Charcoal / sorbitol Side Effects
For the Consumer
Applies to charcoal / sorbitol: suspension
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 / sorbitol:
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 / sorbitol: oral suspension
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, diarrhea, and black colored stools have also been reported.[Ref]
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 of a charcoal bezoar and small bowel obstruction following administration of 30 to 60 grams of activated charcoal via nasogastric tube every 4 to 6 hours for 5 days has been reported.
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 > 12 years, administration by nasogastric or orogastric tube, and ingestion of emetogenic drug or chemical. Charcoal with sorbitol solution did not appear to significantly increase the risk of vomiting.
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 which can be unpalatable.[Ref]
Corneal abrasions may occur if charcoal comes in contact with eyes.[Ref]
Ocular side effects have included corneal abrasions.[Ref]
Metabolic side effects result primarily from the sorbitol and have included electrolyte abnormalities, dehydration, and shock.[Ref]
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.[Ref]
Respiratory side effects have included bronchiolitis obliterans, empyema, and Adult Respiratory Distress Syndrome.[Ref]
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3. Ray MJ, Radin DR, Condie JD, Halls JM, Padin DR "Charcoal bezoar. Small-bowel obstruction secondary to amitriptyline overdose therapy [published erratum appears in Dig Dis Sci 1988 Oct;33(10):1344]." Dig Dis Sci 33 (1988): 106-7
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5. Sack RB, Cassells J, Mitra R, Merritt C, Butler T, Thomas J, Jacobs B, Chaudhuri A, Mondal A "The use of oral replacement solutions in the treatment of cholera and other severe diarrhoeal disorders." Bull World Health Organ 43 (1970): 351-60
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14. "Product Information. Liqui-Char with Sorbitol (charcoal-sorbitol)." Jones Medical-Western Research, St. Louis, MO.
15. The American Academy of Clinical Toxicology "Position statements: single-dose activated charcoal Available from: URL: http://www.clintox.org/Pos_Statements/Charcoal.html." ([2002 May 23]):
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22. Pollack MM, Dunbar BS, Holbrook PR, Fields AI "Aspiration of activated charcoal and gastric contents." Ann Emerg Med 10 (1981): 528-9
23. Elliott CG, Colby TV, Kelly TM, Hicks HG "Charcoal lung. Bronchiolitis obliterans after aspiration of activated charcoal." Chest 96 (1989): 672-4
24. Tomaszewski C "Activated charcoal--treatment or toxin? [comment]." J Toxicol Clin Toxicol 37 (1999): 17-8
25. Justiniani FR, Hippalgaonkar R, Martinez LO "Charcoal-containing empyema complicating treatment for overdose." Chest 87 (1985): 404-5
Not all side effects for charcoal / sorbitol may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.
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- Drug class: antidotes
Other brands: Actidose Plus Sorbitol
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