Activated Charcoal Has No Benefit in Organophosphate Overdose

Early activated charcoal administration was once considered a mainstay of treatment for patients with acute overdose, based on the belief that it adsorbs toxins in the stomach and therefore reduces absorption and systemic toxicity. However, studies have failed to show any benefit from activated charcoal, even from acute or delayed administration for poisons with enterohepatic circulation, and aspiration of charcoal carries serious consequences.

In a prospective, randomized, controlled trial, 4632 patients aged 14 years or older who presented to three hospitals in Sri Lanka after intentional overdoses received no charcoal, a single dose of charcoal (50 g), or multiple doses of charcoal (50 g every 4 hours for 6 doses). Most patients had inges…