Multidose activated charcoal

Background

• Method of enhanced elimination that uses multiple doses of activated charcoal
• No evidence to suggest that MDAC decreases morbidity or mortality
  • Some evidence shows that MDAC increases the elimination of certain drugs (further explained below)

Dosing

• 12.5 g/hr in divided doses (eg. 50g Q4hr)

Contraindications

• Same as with Single Dose Activated Charcoal (SDAC)
• Intestinal obstruction (absolute)
• Decreased gut motility (relative)

Indications

• Mnemonic: These People Drink Charcoal Quickly
  • Theophylline
  • Phenobarbital
  • Dapsone
  • Carbamazepine
  • Quinine

Mechanism of Action

1. Stops enterohepatic circulation
2. Increases passive diffusion and acts as a sink for the xenobiotics
3. Binds drugs in extended release formulations

See Also

Activated Charcoal

References

• ../docss/MultipleDoseActivatedCharcoal.pdf
• Uptodate

Authors

Joel Clinton Miller, Neil Young, Daniel Ostermayer, Ross Donaldson