Activated Charcoal administration in the emergency department: Indications and tolerance

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Published Jun 21, 2026
https://doi.org/10.62438/tunismed.v104i06.6667
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Vol. 104 No. 06 (2026): Tunis Med Jun 2026

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Camillia Jeddi
Emergency department, Center of Mahmoud Yaacoub of Urgent Medical Assistance, Faculty of Medicine of Tunis, University of Tunis el Manar,Tunis, Tunisia
https://orcid.org/0009-0005-7513-3451
Rihab Boudabous
Emergency department, Center of Mahmoud Yaacoub of Urgent Medical Assistance, Faculty of Medicine of Tunis, University of Tunis el Manar,Tunis, Tunisia
https://orcid.org/0009-0008-1576-7251
Mohamed Kilani
Emergency department, Center of Mahmoud Yaacoub of Urgent Medical Assistance, Faculty of Medicine of Tunis, University of Tunis el Manar,Tunis, Tunisia
https://orcid.org/0009-0000-1900-7817
Hafedh Thabet
Emergency department, Center of Mahmoud Yaacoub of Urgent Medical Assistance, Faculty of Medicine of Tunis, University of Tunis el Manar,Tunis, Tunisia
https://orcid.org/0009-0003-8751-8012

Abstract

Introduction: Activated charcoal (AC), a common decontamination method in acute poisoning, is most effective when given shortly after ingestion
of an adsorbable toxin, as its high surface area enables toxin adsorption and reduces gastrointestinal absorption. We aimed to identify the most common toxins treated with activated charcoal in an intoxicated patient presenting to the emergency department (ED). Secondly, we aimed to
determine the tolerance after its administration.
Methods: A retrospective and descriptive study was conducted in the ED of Mahmoud Yaacoub Center over two years (from January 2023 to December 2024). Patients aged ≥15 years who were conscious on admission and received a single 50 g dose of AC for acute charcoal adsorbed
drug intoxication was included. Collected data encompassed demographics, intoxication characteristics, clinical and laboratory findings, and AC tolerance.
Results: We included 88 patients who received a single dose of AC. Median age was 28 years: 65.9% were female. The median delay of consultation was one hour. Most involved drugs were acetaminophen (21.6%), selective serotonin reuptake inhibitors (13.6%), metformin (12.5%), sodium
valproate (12.5%) and carbamazepine (9.1%). Cases of Co-ingestion were reported in 57% of patients. AC was administered to the patient, with good tolerance in 89% of cases. Ten patients (11%) had poor tolerance (vomiting, abdominal discomfort). Multivariate analysis identified cases of co-ingestion as significantly associated with better AC tolerance (OR =6.4, 95% CI: 1.27 – 32.19; p = 0.024).
Conclusion: In our study, the most common indications for AC ...( abstract truncated at 250 words).

Keywords:

Activated charcoal, Tolerance, intoxication, decontamination, Emergency

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