When is activated charcoal contraindicated

Specific drug concentrations may be measured, although these results and other blood tests would return too late to influence the early consideration of Charcoal. Although charcoal should be administered early after ingestions, it should only be administered after appropriate resuscitation has been administered. Activated Charcoal may need to be considered for other drugs, see individual poisoning guidelines and discuss with toxicologist.

Whilst there is evidence of a pharmacokinetic effect, it is not evident that repeating doses of charcoal improves clinical outcome. Multiple dose activated charcoal should be ceased immediately if bowel sounds disappear. If repeating multiple doses of activated charcoal, consider measuring drug concentrations, as well as monitoring the patients clinical condition. In particular, there is some evidence for repeating Charcoal for life threatening ingestions of carbamazepine, dapsone, phenobarbitone, phenytoin, quinine or theophylline.

Accidental ingestion: Parent information sheet from Victorian Poisons Information centre on the prevention of poisoning. Intentional self —harm: Referral to local mental health services eg Orygen Youth Health: The Royal Children's Hospital Melbourne.

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