Activated charcoal

Identification

Name
Activated charcoal
Accession Number
DB09278  (DB05269)
Type
Small Molecule
Groups
Approved
Description

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.

Structure
Thumb
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
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Char-flo Aqueous Base - Sus Orl 208mg/mlSuspension208 mgOralBallard Medical Products1997-08-202004-08-04Canada
Charcodote-aqueous Sus 200mg/mlSuspension200 mgOralPharmascience Inc1997-03-17Not applicableCanada
Over the Counter Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Activated CharcoalCapsule225 mgOralLeo Desilets Maitre Herboriste Inc1998-10-07Not applicableCanada
Activated CharcoalCapsule225 mgOralJamp Pharma CorporationNot applicableNot applicableCanada
Activated Charcoal 260mgCapsule260 mgOralValeant Canada Lp Valeant Canada S.E.C.1998-12-07Not applicableCanada
Activated Charcoal Cap 280mgCapsule280 mgOralNutrition Professionals Inc.1988-12-311997-02-27Canada
Activated Charcoal Cap 280mgCapsule280 mgOralNature's Way Of Canada Ltd.1984-12-312010-07-27Canada
Activated Charcoal PowderPowder, for solution1 gOralLeo Desilets Maitre Herboriste Inc1999-04-082013-06-18Canada
Activated Charcoal USPPowder100 %OralLifeforce Nutri Blends Canada Inc.2002-06-172012-07-05Canada
Adrien Gagnon Charbon Activé/activated Charcoal CapsulesCapsule170 mgOralSantÉ Naturelle (Ag) LtÉe2009-12-212014-06-09Canada
Biochala Charbon Activé/activated CharcoalCapsule225 mgOralImportations Biochala Inc.Not applicableNot applicableCanada
Charac-25Suspension222 mgOralOmega Laboratories Ltd1985-12-31Not applicableCanada
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing End
CarbosylaneActivated charcoal (140 mg) + Dimethicone (45 mg)CapsuleOralLaboratoires Grimberg1990-12-31Not applicableCanada
Char-flo With Sorbitol - SusActivated charcoal (208 mg) + Sorbitol (400 mg)SuspensionOralBallard Medical Products1997-08-202004-08-04Canada
Flat-eezeActivated charcoal (250 mg) + Simethicone (80 mg)TabletOralSeaford Pharmaceuticals Inc1998-03-202003-09-08Canada
Miracle Sos BlackActivated charcoal (0.7 g/100g) + Moringa oleifera leaf (33.8 g/100g)SoapTopicalDdoruroo Co., Ltd.2017-05-01Not applicableUs
Trousse Antipoison Pour Enfants LiqActivated charcoal (120 ml) + Ipecac (30 ml)LiquidOralProdemdis Enr.1988-12-312010-07-15Canada
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing End
ActidoseActivated charcoal (208 mg/1mL)SuspensionOralPaddock Laboratories, Inc.1983-10-01Not applicableUs
Actidose AquaActivated charcoal (208 mg/1mL)SuspensionOralPaddock Laboratories, Inc.1984-01-01Not applicableUs
Categories
UNII
Not Available
CAS number
64365-11-3
Weight
Average: 12.011
Monoisotopic: 12.0
Chemical Formula
C
InChI Key
OKTJSMMVPCPJKN-UHFFFAOYSA-N
InChI
InChI=1S/C
IUPAC Name
carbon
SMILES
[C]

Pharmacology

Indication

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

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
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.

Affected organisms
  • Humans and other mammals
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
DrugInteraction
LeflunomideThe serum concentration of the active metabolites of Leflunomide can be reduced when Leflunomide is used in combination with Activated charcoal resulting in a loss in efficacy.
TeriflunomideThe serum concentration of Teriflunomide can be decreased when it is combined with Activated charcoal.
Food Interactions
Not Available

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. [PubMed:17387602]
  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. [PubMed:18280328]
  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. [PubMed:28535126]
  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. [PubMed:25781707]
  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. [PubMed:25608917]
  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. [PubMed:28133524]
  7. Derlet RW, Albertson TE: Activated charcoal--past, present and future. West J Med. 1986 Oct;145(4):493-6. [PubMed:3538661]
  8. Spector R, Park GD: New roles for activated charcoal. West J Med. 1986 Oct;145(4):511-2. [PubMed:3788134]
  9. Guss DA: Emergency medicine: activated charcoal-the first-line agent in cases of overdose. West J Med. 1989 Jul;151(1):63. [PubMed:18750603]
  10. Neuvonen PJ: Clinical pharmacokinetics of oral activated charcoal in acute intoxications. Clin Pharmacokinet. 1982 Nov-Dec;7(6):465-89. [PubMed:6761032]
  11. World Health Organization Model List of Essential Medicines (19th List) [Link]
  12. World Health Organization Model Formulary2008 [Link]
External Links
KEGG Drug
D03251
PubChem Compound
297
PubChem Substance
347827832
ChemSpider
4575370
ChEBI
27594
ChEMBL
CHEMBL2106049
Wikipedia
Activated_charcoal_(medication)
ATC Codes
A07BA51 — Medicinal charcoal, combinationsA07BA01 — Medicinal charcoal
AHFS Codes
  • 56:04.00 — Antacids and Adsorbents
  • 56:10.00 — Antiflatulents
MSDS
Download (52.3 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
1CompletedNot AvailableAsthma Bronchial2
1CompletedNot AvailableHealthy Volunteers3
1CompletedTreatmentAsthma Bronchial2
1CompletedTreatmentHealthy Volunteers1
1CompletedTreatmentMajor Depressive Disorder (MDD)1
1CompletedTreatmentPulmonary Disease, Chronic Obstructive1
2CompletedTreatmentHepatic Encephalopathy1
2CompletedTreatmentIrritable Bowel Syndrome (IBS)1
2CompletedTreatmentMild Hepatic Encephalopathy1
2CompletedTreatmentPlasmodium Infections / Severe Malaria1
2CompletedTreatmentPouchitis1
2RecruitingTreatmentBreast Diseases1
2TerminatedTreatmentGastro-esophageal Reflux Disease (GERD)1
2TerminatedTreatmentPouchitis1
3CompletedTreatmentAnal Incontinence1
3CompletedTreatmentChronic Kidney Disease (CKD)2
3CompletedTreatmentDisseminated Sclerosis1
3CompletedTreatmentInflammatory Bowel Diseases (IBD) / Intestinal Fistula1
4CompletedTreatmentAST-120 / Chronic Kidney Disease (CKD)1
4CompletedTreatmentChronic Kidney Disease (CKD)1
4CompletedTreatmentLoss of Solute Clearance1
4Not Yet RecruitingTreatmentAnticoagulants; Circulating, Hemorrhagic Disorder1
Not AvailableCompletedTreatmentPhenytoin Toxicity1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage forms
FormRouteStrength
SuspensionOral208 mg/1mL
CapsuleOral225 mg
CapsuleOral260 mg
CapsuleOral280 mg
Powder, for solutionOral1 g
PowderOral100 %
CapsuleOral170 mg
CapsuleOral
SuspensionOral208 mg
SuspensionOral
SuspensionOral222 mg
SuspensionOral50 g
SuspensionOral200 mg
TabletOral230 mg
CapsuleOral162 mg
PelletOral25 g/25g
TabletOral
PowderOral1000 mg/1g
LiquidOral50 g
LiquidOral15 g
SuspensionOral50 g/240mL
SoapTopical
LiquidOral
GelTopical2 g/100mL
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

Taxonomy

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
Organic compound / Aliphatic acyclic compound
Molecular Framework
Aliphatic acyclic compounds
External Descriptors
nonmetal atom, carbon group element atom (CHEBI:27594)

Drug created on October 29, 2015 08:53 / Updated on November 20, 2018 00:59