Does activated charcoal interact with medications?

Activated carbon is a fine, black powder that absorbs chemicals very well and is therefore often used for the treatment of poisoning. Some people use activated charcoal to reduce gas and bloating, prevent hangovers, or “cleanse” the digestive tract – although this is the case little to no scientific evidence to support these claims. And thanks to its ability to turn foods and drinks black, activated charcoal is also a popular food coloring, especially around Halloween.

However, what many people don't realize is this Activated carbon may affect the effectiveness of certain medications by reducing the amount of medication that enters the bloodstream, thereby reducing its effectiveness.

But how does activated charcoal interact with medications?

The main mechanism of this interaction is adsorption. Lingtak-Neander Chanprofessor of pharmacy at the University of Washington, Live Science told LiveScience in an email. Adsorption is a process by which molecules adhere to the surface of a material. Thanks to its incredibly porous structure, activated carbon has a large surface area, which allows it to adsorb or hold onto drug molecules on its surface extremely effectively.

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“It essentially works like a fishing net,” Chan said, because the activated charcoal traps drug molecules in the intestines.

When a medication is taken – for example in pill or liquid form – it must pass through the intestinal lining to enter the bloodstream. From there it develops its effect on the body. However, if activated charcoal is in the digestive tract, the drug molecules remain in the intestines and are eventually excreted along with the activated charcoal.

In certain cases, the consequences of this interaction can be serious. A report published in the magazine The lancet described a case in which activated charcoal interfered with the effectiveness of platelet-lowering medications; Platelets are the part of the blood that is responsible for this Coagulation. This disorder rendered the drug ineffective in a patient with heart disease.

In another case, documented in the diary Antiviral therapyActivated charcoal interfered with antiretroviral drugs used for treatment HIV. This reduced the drug concentration in the bloodstream, which led to an increase in viral load – the number of virus particles in the body. Ideally, antiretroviral medications reduce the amount of HIV in the body until it is no longer detectable. The patient also developed resistance to his medications because these low drug concentrations allowed the virus to survive, adapt, and then continue to multiply.

According to the medical resource StatPearlsActivated charcoal limits the absorption of a variety of medications, including common painkillers, sedatives, and antidepressants. The larger a drug molecule, the more likely it is to be intercepted by activated carbon, Chan noted. For this reason, some hormone-based medications, including birth control pills, can be intercepted by activated charcoal.

On the other hand, medications with strong ionic charges – that is, very positive or very negative electrical charges – do not tend to combine well with activated carbon. These include medications such as lithiumwhich is used to treat bipolar disorder, and oral iron supplements. These substances are still absorbed efficiently even when activated charcoal is in the intestines.

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Not all medications in the same class are equally affected by activated charcoal.

“This is because the adsorption effect depends on the physical properties and size of the drug molecules,” Chan explained. For example, one blood pressure medication might adsorb to activated carbon, but another of the same class might not. It is therefore difficult to make general statements about possible drug interactions.

The right timing is crucial to avoid activated charcoal interactions with medications. The adsorption effect is strongest when both the drug and activated charcoal are taken within an hour, Chan said. It is often used in the emergency room when a patient is suspected of having ingested poison less than an hour or two before admission, he said.

Another factor to consider is the dose of activated charcoal. In cases where it is used to treat poisoning, the typical dose is 1 gram per kilogram of body weight, according to Chan. This ensures maximum adsorption of the ingested toxin. The amount of activated carbon found in trendy household products such as some toothpastes and foods is comparatively small – “much less than 1g/kg in most cases,” he said. This makes it less likely that drug interactions will occur.

People who use activated charcoal for purposes other than treating poisoning – such as supposed colon cleansing or detoxification – should pay attention to how much activated charcoal they take and how much time elapses between taking the activated charcoal and taking medication, Chan advised. Consult a doctor if taking both activated charcoal and medications.

This article is for informational purposes only and does not constitute medical advice.

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