The comparative efficacy of various multiple-dose activated charcoal regimens

Multiple-dose activated charcoal therapy is used in the management of poisoning emergencies to enhance the elimination of enterohepatically and enteroenterically secreted toxins. This study was conducted to determine if increasing the frequency of activated charcoal administration would enhance the elimination of a toxin. In this crossover study, five healthy adult volunteers were randomly assigned to either a control phase or one of three study phases. Subjects in the control phase and each of the study phases received an intravenous infusion of aminophylline (8 mg/kg). During the study phases each subject additionally received activated charcoal 50 gm and activated charcoal 12.5 gm every hour, 25 gm every 2 hours, or 50 gm every 4 hours over a 8-hour period for a cumulative activated charcoal dose of 150 gm. Ten blood samples were obtained over 12 hours and analyzed for theophylline concentrations. Using area under the curve and half-life calculations it was determined that each of the dosage regimens significantly reduced the reabsorption of theophylline and the plasma half-life when compared with control. There were no significant differences between any of the treatment groups. Decreasing the dose but increasing the frequency of activated charcoal administration is as effective as the traditional every 4 hour-therapy regimen.