Effect of Activated Charcoal in Reducing Paracetamol Absorption at a Supra-Therapeutic Dose
Winai Wananukul MD*, Supranee Klaikleun MD*, Charuwan Sriapha BSc*, Achara Tongpoo BSc*
Affiliation : * Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Background : Activated charcoal (AC) is recommended for treatment of acute poisoning, thereby decreasing gastrointestinal
tract absorption. AC from different sources may have different adsorptive capacity. The AC that is available in Thailand has
not been proven yet for its efficacy. The authors simulated paracetamol overdose model for the present study.
Objective : To assess the efficacy of AC that is available in Thailand in decreasing absorption of paracetamol at supra-
therapeutic dose.
Material and Method: This was a two-arm, prospective, crossover study. Washout period was 1 week. Twelve healthy male
volunteers participated. All volunteers were randomly assigned to either sequence of control-experiment (CE) or EC. The
participants ingested 60 mg/Kg of paracetamol at Time = 0. At Time = 0.25 hour, they ingested 50 g of AC as slurry with 250
ml of water when they were assigned as E, but drank 250 mL of water when were assigned as C. Blood samples were serially
collected for determination of paracetamol concentration and calculating pharmacokinetic parameters, area under the time-
concentration curve (AUC (0,∝)).
Results : Means of the AUC (0,∝) were 313.7 + 29.8 and 184.8 + 91.6 mg-h/L in the control and experimental arm,
respectively. It was statistically different (p = 0.01).
Conclusion : The tested AC was found to be able to reduce the absorption of the supratherapeutic dose of paracetamol.
Keywords : Activated charcoal, Paracetamol, Acetaminophen, Overdose, Decontamination, Randomization, Cross-over, Pharmacokinetics
