Koal Tablet
Activated Charcoal
300 mg
Ambee Pharmaceuticals Ltd.
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Indications
Koal Tablet is used for:
Poisonings, Drug overdose, Gastrointestinal disorders
Adult Dose
Oral
Acute oral poisoning
Adult: 25-100 g as a single dose. For multiple-dose treatment: 50-100 g as an initial dose followed by not <12.5 g every hr.
Alternatively, 25 mg every 2 hr or 50 mg every 4 hr.
Minimum dose = 25 g
Commonly used with sorbitol 25 g; multiple dose regimen 25 g PO q2hr or 50 g q4hr without sorbitol
DO NOT give sorbitol after the first dose due to the risk for severe diarrhea; use an aqueous solution
Gastrointestinal disorders
Adult: 0.975 - 3.9 g tid.
Child Dose
Oral
Acute oral poisoning
Child:
<1 yr: 1 g/kg/dose may repeat q4-6hr;
1-12 yr: 25-50 g/dose may repeat q4-6hr.
Renal Dose
Administration
Contra Indications
Cyanide, mineral acids, caustic alkalis, organic solvents, iron, ethanol, methanol poisoning; lithium, methionine; intestinal obstruction, anatomically-broken GI tract, haemorrhage or GI perforation.
ntestinal obstruction
Unprotected airway (aspiration may occur)
Caustic ingestions
Use of cathartic if patient has significant fluid or electrolyte abnormalities
Cathartic doses of sorbitol in young children (unless hospitalized and under immediate care of physician)
Concomitant use of charcoal with sorbitol: Patients with fructose intolerance; Childn <1 yr.
Precautions
Vomiting may occur
Caution in patients with decreased peristalsis
Ipecac may decrease effectiveness of activated charcoal
Sorbitol or other cathartics may increase risk of significant electrolyte abnormalities
Capsules or tablets not recommended for treatment of poisoning
Product containing sorbitol not for use in patients with fructose intolerance
Note: not effective with alcohols, caustics (contraindicated), iron, lithium, heavy metals, mineral acids
For use in a supervised medical facility or under direction of a physician or poison control center
Actidose with Sorbitol and Actidose-Aqua are adjuncts in the management of poisoning emergencies; prior to use, proper basic life support measures must be implemented as well as appropriate gastric emptying technique if indicated
When used to treat a poisoning emergency, patient and health care providers should be aware that activated charcoal will produce black stools that may be diarrhetic and may persist for several hours
Gastrointestinal obstruction from activated charcoal may occur as a consequence of toxin-induced antiperistaltic effects; administer cautiously in patients who have been exposed to toxins that interfere with gastrointestinal tract peristalsis (eg, anticholinergics, opioids, etc); bowel sounds should be frequently monitored to assess peristaltic action, especially in patients undergoing multiple-dose activated charcoal therapy
Monitoring Parameters
Monitor for active bowel sounds before administering charcoal.
Pregnancy-Lactation
Safe use during pregnancy and lactation has not been established.
Interactions
Reduces absorption of most drugs from GI tract. Decreases effectiveness of methionine via adsorption. Decreases ipecac effect.
Adverse Effects
Side effects of Activated Charcoal :
Frequency Not Defined
Common
Black stool
Constipation
Rare
Slowing of intestinal tract
Blocking of intestinal tract
Regurgitation into the lungs
Dehydration
Mechanism of Action
Charcoal due to its large surface area, inhibits the GI absorption of toxic substances or irritants eg, aromatic or benzenoid-type substances through adsorption. As a laxative, the addition of sorbitol provides hyperosmotic environment thus causing catharsis. Moreover, charcoal interferes with the enterohepatic circulation of bile acids resulting to a lower cholesterol level.
Note
Koal 300 mg Tablet manufactured by Ambee Pharmaceuticals Ltd.. Its generic name is Activated Charcoal. Koal is availble in Bangladesh.
Farmaco BD drug index information on Koal Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.