European Journal of Clinical Pharmacology

, Volume 13, Issue 3, pp 213–218 | Cite as

Reduction of absorption of digoxin, phenytoin and aspirin by activated charcoal in man

  • P. J. Neuvonen
  • S. M. Elfving
  • E. Elonen


The inhibitory effect of activated charcoal 50 g suspended in water on the absorption of digoxin, phenytoin and aspirin was studied in six healthy volunteers in a cross-over manner. The absorption of digoxin and phenytoin were almost completely prevented (about 98%) when activated charcoal was ingested immediately after the drug. The total absorption of aspirin was inhibited by 70%, with clear postponement of absorption and partial release of aspirin from the charcoal in the gut: The peak serum concentration of aspirin was reduced by 95% by charcoal. When activated charcoal was ingested 1 hour after the drugs the inhibition of absorption was considerably less. However, since the absorption of larger doses of the drugs is often slow, the administration of an adequate dose of activated charcoal will be of definite value in the treatment of acute intoxication, even if delayed for several hours.

Key words

Activated charcoal acute intoxication digoxin phenytoin aspirin man 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Abdallah, D., Tye, A.: A comparison of the efficacy of emetic drugs and stomach lavage. Amer. J. Dis. Child.113, 571–575 (1976)Google Scholar
  2. 2.
    Alván, G.: Effect of activated charcoal on plasma levels of nortriptyline after single doses in man. Europ. J. clin. Pharmacol.5, 236–238 (1973)Google Scholar
  3. 3.
    Berlin, A., Agurell, S., Borgå, O., Lund, L., Sjöqvist, F.: A micromethod for the determination of diphenylhydantoin in plasma and cerebrospinal fluid — a comparison between a gaschromatographic and a spectrophotometric method. Scand. J. clin. Lab. Invest.29, 281–287 (1972)Google Scholar
  4. 4.
    Bertler, Å., Gustafson, A., Redfors, A.: Massive digoxin intoxication. Report of two cases with pharmacokinetic correlations. Acta med. scand.194, 245–249 (1973)Google Scholar
  5. 5.
    Caldwell, J.H., Cline, Ch.R.: Biliary excretion of digoxin in man. Clin. Pharmacol. Ther.19, 410–415 (1976)Google Scholar
  6. 6.
    Chaput de Saintonge, D.M., Herxheimer, A.: Activated charcoal impairs propantheline absorption. Europ. J. clin. Pharmacol.4, 52–53 (1971)Google Scholar
  7. 7.
    Chernish, S.M., Wolen, R.L., Rodda, B.E.: Absorption of propoxyphene hydrochloride by activated charcoal. Clin. Toxicol.5, 317–329 (1972)Google Scholar
  8. 8.
    Chirigos, M.A., Udenfriend, S.: A simple fluorometric procedure for determining salicylic acid in biologic tissues, J. Lab. clin. Med.54, 769–772 (1959)Google Scholar
  9. 9.
    Corby, D.G., Decker, W.J.: Management of acute posisoning with activated charcoal. Pediatrics54, 324–328 (1974)Google Scholar
  10. 10.
    Decker, W.J., Shpall, R.A., Corby, D.G., Combs, H.F., Payne, C.E.: Inhibition of aspirin absorption by activated charcoal and apomorphine. Clin. Pharmacol. Ther.4, 710–713 (1969)Google Scholar
  11. 11.
    Dordoni, B., Willson, R.A., Thompson, R.P.H., Williams, R.: Reduction of absorption of paracetamol by activated charcoal and cholestyramine: A possible therapeutic measure, Br. med. J.1973/III, 86–87Google Scholar
  12. 12.
    Duncan, D.B.: Multiple range and multiple F tests. Biometrics11, 1–42 (1955)Google Scholar
  13. 13.
    Hayden, J.W., Comstock, E.G.: Use of activated charcoal in acute poisoning. Clin. Toxicol.8, 515–533 (1975)Google Scholar
  14. 14.
    Hobson, J.D., Zettner, A.: Digoxin serum half-life following suicidal digoxin posioning. J. Amer. Med. Ass.233, 147–149 (1973)Google Scholar
  15. 15.
    Horgan, E.D., Riley, W.J.: Radioimmunoassay of plasma digoxin with use of iodinate tracer. Clin. Chem.19, 187–189 (1973)Google Scholar
  16. 16.
    Härtel, G., Manninen, V., Reissel, P.: Treatment of digoxin intoxication. Lancet1973/II, 158Google Scholar
  17. 17.
    Levy, G., Gwilt, P.R.: Activated charcoal for acute acetaminophen intoxication. J. Amer. Med. Ass.219, 621 (1972).Google Scholar
  18. 18.
    Levy, G., Houston, J.B.: Effect of activated charcoal on acetaminophen absorption. Pediatrics58, 432–435 (1976)Google Scholar
  19. 19.
    Levy, G., Tsuchiya, T.: Effect of activated charcoal on aspirin absorption in man. Clin. Pharmacol. Ther.13, 317–322 (1972)Google Scholar
  20. 20.
    Lipscomb, D.J., Widdop, B.: Studies with activated charcoal in the treatment of drug overdosage using the pigs as an animal model. Archs. Toxicol.34, 37–46 (1975)Google Scholar
  21. 21.
    Matthew, H., Mackintosh, T.F., Tompsett, S.L., Cameron, J.C.: Gastric aspiration and lavage in acute poisoning. Br. med. J.1966/I, 1333–1337Google Scholar
  22. 22.
    Nimmo, J., Heading, R.C., Tothill, P., Prescott, L.F.: Pharmacological modification of gastric emptying: Effects of propantheline and metoclopramide on paracetamol absorption. Br. med. J.1973/I, 587–589Google Scholar
  23. 23.
    Nimmo, W.S.: Drugs, diseases and altered gastric emptying. Clin. Pharmacokin.1, 189–203 (1976)Google Scholar
  24. 24.
    Otto, V., Stenberg, B.: Drug adsorption properties of different activated characoal dosage forms in vitro and in man, Sven. Farmaseut. Tidsk.77, 613–615 (1973)Google Scholar
  25. 25.
    Tsuchiya, T., Levy, G.: Relationship between effect of activated charcoal on drug absorption in man and its drug adsorption characteristics in vitro. J. Pharm. Sci.61, 586–589 (1972)Google Scholar

Copyright information

© Springer-verlag 1978

Authors and Affiliations

  • P. J. Neuvonen
    • 1
  • S. M. Elfving
    • 1
  • E. Elonen
    • 1
  1. 1.Department of Clinical Pharmacology and Third Department of MedicineUniversity of Helsinki and University Central HospitalHelsinkiFinland

Personalised recommendations