxide three times a day for a month reduces the symptoms of dyspepsia, such as postprandial fullness, epigastric pain, and abdominal bloating, compared to placebo.

Posologie

posologieOrally

posologie150 - 840 mg


Flatulence
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Preliminary clinical research shows that taking 582 mg of activated charcoal after a meal significantly reduces the incidence of flatulence compared to placebo. On average, subjects taking activated charcoal reported fewer than 3 episodes of flatulence over 8 hours, compared to more than 14 episodes in those taking the placebo. However, other preliminary clinical research shows that taking 520 mg of activated charcoal at breakfast, lunch, dinner, and bedtime for 7 days does not significantly reduce excessive gas or the total number of flatulence episodes compared to baseline values.

Posologie

posologieOrally

posologie582 mg


Properties


Digestive Effect

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Activated charcoal is capable of absorbing many medications, and it has been demonstrated that it absorbs gases, suggesting it could play a role in reducing flatulence after gas-producing meals. Preliminary clinical evidence suggests that activated charcoal decreases bile acid levels in pregnant patients with cholestasis (the serum bile acid level is associated with cholestasis symptoms).

Usages associés

Diarrhea, Digestive Disorders, Flatulence

Purifying

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Activated charcoal is widely recognized for its effectiveness in reducing absorption of most common toxic ingestions. Activated charcoal adsorbs many medications, which increases clearance and decreases the elimination half-life. It binds unabsorbed drugs in the gastrointestinal tract. It also binds drugs that diffuse or are transported from the circulation to the intestine, interrupting the enterohepatic circulation of drugs. By this latter mechanism, it can reduce exposure to intravenous medications, including amiodarone, azithromycin, acetaminophen, aspirin, ceftriaxone, doxycycline, lorazepam, methotrexate, metronidazole, morphine, phenytoin, and valproate.

Usages associés

Detoxification

Hypocholesterolemic

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Activated charcoal is believed to decrease serum cholesterol levels by interfering with the enterohepatic circulation of bile acids. Cholesterol is necessary for the production of bile acids and is used in greater quantities when bile acid synthesis is increased to normalize levels.


Safety dosage

Adult: 500 mg - 10,000 mg

Activated charcoal is administered in single doses up to 100 g. Lower doses, up to 3.6 grams per day, have been used for up to 3 years. When taking activated charcoal, stools turn dark in color.


Interactions

Médicaments

Oral Contraceptives: Moderate Interaction

Activated charcoal, taken at a dose of 5 g four times a day for 3 days, can bind to oral contraceptives and reduce their absorption, thus limiting their effectiveness and increasing the risk of contraceptive failure. However, some clinical research shows that the risk of this interaction is minimal when activated charcoal is taken either 3 hours after or at least 12 hours before oral contraceptives.

Oral Medications: Strong Interaction

Activated charcoal adsorbs various drugs and can reduce their absorption and/or half-life. Examples of affected medications include: acetaminophen, aminophylline, amiodarone, atenolol, carbamazepine, dapsone, digoxin, disopyramide, fluoxetine, indomethacin, moxifloxacin, nadolol, phenytoin, phenobarbital, piroxicam, quinine, sotalol, theophylline, tricyclic antidepressants, valproate, verapamil, hypertension medications, rheumatism medications. Avoid co-administration.


Precautions

Breastfeeding Women: Use with caution

Charcoal has been used safely orally and short-term.

Pregnant Women: Use with caution

Activated charcoal, 50 g three times a day for 8 days, has been used with apparent safety during pregnancy.


Contraindications

Intestinal Blockage: Forbidden

Use of activated charcoal is contraindicated in cases of intestinal blockage.