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Detailed Description
Toxiban Suspension
Charcoal, Activated
(char-kole)
Trade name: ToxiBan®, Actidose®
Drug class: Oral Adsorbent
DOSAGES
DOSAGE FORMS
Prescriber Highlights
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Orally administered adsorbent for ingested toxins and drug overdoses; consider consulting with an animal poison control center before use
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Some formulations contain a cathartic (eg, sorbitol). Use caution when administering with cathartics; monitor closely for dehydration and electrolyte disturbances (eg, hypernatremia, hyperkalemia).
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Contraindications include administration to animals with a reduced gag reflex or at risk for aspiration pneumonia (eg, megaesophagus, CNS depression), decreased peristalsis, hypernatremia, or hyperosmolar states (eg, diabetic ketoacidosis).
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Not effective for treatment of inorganic molecules (eg, iron), mineral acid or alkali ingestion
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Adverse effects include emesis with rapid administration, dehydration, hypernatremia, constipation, or diarrhea.
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Charcoal stains clothing and animal fur.
Uses / Indications
Activated charcoal is administered orally to prevent or reduce systemic absorption of certain drugs or toxins in the GI tract. To enhance elimination of the charcoal-toxin moiety, an osmotic cathartic (eg, sorbitol; combinations are commercially available) is often given with activated charcoal. In humans, the benefit of adding a cathartic remains unproven. There is little need to administer a cathartic if significant diarrhea is already present. One study suggested single-dose activated charcoal alone was equally as effective as activated charcoal with sorbitol (as a cathartic) in reducing the serum concentration of carprofen following overdose in dogs.
In humans, a single dose of activated charcoal is recommended when a potentially toxic amount of a substance (known to be adsorbed by charcoal) has been ingested in the past hour2; this same recommendation appears to also apply to veterinary patients.
Pharmacology / Actions
Activated charcoal has a large surface area and adsorbs many chemicals and drugs via ion–ion, hydrogen bonding, dipole, and Van der Waals forces in the upper GI tract, thereby preventing or reducing their absorption. Efficiency of adsorption increases with the molecular size of the toxin, and poorly water-soluble organic substances are better adsorbed than small, polar, water-soluble organic compounds.
Although activated charcoal also adsorbs various nutrients and enzymes from the gut, there are generally no significant impacts on nutritional needs when used for acute poisonings.
Activated charcoal slurries are most effective in adsorbing most toxins.
3
Charcoal is most effective if given within 1 hour of toxin ingestion and is generally not recommended over 4 hours postingestion unless the exposure involves a drug that is enterohepatically recirculated.
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