Research

Activated Charcoal

71 peer-reviewed studies curated from PubMed and Semantic Scholar.

2
Meta-analyses
3
Systematic reviews
64
RCTs
2
Other studies
Meta-analyses (3%)
Systematic reviews (4%)
RCTs (90%)
Observational (1%)

Studies

Sorted by quality and recency

2024·Clinical toxicology (Philadelphia, Pa.)·Jurriaan Varekamp, Jia Lin Tan, Janine Stam, et al

Effects of interrupting the enterohepatic circulation in amatoxin intoxications.

Systematic reviewn = 1,119

Systematic review of 133 publications with 1,119 cases evaluating the effect of activated charcoal on amatoxin poisoning. Treatment with activated charcoal was associated with an 83% survival rate compared to 75% in the control group, and a reduction in markers of liver function.

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2022·Annals of anatomy = Anatomischer Anzeiger : official organ of the Anatomische Gesellschaft·Dolores Bibiana Montero Tomás, María Pilar Pecci-Lloret, Julia Guerrero-Gironés

Effectiveness and abrasiveness of activated charcoal as a whitening agent: A systematic review of in vitro studies.

Systematic review

Systematic review of in vitro studies on activated charcoal-based toothpaste for tooth whitening. The review found that activated charcoal has a lower whitening effect compared to other agents and a higher abrasive potential, raising safety concerns.

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2020·Nederlands tijdschrift voor tandheelkunde·S E M Oudeman

[Black dentifrice, white teeth?].

Systematic review

The paper reviews the effectiveness of activated charcoal-based whitening dentifrices. It references a randomized controlled in vitro study showing that 'Black is White Curaprox' dentifrice is less effective in reducing extrinsic staining compared to other whitening dentifrices. The review concludes there is insufficient scientific evidence to support the cosmetic benefits of charcoal-based dentifrices.

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2018·The Cochrane database of systematic reviews·Bert Avau, Vere Borra, Anne-Catherine Vanhove, et al

First aid interventions by laypeople for acute oral poisoning.

Meta-analysisn = 7,099

Meta-analysis of 24 trials involving 7099 participants assessing pre-hospital interventions for acute oral poisoning, including activated charcoal and syrup of ipecac. The evidence was mostly of low to very low certainty, with only one study conducted in a pre-hospital setting, limiting the applicability of results.

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2008·Lancet (London, England)·Michael Eddleston, Edmund Juszczak, Nick A Buckley, et al

Multiple-dose activated charcoal in acute self-poisoning: a randomised controlled trial.

RCTn = 4,632

RCT in Sri Lanka comparing multiple-dose activated charcoal, single-dose charcoal, and no charcoal in 4632 patients with acute self-poisoning. Mortality did not differ significantly between groups, suggesting no benefit of routine multiple-dose charcoal in this setting.

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2007·Clinical toxicology (Philadelphia, Pa.)·Fahim Mohamed, M Roshini Sooriyarachchi, Lalith Senarathna, et al

Compliance for single and multiple dose regimens of superactivated charcoal: a prospective study of patients in a clinical trial.

RCTn = 1,103

RCT in Sri Lanka with 1,103 patients randomized to single or multiple doses of superactivated charcoal for self-poisoning treatment. Compliance was high for the first dose but decreased for subsequent doses, with 12.3% refusing the sixth dose.

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2002·American journal of therapeutics·Kevin S Merigian, Kari E Blaho

Single-dose oral activated charcoal in the treatment of the self-poisoned patient: a prospective, randomized, controlled trial.

RCTn = 1,479

Prospective, randomized, controlled trial of oral activated charcoal (OAC) in 1479 self-poisoned adult patients. The study found no significant differences in clinical outcomes between the OAC treatment group and controls, with OAC associated with a higher incidence of vomiting and longer ED stay.

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2024·Journal of dentistry·Edgar Pedreiro Ribeiro, Gabriela Torres Zanin, Andrey Emídio Gonçalves, et al

Whitening efficacy of activated charcoal-based products: A single-blind randomized controlled clinical trial.

RCTn = 56

This randomized controlled clinical trial evaluated the whitening efficacy, tooth sensitivity, and volunteers' satisfaction following the use of activated charcoal powder and toothpaste. Activated charcoal-based products presented a minor and unsatisfactory whitening effect compared to carbamide peroxide, which resulted in optimal tooth whitening and the highest level of satisfaction among volunteers.

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2023·Journal of dentistry·Edgar Pedreiro Ribeiro, Andrey Gonçalves Emídio, Gabriela Torres Zanin, et al

Dental aesthetic perception of patients submitted to activated charcoal-based bleaching agents: A randomized clinical trial.

RCTn = 56

RCT comparing activated charcoal-based products (powder and toothpaste) to 10% carbamide peroxide and conventional toothpaste on aesthetic perception and psychosocial impact. Activated charcoal-based products showed lower scores in all questionnaires compared to carbamide peroxide, indicating a lower impact on quality of life and aesthetic perception.

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2009·Clinical pharmacology and therapeutics·G Jürgens, L C Groth Hoegberg, N A Graudal

The effect of activated charcoal on drug exposure in healthy volunteers: a meta-analysis.

Meta-analysis

Meta-analysis of 64 controlled studies estimating the effect of activated charcoal on drug exposure. Activated charcoal significantly reduced drug exposure when administered within 6 hours of drug intake, with the greatest effect when given immediately after ingestion.

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2005·QJM : monthly journal of the Association of Physicians·G M Cooper, D G Le Couteur, D Richardson, et al

A randomized clinical trial of activated charcoal for the routine management of oral drug overdose.

RCTn = 327

RCT of 327 patients with oral drug overdose comparing activated charcoal to no decontamination. No significant differences were found in length of stay or secondary outcomes such as vomiting, mortality, and intensive care admission.

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2024·American journal of cardiovascular drugs : drugs, devices, and other interventions·Samira Merali, Manting Chiang, Caroline Sychterz, et al

Effect of Activated Charcoal on Mavacamten Pharmacokinetics in Healthy Participants.

RCTn = 45

Open-label, randomized study assessing the effect of activated charcoal on mavacamten pharmacokinetics in healthy adults. Activated charcoal reduced mavacamten absorption and exposure when administered 2 hours after dosing, but not when administered 6 hours after.

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2024·Journal of emergency nursing·Michael Keenan, Susan Wojcik, Brian M Clemency, et al

Does Mixing Activated Charcoal With Cola Improve Tolerability Without Affecting Pharmacokinetics? A Randomized Controlled Crossover Trial.

RCTn = 5

This randomized controlled crossover trial studied the effect of mixing activated charcoal with cola on its tolerability and pharmacokinetics in five healthy adults. The study found no statistical difference in acetaminophen absorption or preference scores between activated charcoal alone and the cola-activated charcoal mixture.

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2023·Journal of medicine and life·Waleed Khaild Rahman, Ihsan Salah Rabea, Mudhfar Mohammed Meizel

Protective effect of activated charcoal against progression of chronic kidney disease: A randomized clinical study.

RCTn = 28

RCT investigating the effect of oral activated charcoal supplementation in 28 patients with end-stage renal disease on hemodialysis. The study found significant reductions in serum urea and phosphorus levels after eight weeks of treatment, while other biomarkers were unaffected.

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2023·Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia·Mahmoud Zanganeh, Ali Abbasi, Ahmad Khosravi, et al

Effects of Increased Blood Flow Rate and Oral Activated Charcoal on the Severity of Uremic Pruritus: A Randomized Crossover Clinical Trial.

RCTn = 20

Randomized crossover clinical trial comparing increased blood flow rate and oral activated charcoal suspension on uremic pruritus severity in hemodialysis patients. Each group received three 2-week interventions with washout periods. All interventions reduced pruritus severity, with the greatest decrease from combined increased pumping speed and charcoal suspension.

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2018·Journal of nephrology·Ying Gao, Guiyun Wang, Yang Li, et al

Effects of oral activated charcoal on hyperphosphatemia and vascular calcification in Chinese patients with stage 3-4 chronic kidney disease.

RCTn = 97Heart Health Nutrition

RCT of 97 patients with stage 3-4 chronic kidney disease comparing oral activated charcoal to placebo. Activated charcoal significantly delayed the onset of hyperphosphatemia and reduced coronary calcification scores compared to calcium carbonate and lanthanum carbonate.

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2011·Veterinary parasitology·C Paraud, I Pors, J P Journal, et al

Control of cryptosporidiosis in neonatal goat kids: efficacy of a product containing activated charcoal and wood vinegar liquid (Obionekk®) in field conditions.

RCT

The study evaluated the efficacy of a product containing activated charcoal and wood vinegar liquid (Obionekk) in preventing cryptosporidiosis in neonatal goat kids under field conditions. The product significantly reduced oocyst excretion and clinical signs of diarrhea when administered preventively.

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2009·Gastroenterologie clinique et biologique·M Lecuyer, T Cousin, M-N Monnot, et al

Efficacy of an activated charcoal-simethicone combination in dyspeptic syndrome: results of a randomized prospective study in general practice.

RCTn = 132Gut Health

RCT evaluating the efficacy of a combination of simethicone and activated charcoal (Carbosylane) on dyspeptic symptoms in 132 patients. Carbosylane significantly reduced symptom intensity compared to placebo, with improvements persisting 2 months post-treatment.

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2004·MMW Fortschritte der Medizin·M Dorn

[Controlled clinical testing of an antidiarrheal].

RCTn = 94Gut Health

Randomized, double-blind study on 100 adults with nonspecific diarrhea, with 94 included in the final analysis. Activated charcoal significantly reduced stool frequency and duration of diarrhea compared to placebo, proving effective and well-tolerated for treating nonspecific diarrhea.

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2000·British journal of clinical pharmacology·P J Yeates, S H Thomas

Effectiveness of delayed activated charcoal administration in simulated paracetamol (acetaminophen) overdose.

RCT

An open randomized-order four-way crossover study in healthy volunteers investigated the efficacy of activated charcoal in reducing paracetamol absorption after simulated overdose. Activated charcoal significantly reduced paracetamol absorption when administered 1 or 2 hours after ingestion, but not after 4 hours.

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1995·The Medical journal of Australia·S M Pond, D J Lewis-Driver, G M Williams, et al

Gastric emptying in acute overdose: a prospective randomised controlled trial.

RCTn = 876

Prospective RCT comparing the efficacy and safety of activated charcoal alone versus gastric emptying plus charcoal in adults after acute oral overdose. No significant differences in outcomes were found between the groups, suggesting gastric emptying can be omitted from treatment protocols.

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1989·Annals of emergency medicine·T E Albertson, R W Derlet, G E Foulke, et al

Superiority of activated charcoal alone compared with ipecac and activated charcoal in the treatment of acute toxic ingestions.

RCTn = 200

A prospective, randomized clinical trial compared the effectiveness of syrup of ipecac and activated charcoal to activated charcoal alone in treating acute toxic ingestions in 200 adults. Patients receiving only activated charcoal were discharged significantly faster and had fewer complications compared to those receiving both treatments.

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2018·The Journal of infectious diseases·Jean de Gunzburg, Amine Ghozlane, Annie Ducher, et al

Protection of the Human Gut Microbiome From Antibiotics.

RCTn = 28Gut Health

RCT of 28 human volunteers treated with moxifloxacin, with or without DAV132 coadministration. DAV132 decreased free moxifloxacin fecal concentrations by 99% and preserved intestinal microbiota richness and composition. No adverse effects observed.

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2017·Basic & clinical pharmacology & toxicology·Tejs Jansen, Lotte C G Hoegberg, Thomas Eriksen, et al

Advanced Electrocardiogram Analysis in the Amitriptyline-poisoned Pig Treated with Activated Charcoal Haemoperfusion.

RCTn = 14

Non-blinded, randomized controlled animal trial investigating the effect of coated activated charcoal haemoperfusion (CAC-HP) on ECG changes in amitriptyline-poisoned pigs. The study found no significant difference in ECG alterations between the CAC-HP group and the control group receiving standard care.

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2014·American journal of cardiovascular drugs : drugs, devices, and other interventions·Xiaoli Wang, Sabiha Mondal, Jessie Wang, et al

Effect of activated charcoal on apixaban pharmacokinetics in healthy subjects.

RCTn = 18

Open-label, three-treatment, three-period, randomized, crossover study evaluating the effect of activated charcoal on apixaban exposure in 18 healthy subjects. Activated charcoal reduced apixaban AUCINF by 50% and 28% when administered at 2 and 6 hours post-dose, respectively, and decreased the terminal half-life of apixaban.

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2012·Clinical toxicology (Philadelphia, Pa.)·Carl G Skinner, Arthur S Chang, Andre S Matthews, et al

Randomized controlled study on the use of multiple-dose activated charcoal in patients with supratherapeutic phenytoin levels.

RCTn = 17

RCT on the use of multiple-dose activated charcoal (MDAC) in patients with supratherapeutic serum phenytoin levels. The study found that the median time to reach subtoxic phenytoin levels was shorter in the charcoal group compared to the control group.

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2010·Arzneimittel-Forschung·Tapani Keränen, Annamari Sorri, Eeva Moilanen, et al

Effects of charcoal on the absorption and elimination of the antiepileptic drugs lamotrigine and oxcarbazepine.

RCTn = 6

The study investigated the effects of oral activated charcoal (OAC) on the absorption and elimination of the antiepileptic drugs lamotrigine and oxcarbazepine in healthy volunteers. Single and repeated doses of OAC significantly reduced the absorption and accelerated the elimination of these drugs, suggesting its potential use in overdose treatment.

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2009·Clinical toxicology (Philadelphia, Pa.)·Michael Mullins, Brian R Froelke, Maria Regina-Paz Rivera

Effect of delayed activated charcoal on acetaminophen concentration after simulated overdose of oxycodone and acetaminophen.

RCTn = 9

Prospective cross-over study of nine healthy volunteers to determine the effect of activated charcoal on acetaminophen absorption kinetics after overdose with oxycodone. Activated charcoal reduced the area under the curve for acetaminophen concentration significantly when administered at 1 hour, with diminishing effects at 2 and 3 hours.

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2008·Pediatric blood & cancer·Gallegos-Castorena Sergio, Gaytán-Morales Félix, Juárez-Villegas Luis

Activated charcoal to prevent irinotecan-induced diarrhea in children.

RCTn = 22Gut Health

Prospective trial evaluating activated charcoal (AC) to prevent irinotecan-induced diarrhea in children. AC reduced the frequency and severity of diarrhea, improving treatment compliance. 22 patients were included, with 10 receiving AC and 12 not. Significant reduction in grade 3 and 4 diarrhea was observed in the AC group.

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2006·The American journal of emergency medicine·Nozha Brahmi, Nadia Kouraichi, Hafedh Thabet, et al

Influence of activated charcoal on the pharmacokinetics and the clinical features of carbamazepine poisoning.

RCTn = 12

Prospective study of 12 acute carbamazepine-poisoned patients randomized to receive multiple-dose or single-dose activated charcoal. Multiple-dose activated charcoal significantly decreased the duration of coma, mechanical ventilation, and length of hospital stay compared to single-dose, and reduced the half-life of carbamazepine in serum.

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2005·Clinical toxicology (Philadelphia, Pa.)·Lotte Christine Groth Hoegberg, Anne-Bolette Christophersen, Hanne Rolighed Christensen, et al

Comparison of the adsorption capacities of an activated-charcoal--yogurt mixture versus activated-charcoal--water slurry in vivo and in vitro.

RCTn = 15

A randomized crossover study on 15 adult volunteers compared the gastrointestinal absorption of paracetamol using activated-charcoal--yogurt mixture versus activated-charcoal--water slurry. No significant difference in paracetamol absorption was found between the two preparations. The study also evaluated palatability and found that the yogurt mixture prolonged ingestion time but did not improve palatability. In vitro, the presence of yogurt reduced the adsorption capacity of activated charcoal by 9-13%.

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2004·Life sciences·Hiroshi Yamazaki, Masaki Fujieda, Masahiro Togashi, et al

Effects of the dietary supplements, activated charcoal and copper chlorophyllin, on urinary excretion of trimethylamine in Japanese trimethylaminuria patients.

RCTn = 7

RCT studying the effects of activated charcoal and copper chlorophyllin on urinary excretion of trimethylamine in Japanese trimethylaminuria patients. Both supplements reduced urinary free TMA concentration and increased TMAO concentration to normal values, with copper chlorophyllin having longer-lasting effects.

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2002·Hawaii medical journal·Renee L Sato, Jeffrey J Wong, Shawn M Sumida, et al

Adverse effects of superactivated charcoal administered to healthy volunteers.

RCTn = 48

RCT assessing adverse effects of superactivated charcoal (SAC) in healthy volunteers. SAC was administered to 24 subjects, resulting in adverse effects such as black stool, constipation, nausea, and vomiting. The study highlights significant adverse effects that may affect the willingness of drug overdose patients to consume charcoal slurry.

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2002·British journal of clinical pharmacology·A B Christophersen, D Levin, L C G Hoegberg, et al

Activated charcoal alone or after gastric lavage: a simulated large paracetamol intoxication.

RCTn = 12

A four-limbed randomized cross-over study in 12 volunteers examined the efficacy of activated charcoal alone or in combination with gastric lavage in reducing systemic absorption of paracetamol. Activated charcoal significantly reduced paracetamol AUC when administered 1 hour post-ingestion, with no additional benefit from combination therapy. Efficacy was reduced when charcoal was administered 2 hours post-ingestion.

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2001·Journal of toxicology. Clinical toxicology·R Green, R Grierson, D S Sitar, et al

How long after drug ingestion is activated charcoal still effective?

RCTn = 10

Randomized crossover study with 10 volunteers to determine the effectiveness of activated charcoal administered 1, 2, and 3 hours after acetaminophen ingestion. The study found that activated charcoal significantly reduced acetaminophen bioavailability only when administered within 1 hour, with a 30.3% decrease in bioavailability.

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2001·Clinical pharmacology and therapeutics·O Lapatto-Reiniluoto, K T Kivistö, P J Neuvonen

Activated charcoal alone and followed by whole-bowel irrigation in preventing the absorption of sustained-release drugs.

RCTn = 9

Randomized crossover study with 9 healthy subjects examining the effect of activated charcoal on the absorption of sustained-release drugs. Activated charcoal significantly reduced the absorption of carbamazepine, theophylline, and verapamil when given 1 hour after drug intake. Whole-bowel irrigation did not enhance and may decrease the efficacy of charcoal.

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2001·Journal of the American Veterinary Medical Association·C J Giffard, S B Collins, N C Stoodley, et al

Administration of charcoal, Yucca schidigera, and zinc acetate to reduce malodorous flatulence in dogs.

RCTn = 8

RCT assessing the effects of activated charcoal, Yucca schidigera, and zinc acetate on flatulence in 8 dogs. The study found that while total gas production and frequency of flatulence episodes were unaffected, the combination of the three agents significantly reduced the malodor of flatus by reducing hydrogen sulfide production.

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1999·Academic emergency medicine : official journal of the Society for Academic Emergency Medicine·T F Fischer, A J Singer

Comparison of the palatabilities of standard and superactivated charcoal in toxic ingestions: a randomized trial.

RCTn = 60

RCT comparing the palatability of standard activated charcoal (LiquiChar) with a superactivated granulated form (CharcoAid) in 60 patients with toxic ingestions. CharcoAid was found to be more palatable, potentially improving patient compliance.

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1999·Journal of accident & emergency medicine·R Boyd, J Hanson

Prospective single blinded randomised controlled trial of two orally administered activated charcoal preparations.

RCT

Prospective single blinded RCT comparing two activated charcoal preparations, Carbomix and Actidose-Aqua, in terms of amount ingested and incidence of vomiting. Carbomix resulted in a higher amount ingested, with low rates of vomiting for both preparations.

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1991·Annals of emergency medicine·A E Kornberg, J Dolgin

Pediatric ingestions: charcoal alone versus ipecac and charcoal.

RCTn = 70

RCT comparing syrup of ipecac (SOI) followed by activated charcoal (AC) versus AC alone in 70 children with mild-to-moderate acute oral ingestions. SOI delayed AC administration, increased vomiting of AC, and prolonged ED time compared to AC alone.

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1990·Archives of emergency medicine·T J Underhill, M K Greene, A F Dove

A comparison of the efficacy of gastric lavage, ipecacuanha and activated charcoal in the emergency management of paracetamol overdose.

RCT

Prospective trial comparing the efficacy of gastric lavage, activated charcoal, and ipecacuanha in limiting paracetamol absorption in overdose cases. Activated charcoal was found to be more effective than gastric lavage or ipecacuanha at reducing plasma paracetamol levels.

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1988·Human toxicology·B A Hultén, R Adams, R Askenasi, et al

Activated charcoal in tricyclic antidepressant poisoning.

RCTn = 91

RCT examining the effect of a single dose of 20 g of activated charcoal in 91 patients with suspected TCA overdose. No significant difference was found in plasma drug concentration or toxic symptoms between the treated and control groups.

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1986·Human toxicology·B A Hultén, A Heath, T Mellstrand, et al

Does alcohol absorb to activated charcoal?

RCT

A randomized cross-over study investigated the effect of activated charcoal on alcohol absorption. Participants consumed 88 g of alcohol followed by either 20 g of activated charcoal or water. No significant differences in plasma alcohol concentrations were observed with or without charcoal.

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1985·Drug intelligence & clinical pharmacy·G D Park, M J Goldberg, R Spector, et al

The effects of activated charcoal on digoxin and digitoxin clearance.

RCT

The study investigated the effects of multiple oral doses of activated charcoal on the clearance of digoxin and digitoxin in normal subjects and a subject with chronic renal failure. Activated charcoal significantly increased digitoxin clearance but had limited effect on digoxin clearance in normal subjects. In the renal failure subject, digoxin clearance increased significantly. The findings suggest potential utility of activated charcoal in treating digitoxin toxicity and possibly digoxin toxicity in patients with renal dysfunction.

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1981·The American journal of gastroenterology·R G Hall, H Thompson, A Strother

Effects of orally administered activated charcoal on intestinal gas.

RCTGut Health

RCT comparing the effectiveness of orally administered activated charcoal to placebo in treating intestinal gas. Activated charcoal was effective in preventing the increase in flatus events and breath hydrogen concentrations following a gas-producing meal.

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2012·Nephrology (Carlton, Vic.)·Zunsong Wang, Meiyu Cui, Lijun Tang, et al

Oral activated charcoal suppresses hyperphosphataemia in haemodialysis patients.

Studyn = 135Nutrition

Open-label, prospective, uncontrolled study of 135 haemodialysis patients examining the effect of oral activated charcoal (oAC) on serum phosphate levels. oAC reduced mean phosphate levels significantly, with 90.4% of patients reaching the phosphate target. Serum intact parathyroid hormone levels also declined during the study.

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1999·British journal of clinical pharmacology·O Lapatto-Reiniluoto, K T Kivistö, P J Neuvonen

Effect of activated charcoal alone or given after gastric lavage in reducing the absorption of diazepam, ibuprofen and citalopram.

RCTn = 9

Randomized cross-over study with nine healthy volunteers to assess the efficacy of activated charcoal alone and combined with gastric lavage in reducing the absorption of diazepam, ibuprofen, and citalopram. Both interventions significantly reduced the absorption of these drugs, suggesting that gastric lavage may not be necessary before charcoal administration.

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1997·British journal of clinical pharmacology·K Laine, K T Kivistö, I Laakso, et al

Prevention of amlodipine absorption by activated charcoal: effect of delay in charcoal administration.

RCTn = 32

RCT investigating the effect of activated charcoal on amlodipine absorption in 32 healthy volunteers. Activated charcoal significantly reduced amlodipine absorption when administered immediately or 2 hours after ingestion, suggesting its use in amlodipine overdose.

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1997·Journal of toxicology. Clinical toxicology·K Laine, K T Kivistö, P J Neuvonen

Effect of delayed administration of activated charcoal on the absorption of conventional and slow-release verapamil.

RCTn = 17

The study investigated the effect of activated charcoal on the absorption of conventional and slow-release verapamil in healthy volunteers. Activated charcoal significantly reduced verapamil absorption when administered immediately after ingestion, with a lesser effect when delayed, particularly for the slow-release formulation.

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1997·British journal of clinical pharmacology·A al-Shareef, D C Buss, H G Shetty, et al

The effect of repeated-dose activated charcoal on the pharmacokinetics of sodium valproate in healthy volunteers.

RCTn = 7

RCT investigating the effects of repeated-dose activated charcoal on the pharmacokinetics of sodium valproate in seven healthy volunteers. Charcoal did not enhance the rate of elimination of sodium valproate after therapeutic doses.

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1996·Pharmacology & toxicology·K Laine, K T Kivistö, S Pelttari, et al

The effect of activated charcoal on the absorption of fluoxetine, with special reference to delayed charcoal administration.

RCTn = 32

Randomized study with four parallel groups of eight healthy volunteers investigating the effect of activated charcoal on fluoxetine absorption. Immediate administration of charcoal after fluoxetine significantly reduced fluoxetine absorption, while delayed administration (2-4 hours later) showed a non-significant reduction.

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1994·Human & experimental toxicology·K Laine, K T Kivistö, P J Neuvonen

The effect of activated charcoal on the absorption and elimination of astemizole.

RCTn = 21

RCT studying the effect of activated charcoal on the absorption and elimination of astemizole in healthy volunteers. Activated charcoal reduced astemizole absorption by 85% when administered immediately after ingestion, but multiple doses did not affect the elimination rate.

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1993·The American journal of emergency medicine·K Ilkhanipour, D M Yealy, E P Krenzelok

Activated charcoal surface area and its role in multiple-dose charcoal therapy.

RCTn = 5

A prospective, randomized, crossover study with 5 healthy male volunteers tested the effect of activated charcoal surface area on theophylline elimination. Two types of activated charcoal with different surface areas were compared in multiple-dose therapy, with blood samples taken to measure theophylline levels.

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1992·Journal of toxicology. Clinical toxicology·P E McKinney, R Gillilan, W A Watson

The preadministration of activated charcoal and aspirin absorption.

RCTn = 15

RCT with 15 volunteers to determine the effect of activated charcoal preadministration on aspirin absorption. Activated charcoal was administered 30 and 60 minutes before aspirin ingestion. Results showed little effect on aspirin absorption, with no significant difference in aspirin recovery between control and charcoal phases.

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1991·Annals of emergency medicine·S R Rose, R L Gorman, G M Oderda, et al

Simulated acetaminophen overdose: pharmacokinetics and effectiveness of activated charcoal.

RCTn = 10

Randomized crossover study in 10 healthy adult males to assess the effect of activated charcoal on acetaminophen absorption. Activated charcoal reduced urinary recovery of acetaminophen and metabolites when administered 15, 30, and 120 minutes after ingestion, but did not significantly affect absorption when given two hours post-ingestion.

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1989·European journal of clinical pharmacology·P J Neuvonen, P Kuusisto, H Vapaatalo, et al

Activated charcoal in the treatment of hypercholesterolaemia: dose-response relationships and comparison with cholestyramine.

RCTn = 17Heart Health

The study investigated the dose-response relationship of activated charcoal in reducing serum cholesterol and compared its effects with cholestyramine in patients with hypercholesterolaemia. Activated charcoal decreased serum total and LDL-cholesterol and increased the HDL/LDL-cholesterol ratio in a dose-dependent manner. The efficacy and acceptability of activated charcoal, cholestyramine, and their combination were similar.

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1989·Annals of emergency medicine·E C Dillon, J H Wilton, J C Barlow, et al

Large surface area activated charcoal and the inhibition of aspirin absorption.

RCTn = 12

RCT comparing the efficacy of two activated charcoal preparations, Actidose-Aqua and Super Char, in inhibiting aspirin absorption in 12 healthy male subjects. Both preparations significantly reduced gastrointestinal absorption of aspirin, with Super Char being more effective than Actidose-Aqua.

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1988·British journal of clinical pharmacology·P J Neuvonen, K Kivistö, E L Hirvisalo

Effects of resins and activated charcoal on the absorption of digoxin, carbamazepine and frusemide.

RCTn = 6

Cross-over study with six healthy volunteers examining the effects of colestipol hydrochloride, cholestyramine, and activated charcoal on the absorption of digoxin, carbamazepine, and frusemide. Activated charcoal greatly reduced the absorption of digoxin and carbamazepine, while all agents significantly diminished the absorption and diuretic effect of frusemide.

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1987·Annals of emergency medicine·M Tenenbein, S Cohen, D S Sitar

Efficacy of ipecac-induced emesis, orogastric lavage, and activated charcoal for acute drug overdose.

RCTn = 10

RCT comparing the efficacy of ipecac-induced emesis, orogastric lavage, and activated charcoal for gastrointestinal decontamination after acute ampicillin overdose in ten human volunteers. Activated charcoal showed the greatest reduction in ampicillin absorption, supporting its use as the primary decontamination procedure.

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1987·Therapeutic drug monitoring·M J Berg, J Q Rose, D E Wurster, et al

Effect of charcoal and sorbitol-charcoal suspension on the elimination of intravenous phenobarbital.

RCTn = 6

Randomized crossover study in six healthy male volunteers to determine the effects of oral charcoal suspensions on the elimination of intravenous phenobarbital. Activated charcoal and sorbitol-charcoal suspensions decreased the AUC of phenobarbital and increased its systemic clearance. The sorbitol-charcoal preparation caused diarrhea in all subjects, while activated charcoal caused constipation in one subject.

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1986·Human toxicology·P J Neuvonen, K T Olkkola

Effect of purgatives on antidotal efficacy of oral activated charcoal.

RCTn = 7

The study investigated the effects of purgatives on the antidotal efficacy of oral activated charcoal in seven volunteers. Charcoal alone significantly reduced the absorption of aspirin, phenylpropanolamine, and atenolol. Purgatives did not significantly modify the efficacy of charcoal, although magnesium citrate was more effective in hastening gastrointestinal transit.

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1985·British journal of clinical pharmacology·N el-Bahie, E M Allen, J Williams, et al

The effect of activated charcoal and hyoscine butylbromide alone and in combination on the absorption of mefenamic acid.

RCTn = 9

RCT with nine healthy volunteers examining the effects of activated charcoal and hyoscine butylbromide on the absorption of mefenamic acid. Charcoal reduced the area under the plasma concentration curve by 36%, and the combination with hyoscine reduced it by 42%. Early charcoal administration may reduce mefenamic acid toxicity after overdose.

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1985·British journal of clinical pharmacology·K T Olkkola

Effect of charcoal-drug ratio on antidotal efficacy of oral activated charcoal in man.

RCTn = 6

Randomized cross-over study in six healthy volunteers examining the effect of charcoal-drug ratio on the antidotal efficacy of oral activated charcoal. The study found that increasing the dose of aminosalicylic acid reduced the antidotal efficacy of activated charcoal, with higher charcoal-drug ratios resulting in less absorption of the drug.

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1984·Journal of toxicology. Clinical toxicology·R E Galinsky, G Levy

Evaluation of activated charcoal-sodium sulfate combination for inhibition of acetaminophen absorption and repletion of inorganic sulfate.

RCTn = 8

RCT involving 8 normal adults to evaluate the effect of activated charcoal and sodium sulfate on acetaminophen absorption. The study confirms that activated charcoal reduces acetaminophen absorption and that sodium sulfate does not alter this effect or the bioavailability of sulfate. The combination may be useful for managing acetaminophen overdose.

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1984·Journal of toxicology. Clinical toxicology·P J Neuvonen, K T Olkkola

Activated charcoal and syrup of ipecac in prevention of cimetidine and pindolol absorption in man after administration of metoclopramide as an antiemetic agent.

RCTn = 7

The study investigated the effects of activated charcoal and ipecac syrup on the absorption of cimetidine and pindolol in seven subjects who had ingested metoclopramide. Activated charcoal significantly reduced the absorption of the drugs by 99% or more, while ipecac syrup reduced absorption by 75% and 60% for cimetidine and pindolol, respectively. The study suggests the use of activated charcoal without preceding lavage or emesis in certain poisonings.

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1984·British journal of clinical pharmacology·K T Olkkola, P J Neuvonen

Do gastric contents modify antidotal efficacy of oral activated charcoal?

RCTn = 6

RCT studying the effect of food on the antidotal efficacy of activated charcoal in six healthy volunteers. Activated charcoal reduced the bioavailability of aspirin, mexiletine, and tolfenamic acid by varying degrees depending on timing and presence of food. Food moderately weakened the effect when charcoal was given 5 minutes after drug ingestion, but had less impact when given 60 minutes later.

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1983·Human toxicology·P Crome, R Adams, C Ali, et al

Activated charcoal in tricyclic antidepressant poisoning: pilot controlled clinical trial.

RCTn = 48

A randomized clinical trial assessed the effects of activated charcoal in managing suspected tricyclic antidepressant poisoning. Forty-eight patients were studied, with no significant effect of activated charcoal on coma lightening or plasma antidepressant concentration in the tricyclic antidepressant poisoning group.

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1983·Clinical pharmacology and therapeutics·W G Berlinger, R Spector, M J Goldberg, et al

Enhancement of theophylline clearance by oral activated charcoal.

RCTn = 6

A randomized crossover trial in six normal male subjects studied the effect of oral activated charcoal on the kinetics of intravenous theophylline. Activated charcoal decreased the serum half-life and AUC of theophylline, suggesting enhanced total body clearance and potential efficacy in treating theophylline poisoning.

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1983·European journal of clinical pharmacology·P J Neuvonen, M Vartiainen, O Tokola

Comparison of activated charcoal and ipecac syrup in prevention of drug absorption.

RCTn = 6

Randomized cross-over study in 6 healthy adults comparing the efficacy of activated charcoal and ipecac syrup in preventing drug absorption. Activated charcoal significantly reduced the absorption of paracetamol, tetracycline, and aminophylline, and was more effective than ipecac syrup, which caused emesis but was less effective in reducing drug absorption.

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1982·Cancer treatment reports·S D Gadgil, S R Damle, S H Advani, et al

Effect of activated charcoal on the pharmacokinetics of high-dose methotrexate.

RCTn = 15

RCT comparing the effect of activated charcoal on the pharmacokinetics of high-dose methotrexate in patients. Activated charcoal significantly reduced methotrexate concentrations by aiding in its elimination through interruption of enterohepatic circulation, without causing undesirable effects.

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1995·International journal of cardiology·C Ibañez, A J Carcas, J Frias, et al

Activated charcoal increases digoxin elimination in patients.

Observationaln = 39

The study reviewed serum digoxin levels in 39 adult in-patients with digoxin levels > 2.5 ng/ml to evaluate the effect of activated charcoal on digoxin elimination. Patients treated with activated charcoal showed a reduced digoxin elimination half-life and increased total body clearance compared to those not treated.

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