What is it?
Activated charcoal is commonly taken by mouth to treat poisonings. It is also used for intestinal gas (flatulence), high cholesterol, hangovers, upset stomach, and bile flow problems (cholestasis) during pregnancy.
Activated charcoal is applied to the skin as part of bandages for helping heal wounds.
How effective is it?
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
The effectiveness ratings for ACTIVATED CHARCOAL are as follows:
Possibly effective for...
- Poisoning. Activated charcoal is useful for trapping chemicals to stop some types of poisoning when used as part of standard treatment. Activated charcoal should be given within 1 hour after a poison has been ingested. It does not seem to be beneficial if given for 2 or more hours after some types of poisoning. And activated charcoal doesn't seem to help stop all types of poisoning.
Insufficient evidence to rate effectiveness for...
- Diarrhea caused by cancer drug treatment. Irinotecan is a cancer drug known to cause diarrhea. Early research shows that taking activated charcoal during treatment with irinotecan decreases diarrhea, including severe diarrhea, in children taking this drug.
- Reduced or blocked flow of bile from the liver (cholestasis). Taking activated charcoal by mouth seems to help treat cholestasis in pregnancy, according to some early research reports.
- Indigestion (dyspepsia). Some early research shows that taking certain combination products containing activated charcoal and simethicone, with or without magnesium oxide, can reduce pain, bloating, and feelings of fullness in people with indigestion. It's unclear if taking activated charcoal by itself will help.
- Gas (flatulence). Some studies show that activated charcoal is effective in reducing intestinal gas. But other studies don't agree. It's too early to come to a conclusion on this.
- Hangover. Activated charcoal is included in some hangover remedies, but experts are skeptical about how well it might work. Activated charcoal doesn't seem to trap alcohol well.
- High cholesterol. So far, research studies don't agree about the effectiveness of taking activated charcoal by mouth to lower cholesterol levels in the blood.
- High levels of phosphate in the blood (hyperphosphatemia). Early research shows that taking activated charcoal daily for up to 12 months appears to reduce phosphate levels in people with kidney disease, including those on hemodialysis who have high phosphate levels.
- Wound healing. Studies on the use of activated charcoal for wound healing are mixed. Some early research shows that using bandages with activated charcoal helps wound healing in people with venous leg ulcers. But other research shows that activated charcoal does not help treat bed sores or venous leg ulcers.
- Other conditions.
How does it work?
Are there safety concerns?
When applied to the skin: Activated charcoal is LIKELY SAFE for most adults when applied to wounds.
Special precautions & warnings:Pregnancy and breast-feeding: Activated charcoal might be safe when used short-term if you are pregnant or breast-feeding, but consult with your healthcare professional before using if you are pregnant.
Gastrointestinal (GI) blockage or slow movement of food through the intestine: Don't use activated charcoal if you have any kind of intestinal obstruction. Also, if you have a condition that slows the passage of food through your intestine (reduced peristalsis), don't use activated charcoal, unless you are being monitored by your healthcare provider.
Are there interactions with medications?
- Alcohol (Ethanol)
- Activated charcoal is sometimes used to prevent poisons from being absorbed into the body. Taking alcohol with activated charcoal might decrease how well activated charcoal works to prevent poison absorption.
- Birth control pills (Contraceptive drugs)
- Activated charcoal absorbs substances in the stomach and intestines. Taking activated charcoal along with birth control pills can decrease how much of the birth control pills your body absorbs. This can decrease the effectiveness of your birth control pills. To prevent this interaction, take activated charcoal at least 3 hours after and 12 hours before you take birth control pills.
- Medications taken by mouth (Oral drugs)
- Activated charcoal absorbs substances in the stomach and intestines. Taking activated charcoal along with medications taken by mouth can decrease how much medicine your body absorbs, and decrease the effectiveness of your medication. To prevent this interaction, take activated charcoal at least one hour after medications you take by mouth.
- Syrup of ipecac
- Activated charcoal can bind up syrup of ipecac in the stomach. This decreases the effectiveness of syrup of ipecac.
Are there interactions with herbs and supplements?
- There are no known interactions with herbs and supplements.
Are there interactions with foods?
- Alcohol (Ethanol)
- Alcohol may make activated charcoal less effective in "trapping" poisons and other chemicals.
- Activated charcoal can make it more difficult for the body to absorb micronutrients.
What dose is used?
- For drug overdose or poisoning: 50-100 grams of activated charcoal is given at first, followed by charcoal every 2-4 hours at a dose equal to 12.5 grams per hour. Sometimes a single-dose of 25-100 grams of activated charcoal may be used.
- For drug overdose or poisoning: Activated charcoal 10-25 grams is recommended for children up to one year of age, while activated charcoal 25-50 grams is recommended for children 1-12 years of age. Activated charcoal 10-25 grams is recommended if multiple-doses of activated charcoal are needed.
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.
- Gao Y, Wang G, Li Y, Lv C, Wang Z. Effects of oral activated charcoal on hyperphosphatemia and vascular calcification in Chinese patients with stage 3-4 chronic kidney disease. J Nephrol. 2019;32:265-72. View abstract.
- Elomaa K, Ranta S, Tuominen J, Lähteenmäki P. Charcoal treatment and risk of escape ovulation in oral contraceptive users. Hum Reprod. 2001;16:76-81. View abstract.
- Mulligan CM, Bragg AJ, O'Toole OB. A controlled comparative trial of Actisorb activated charcoal cloth dressings in the community. Br J Clin Pract 1986;40:145-8. View abstract.
- Chiew AL, Gluud C, Brok J, Buckley NA. Interventions for paracetamol (acetaminophen) overdose. Cochrane Database Syst Rev 2018;2:CD003328. View abstract.
- Kerihuel JC. Charcoal combined with silver for the treatment of chronic wounds. Wounds UK 2009;5:87-93.
- Chyka PA, Seger D, Krenzelok EP, et al. Position paper: single-dose activated charcoal. Clin Toxicol (Phila) 2005;43:61-87. View abstract.
- Wang X, Mondal S, Wang J, et al. Effect of activated charcoal on apixaban pharmacokinetics in healthy subjects. Am J Cardiovasc Drugs 2014;14:147-54. View abstract.
- Wang Z, Cui M, Tang L, et al. Oral activated charcoal suppresses hyperphosphataemia in haemodialysis patients. Nephrology (Carlton) 2012;17:616-20. View abstract.
- Wananukul W, Klaikleun S, Sriapha C, Tongpoo A. Effect of activated charcoal in reducing paracetamol absorption at supra-therapeutic dose. J Med Assoc Thai 2010;93:1145-9. View abstract.
- Skinner CG, Chang AS, Matthews AS, Reedy SJ, Morgan BW. Randomized controlled study on the use of multiple-dose activated charcoal in patients with supratherapeutic phenytoin levels. Clin Toxicol (Phila) 2012;50:764-9. View abstract.
- Sergio GC, Felix GM, Luis JV. Activated charcoal to prevent irinotecan-induced diarrhea in children. Pediatr Blood Cancer 2008;51:49-52. View abstract.
- Roberts DM, Southcott E, Potter JM, et al. Pharmacokinetics of digoxin cross-reacting substances in patients with acute yellow oleander (Thevetia peruviana) poisoning, including the effect of activated charcoal. Ther Drug Monit 2006;28:784-92. View abstract.
- Mullins M, Froelke BR, Rivera MR. Effect of delayed activated charcoal on acetaminophen concentration after simulated overdose of oxycodone and acetaminophen. Clin Toxicol (Phila) 2009;47:112-5. View abstract.
- Lecuyer M, Cousin T, Monnot MN, Coffin B. Efficacy of an activated charcoal-simethicone combination in dyspeptic syndrome: results of a randomized prospective study in general practice. Gastroenterol Clin Biol 2009;33(6-7):478-84. View abstract.
- Kerihuel JC. Effect of activated charcoal dressings on healing outcomes of chronic wounds. J Wound Care. 2010;19:208,210-2,214-5. View abstract.
- Gude AB, Hoegberg LC, Angelo HR, Christensen HR. Dose-dependent adsorptive capacity of activated charcoal for gastrointestinal decontamination of a simulated paracetamol overdose in human volunteers. Basic Clin Pharmacol Toxicol 2010;106406-10. View abstract.
- Eddleston M, Juszczak E, Buckley NA, et al. Multiple-dose activated charcoal in acute self-poisoning: a randomised controlled trial. Lancet 2008;371:579-87. View abstract.
- Cooper GM, Le Couteur DG, Richardson D, Buckley NA. A randomized clinical trial of activated charcoal for the routine management of oral drug overdose. QJM 2005;98:655-60. View abstract.
- Coffin B, Bortolloti C, Bourgeouis O, Denicourt L. Efficacy of a simethicone, activated charcoal and magnesium oxide combination (Carbosymag) in functional dyspepsia: results of a general practice-based randomized trial. Clin Res Hepatol Gastroenterol 2011;35(6-7):494-9.View abstract.
- Brahmi N, Kouraichi N, Thabet H, Amamou M. Influence of activated charcoal on the pharmacokinetics and the clinical features of carbamazepine poisoning. Am J Emerg Med 2006;24:440-3. View abstract.
- Rehman H, Begum W, Anjum F, Tabasum H, Zahid S. Effect of rhubarb (Rheum emodi) in primary dysmenorrhoea: a single-blind randomized controlled trial. J Complement Integr Med. 2015 Mar;12:61-9. View abstract.
- Hoegberg LC, Angelo HR, Christophersen AB, Christensen HR. Effect of ethanol and pH on the adsorption of acetaminophen (paracetamol) to high surface activated charcoal, in vitro studies. J Toxicol Clin Toxicol 2002;40:59-67. View abstract.
- Hoekstra JB, Erkelens DW. No effect of activated charcoal on hyperlipidaemia. A double-blind prospective trial. Neth J Med 1988;33:209-16.
- Park GD, Spector R, Kitt TM. Superactivated charcoal versus cholestyramine for cholesterol lowering: a randomized cross-over trial. J Clin Pharmacol 1988;28:416-9. View abstract.
- Neuvonen PJ, Kuusisto P, Vapaatalo H, Manninen V. Activated charcoal in the treatment of hypercholesterolaemia: dose-response relationships and comparison with cholestyramine. Eur J Clin Pharmacol 1989;37:225-30. View abstract.
- Suarez FL, Furne J, Springfield J, Levitt MD. Failure of activated charcoal to reduce the release of gases produced by the colonic flora. Am J Gastroenterol 1999;94:208-12. View abstract.
- Hall RG Jr, Thompson H, Strother A. Effects of orally administered activated charcoal on intestinal gas. Am J Gastroenterol 1981;75:192-6. View abstract.
- Anon. Position paper: Ipecac syrup. J Toxicol Clin Toxicol 2004;42:133-43. View abstract.
- Bond GR. The role of activated charcoal and gastric emptying in gastrointestinal decontamination: a state-of-the-art review. Ann Emerg Med 2002;39:273-86. View abstract.
- Anon. Position statement and practice guidelines on the use of multi-dose activated charcoal in the treatment of acute poisoning. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. J Toxicol Clin Toxicol 1999;37:731-51. View abstract.
- Kaaja RJ, Kontula KK, Raiha A, Laatikainen T. Treatment of cholestasis of pregnancy with peroral activated charcoal. A preliminary study. Scand J Gastroenterol 1994;29:178-81. View abstract.
- McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.