Charcoal Side Effects
Not all side effects for charcoal may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.
For the Consumer
Applies to charcoal: capsules, tablets
Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur while taking charcoal:
Constipation; diarrhea; temporary darkening of the stool; vomiting.
Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue).
For Healthcare Professionals
Applies to charcoal: compounding powder, oral capsule, oral delayed release tablet, oral granule for reconstitution, oral powder for reconstitution, oral suspension, oral tablet
Gastrointestinal side effects have frequently included nausea and vomiting (13% to 30%) and constipation. Bowel obstruction, ileus, chalk like taste, perforation of the gastrointestinal tract and subsequent charcoal peritoneum, and black colored stools have also been reported.
A young woman developed a surgically acute abdomen following orogastric lavage and charcoal administration. Laparotomy revealed charcoal throughout the peritoneum. Complications included peritonitis, adhesions, abscess formation, persistent peritoneal charcoal deposits, oophorectomy, and small bowel resection.
A case report has described charcoal bezoar and small bowel obstruction following administration of 30 to 60 g of activated charcoal via nasogastric tube every 4 to 6 hours for 5 days.
In a study of 275 patients, 18 years old or younger, 20.4% (56/275) experienced vomiting within < 1 to 120 minutes (mean of 10 minutes) following enteral administration of 1 g/kg (no more than 50 g) of activated charcoal for acute poison ingestion. The following risk factors for vomiting were identified: nausea, a vomiting occurrence prior to charcoal ingestion, presence of signs or symptoms of poisoning (exclusive of nausea &/or vomiting), age greater than 12 years, administration by nasogastric or orogastric tube, and ingestion of emetogenic drug or chemical.
Bowel obstruction and ileus have occurred with multiple-dose administration.
Although charcoal is tasteless, it adheres to the surfaces of the mouth and tongue, producing a chalk like taste that can be unpalatable.
Metabolic side effects have included hypernatremia, hypermagnesemia. electrolyte abnormalities, dehydration, and shock.
Metabolic side effects occur primarily when sorbitol is combined with charcoal. Multiple-dose activated charcoal has been associated with hypernatremia and hypermagnesemia.
Respiratory side effects have included bronchiolitis obliterans, empyema, and Adult Respiratory Distress Syndrome.
Bronchiolitis obliterans and empyema have occurred due to charcoal aspiration following emesis.
Accidental administration of charcoal directly into the lungs has resulted in Adult Respiratory Distress Syndrome.
Ocular side effects have included corneal abrasions.
Corneal abrasions may occur if charcoal comes in contact with eyes.
Exacerbation of variegate porphyria may lead to increases in skin lesions, and urine and plasma porphyrins.
Hematologic side effects have included exacerbation of variegate porphyria.
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