Activated charcoal

background

Activated charcoal is a carbon-rich material that has been processed to have an increased surface area. Activated charcoal is widely used for treating drug overdoses and poisonings.
Activated charcoal is most effective if used within one hour of ingesting toxic substances. It has proven to be effective in both adult and child overdoses of drugs such as acetaminophen, digoxin, digitoxin, tricyclic antidepressants, and barbiturates. However, activated charcoal is not effective in poisonings caused by strong acids or bases, cyanide, organic solvents, ethanol, methanol, iron, or lithium, among other substances.
Activated charcoal has been traditionally given with laxatives to encourage removal of toxic contents and improve tolerance to charcoal. However, in 2004 and 1997, the American Academy of Clinical Toxicology and the European Association of Poisons Centres and Clinical Toxicologists stated that they do not endorse the combination of activated charcoal with a laxative. This combination may cause serious side effects such as dehydration, electrolyte imbalances, and low blood pressure.
Activated charcoal has been studied for many stomach disorders, including diarrhea, gas, and indigestion. Research suggests that activated charcoal may benefit people who have diarrhea caused by chemotherapy. When combined with simethicone, activated charcoal may improve symptoms of indigestion. Activated charcoal may also improve bloating and stomach cramps and prevent gas.
Due to its adsorbing effects (attracts substances to the surface of the material), activated charcoal may help treat liver and kidney disorders. Taking activated charcoal by mouth may lower cholesterol levels and reduce high levels of bile acids. Charcoal may also be given with light therapy to help prevent jaundice (yellowing of the skin) in newborn babies.
Activated charcoal particles have been studied as a drug delivery system to improve effectiveness of therapies and reduce chemotherapy agent side effects. However, more research is needed in this area.

Related Terms

AC, Acta-Char®, Actidose®, Actidose Aqua™, activated carbon, activated carbon nanoparticles adsorbing mitomycin C (MMC-ACNP), activated coal, Adsorba®, animal charcoal, Arm-a-char®, AST-120, carbo (Latin), Carbomix®, Carbomix® BP, carbon, Carbosorb® X, carvão vegetal (Portuguese), charbon de bois (French), CharcoAid®, charcoal, Charcocaps®, Charcodote®, Charcotrace™, chitosan encapsulated activated charcoal beads (ACCB), CHR-30, dřevěné uhlí (Czech), EZ-Char™, gas black, gastrointestinal decontamination agent, Holzkohle (German), Insta-Char®, Kremezin®, lamp black, Liqui-Char®, Medicoal®, Merckmezin®, mitomycin C bound to activated carbon particles (MMC-AC or MMC-CH), multiple-dose activated charcoal (MDAC), Norit® A Supra, Norit® C, Norit® C Extra, Nuchar®, oral activated charcoal (OAC), SIAX, silver-impregnated activated charcoal, single-dose activated charcoal (SDAC), Super-Char®, superactivated charcoal, trækul (Danish), trekull (Norwegian), viðarkol (Icelandic).
Select combination products: Carbosylane® (simethicone and activated charcoal); Carbosymag® (simethicone, activated charcoal, and magnesium oxide); Carbosorb® XS (50g of activated charcoal and 100g of sorbitol in 250mL); Actisorb® Silver 220 (silver-impregnated activated charcoal dressing).

evidence table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
 
Poisoning (Grade: A)
Activated charcoal has strong adsorbent properties. It is most effective when given within one hour after ingestion of toxic substances. Activated charcoal has been traditionally given with laxatives such as sorbitol or magnesium citrate. However, the American Academy of Clinical Toxicology and the European Association of Poisons Centres and Clinical Toxicologists have stated that they do not endorse this combination.
Diarrhea (Grade: B)
Research suggests that activated charcoal may benefit people who have diarrhea. However, it is not considered standard care for nonspecific diarrhea. Studies report that activated charcoal may be effective in preventing diarrhea in people undergoing chemotherapy. Experts warn against using activated charcoal with other agents used to treat diarrhea.
Itching (Grade: B)
Itchy skin may be caused by advanced chronic kidney failure and dialysis. Research suggests that activated charcoal may benefit people with this condition. The reasons for this benefit are not well understood. However, experts suggest that activated charcoal may adsorb a compound that causes the itching.
Bile flow improvement (in pregnancy) (Grade: C)
Studies suggest that high levels of bile acids may lead to bile flow problems in pregnancy. Early evidence shows that activated charcoal may be effective in preventing this condition. However, more research is needed in this area.
Cancer (Grade: C)
Anticancer drugs have been found to be unsuccessful in reducing secondary cancer development in people who have had stomach cancer surgery. Early research suggests that chemotherapy with mitomycin C adsorbed onto activated charcoal (MMC-CH) may help increase survival rates after stomach cancer surgery. However, more research is needed in this area.
Gas (Grade: C)
Some studies suggest that activated charcoal may adsorb gas. However, results are inconsistent. More research is needed in this area.
High cholesterol (Grade: C)
Early research reports that activated charcoal may lower cholesterol levels. More research is needed in this area.
Indigestion (Grade: C)
Early research suggests that activated charcoal plus simethicone (with or without magnesium oxide) may reduce indigestion symptoms. More research is needed on the potential effects of activated charcoal alone.
Kidney disease (Grade: C)
Research shows that activated charcoal may help reduce nitrogen-containing waste products. A low-protein diet combined with activated charcoal has been found to benefit elderly people who have advanced kidney disease. Other research found that Kremezin®, an activated charcoal formula sold in Japan, may have more benefit for kidney function than Merckmezin®, another product available in Japan. More research is needed in this area.
Neonatal jaundice (Grade: C)
High levels of bilirubin, a compound found in the bile, may lead to jaundice (yellowing of the skin) in newborn babies. Light therapy is the most common treatment for this condition. Early evidence suggests that activated charcoal may help increase the effects of light therapy. Additional research is needed in this area.
Wound healing (Grade: C)
Evidence suggests that activated charcoal dressings that contain silver may help decrease bacteria and speed healing time. This therapy may have greater benefit than some ointments or zinc paste. Additional research is needed in this area.