Activated Charcoal for Poisoning

(CHARPP-Pilot Trial)

Overseen By Maude St-Onge, MD PhD FRCPC

Age: Any Age

Sex: Any

Trial Phase: Phase 4

Sponsor: Laval University

Disqualifiers: Other decontamination, Charcoal contraindication, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Prior Safety Data This treatment has passed at least one previous human trial

Compensation: Varies

Number of Visits: 1

Duration: 15 minutes per administration

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether activated charcoal can treat poisoning by preventing toxins from worsening and reducing hospital stays. Participants divide into two groups: one receives activated charcoal, and the other receives standard care. The trial aims to determine if activated charcoal can improve recovery and allow patients to return home sooner. Individuals who have ingested a toxic substance within the last six hours might be suitable candidates for this study.

As a Phase 4 trial, this research seeks to understand how the already FDA-approved and effective treatment benefits more patients, offering a chance to contribute to broader medical knowledge.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What is the safety track record for activated charcoal?

Studies have shown that activated charcoal is generally safe for short-term use. It often helps remove toxins from the stomach in cases of poisoning. Common side effects include mild nausea or vomiting. Research indicates that the benefits of using activated charcoal can outweigh these risks, especially when used soon after poisoning occurs.

One study found that activated charcoal effectively treats people who have been poisoned. However, there is a risk of vomiting and accidentally inhaling material into the lungs, particularly if the poisoning is not severe. Overall, activated charcoal is well-tolerated and can be a useful tool in managing certain types of poisoning. ^{1 2 3 4 5}

Why are researchers enthusiastic about this study treatment?

Activated charcoal is unique because it offers a fast and straightforward way to manage poisoning by preventing the absorption of toxins in the stomach. Unlike other treatments that might require more invasive procedures or longer timeframes to take effect, activated charcoal can be administered quickly and is effective almost immediately. Researchers are excited about its ability to be mixed with a familiar black soft drink, making it easier for patients to take, which can improve adherence to the treatment. This quick action and ease of use make activated charcoal a standout option for treating poisoning.

What evidence suggests that activated charcoal is effective for acute poisoning?

Research shows that activated charcoal can help treat poisonings when used properly. It can reduce the absorption of certain poisons, like paracetamol, if taken soon after ingestion. In this trial, participants in one arm will receive activated charcoal, which studies have shown can lower drug levels in the blood. However, it did not significantly affect hospital stay duration or survival chances. Another study found a slight improvement in survival rates with multiple doses, but the results were not strong. Although activated charcoal is commonly used for poisonings, controlled studies have not proven it changes overall outcomes. Nevertheless, it remains a standard treatment for certain poisonings because it can bind to toxins in the stomach. ^{1 5 6 7 8}

Who Is on the Research Team?

Maude St-Onge, MD PhD FRCPC

Principal Investigator

CHU de Québec - Université Laval

Are You a Good Fit for This Trial?

This trial is for adults and children who arrived at the hospital within 8 hours after ingesting a potentially toxic dose of a substance that can be absorbed by activated charcoal. It's not specified who cannot participate, but typically there would be criteria excluding certain individuals.

Inclusion Criteria

I arrived at the hospital within 8 hours after ingesting a potentially harmful substance.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants receive either activated charcoal or standard supportive care. Activated charcoal is administered at 1g/kg up to a maximum of 50g, either orally or via naso-gastric tube.

15 minutes per administration

1 visit (in-person)

Follow-up

Participants are monitored for progression of toxicity and other relevant outcomes. Follow-up is conducted every 8 hours by the poison centres.

3 months

Long-term follow-up

Functional outcomes and adverse events are documented, including the ability to return to daily activities and manage personal hygiene tasks independently.

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Activated Charcoal

Trial Overview Researchers are testing if giving activated charcoal to patients with acute poisoning is better than standard supportive care alone. They want to know if it prevents worsening of toxicity, shortens hospital or ICU stays, and improves patient outcomes like independence in daily activities.

How Is the Trial Designed?

Group I: AC administration Experimental Treatment 1 Intervention

Participants will receive 1g/kg up to a maximum of 50g of activated charcoal by mouth or by naso-gastric tube. The intervention is giving over 15 minutes, as recommended. Activated charcoal can be mixed in a black soft drink to improve palatability and treatment adherence which is often done in usual practice.

Group II: No AC Active Control 1 Intervention

Participants will not receive any activated charcoal

Who Is Running the Clinical Trial?

Laval University

Lead Sponsor

Trials

439

Recruited

178,000+

Canadian Institutes of Health Research (CIHR)

Collaborator

Trials

1,417

Recruited

26,550,000+

VITAM - Centre de recherche en santé durable

Collaborator

Trials

1

Recruited

100+

CHU de Quebec-Universite Laval

Collaborator

Trials

177

Recruited

110,000+

Citations

1. ncbi.nlm.nih.gov ncbi.nlm.nih.gov/books/NBK482294/

Activated Charcoal - StatPearls - NCBI Bookshelf - NIH An oral suspension of activated charcoal should be considered in poisonings when gastrointestinal decontamination of an ingested toxin is indicated.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2014891/

Effectiveness of delayed activated charcoal administration ... The results of this study indicate that, in healthy volunteers, activated charcoal given after an interval of 1 h reduces paracetamol absorption.

3. journals.lww.com journals.lww.com/atmr/fulltext/2024/07000/therapeutic_effectiveness_and_safety_of_activated.24.aspx

Therapeutic Effectiveness and Safety of Activated Charcoal ... AC administration led to reduced drug plasma concentration and AUC, with no significant impact on hospital stay. Mortality rates did not differ significantly, ...

4. thelancet.com thelancet.com/journals/lancet/article/PIIS0140673608602706/fulltext

Multiple-dose activated charcoal in acute self-poisoning 97 (6·3%) of 1531 participants in the multiple-dose group died, compared with 105 (6·8%) of 1554 in the no charcoal group (adjusted odds ratio 0 ...

5. emergency.med.ufl.edu emergency.med.ufl.edu/files/2013/02/Activated-charcoal.pdf

Activated charcoal for pediatric poisonings Although no controlled studies demonstrating changes in clinical outcome have ever been performed with activated charcoal, these previous data probably are.

6. clintox.org clintox.org/wp-content/uploads/2016/04/Position-Statement-Multi-Dose-Activated-Charcoal-1.pdf

Position-Statement-Multi-Dose-Activated-Charcoal- ... Data in poisoned patients are insufficient presently to recommend the use of multiple-dose charcoal ther- apy for salicylate poisoning. Multiple ...

7. webmd.com webmd.com/vitamins/ai/ingredientmono-269/activated-charcoal

Activated Charcoal - Uses, Side Effects, and More When taken by mouth: Activated charcoal is likely safe when used short-term. Taking activated charcoal long-term is possibly safe. Common side effects include ...

8. poisoncontrol.utah.edu poisoncontrol.utah.edu/news/2023/01/activated-charcoal

Activated Charcoal | Poison Control In overdoses with no more than mild effects expected, the risk of vomiting and aspiration often outweighs the limited benefit of charcoal in ...