Page 98 - 2026 SMOG

ACTIVATED CHARCOAL (ACTIDOSE)
Class/Mechanism of Action
• Antidote
Non-absorbable agent that absorbs toxins within the GI tract, inhibiting GI absorption.
Indications
• Labeled Indications
˚ Management of suspected or known poisonings when gastrointestinal decontamination is
an option
˚ Decontamination within 1hr of ingestion of a toxic substance
Contraindications
• Presence of intestinal obstruction or GI tract not anatomically intact
• Patients at risk of GI hemorrhage or perforation
• Patients with an unprotected airway (e.g., CNS depression without intubation) or if use would
increase the risk and severity of aspiration
Adverse Reactions/Precautions
• Aspiration and respiratory failure may occur. If the patient is unconscious, establish the airway
and utilize an NG/OG tube.
• Be prepared for possible emesis. Consider the use of an antiemetic. Other GI side effects
include abdominal distention, constipation, intestinal obstruction, and mouth/teeth
discoloration.
• Pregnancy: Safe
• Lactation: Safe
Dose/Administration
PEDIATRIC
ADULT
(Always reference Broselow Tape)
Acute Poisoning Acute Poisoning
• PO/NG/OG • PO/NG/OG
˚ Single dose: 25–100g ˚ Infants <1 y/o: 10–25g
Note: Activated Charcoal has limited efficacy ˚ Children 112 y/o: 25–50g
if not utilized within 1hr of toxin ingestion ˚ Adolescents: 25–100g
Note: Some products may contain sorbitol. Note: Activated Charcoal has limited efficacy
Coadministration of a cathartic, including if not utilized within 1hr of toxin ingestion
sorbitol, is no longer recommended. Note: Some products may contain sorbitol.
Note: Multidose charcoal is indicated if the Coadministration of a cathartic, including
patient ingested a life-threatening amount of sorbitol, is no longer recommended.
drug (carbamazepine, dapsone, phenobarbital,
guanine, or theophylline)

90 • MEDICATIONS