Selection of activated charcoal products for the treatment of poisonings

OBJECTIVE: To determine if differences exist among currently available activated charcoal products, and if an evaluation of risk versus benefit provides a guide to product selection. DESIGN: National survey by mail. PARTICIPANTS: US manufacturers of activated charcoal products. RESULTS: Six companies market activated charcoal products in ready-to-use containers. The products differ in surface area of charcoal, sorbitol content, and packaging (aqueous or powdered form). No significant differences were noted in the cost of 25- to 30-g units or efficacy based on surface area of activated charcoal. The addition of sorbitol to activated charcoal, particularly at high concentrations, increases the incidence of adverse effects, especially in children. CONCLUSIONS: Although differences do exist among currently marketed activated charcoal products, the clinical significance of these variations is unknown. Based on an evaluation of risks and benefits, any activated charcoal product that does not contain sorbitol appears to be a suitable choice for treating poisoning victims.

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