Journal Article

A randomized clinical trial of activated charcoal for the routine management of oral drug overdose

G.M. Cooper, D.G. Le Couteur, D. Richardson and N.A. Buckley

in QJM: An International Journal of Medicine

Published on behalf of Association of Physicians of Great Britain and Ireland

Volume 98, issue 9, pages 655-660
Published in print September 2005 | ISSN: 1460-2725
Published online July 2005 | e-ISSN: 1460-2393 | DOI:
A randomized clinical trial of activated charcoal for the routine management of oral drug overdose

Show Summary Details


Background: Activated charcoal (AC) is commonly used for the routine management of oral drug overdose.

Aim: To determine whether the routine use of activated charcoal has an effect on patient outcomes.

Design: Randomized controlled unblinded trial.

Methods: We recruited all adult patients presenting with an oral overdose at The Canberra Hospital, excluding only transfers, late presenters, those who had ingested drugs not adsorbed by activated charcoal or where administration was contraindicated, and very serious ingestions (at the discretion of the admitting physician). Patients were randomized to either activated charcoal or no decontamination.

Results: The trial recruited 327 patients over 16 months. Of 411 presentations, four refused consent, 27 were protocol violations and 53 were excluded from the trial. Only seven were excluded due to the severity of their ingestion. The most common substances ingested were benzodiazepines, paracetamol and selective serotonin reuptake inhibitor antidepressants. More than 80% of patients presented within 4 h following ingestion. There were no differences between AC and no decontamination in terms of length of stay (AC 6.75 h, IQR 4–14 vs. controls 5.5 h, IQR 3–12; p = 0.11) or secondary outcomes including vomiting, mortality and intensive care admission.

Discussion: Routine administration of charcoal following oral overdose did not significantly influence length of stay or other patient outcomes following oral drug overdose. There were few adverse events. This does not exclude a role in patients who present shortly after ingestion of highly lethal drugs.

Journal Article.  3130 words.  Illustrated.

Subjects: Medicine and Health

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content. subscribe or purchase to access all content.