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

100 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this clinical pilot trial is to determine the feasibility of the clinical trial. Then the large-scale CHARPP will be conducted in order to determine the efficacity of activated charcoal as a treatment for acute poisoning in a diverse population of both adults and children suspected of ingesting toxic substances that activated charcoal can adsorb. The main questions it aims to answer are: * Can activated charcoal administered within a specific time frame prevent the progression of toxicity? * How does activated charcoal affect the length of stay in the hospital and the intensive care unit? Researchers will compare the intervention arm (receiving activated charcoal) to the control arm (receiving standard supportive care) to see if activated charcoal reduces hospital stay duration, ICU stay and improves overall patient outcomes. Participants will: * Be randomly assigned to either receive activated charcoal or standard supportive care. * Undergo assessments using standardized clinical scales such as the Poison Severity Score and, for children, the PELODS score. * Have their functional outcomes evaluated, such as the ability to return to their original residence without help and manage personal hygiene tasks independently. This structured approach will help clarify the role of activated charcoal in clinical toxicology and inform future treatment protocols.

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 data supports the effectiveness of the treatment activated charcoal for poisoning?

Activated charcoal is effective in preventing the absorption of certain poisons if given within one hour of ingestion. It can also help speed up the removal of some drugs from the body, like phenobarbitone, when given in repeated doses. ^{1 2 3 4 5}

Is activated charcoal safe for use in humans?

Activated charcoal is generally considered safe for use in treating poisonings, but some studies have reported adverse reactions. These reactions can vary in severity, and certain factors may increase the risk of these reactions. ^{6 7 8 9 10}

How does activated charcoal differ from other treatments for poisoning?

Activated charcoal is unique because it works by adsorbing (binding to) the poison in the stomach, preventing it from being absorbed into the body. It is typically administered orally and is most effective when given within 30 minutes of ingestion, making it a quick and non-invasive option compared to other treatments. ^{2 6 11 12 13}

Research Team

Maude St-Onge, MD PhD FRCPC

Principal Investigator

CHU de Québec - Université Laval

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

References

1. United States pubmed.ncbi.nlm.nih.gov

Position statement: single-dose activated charcoal. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Expanded role of charcoal therapy in the poisoned and overdosed patient. [2004]

3. England pubmed.ncbi.nlm.nih.gov

Compliance for single and multiple dose regimens of superactivated charcoal: a prospective study of patients in a clinical trial. [2018]

4. England pubmed.ncbi.nlm.nih.gov

Treatment of phenobarbitone poisoning with repeated oral administration of activated charcoal. [2013]

5. United States pubmed.ncbi.nlm.nih.gov

Activated charcoal--past, present and future. [2018]

6. Spain pubmed.ncbi.nlm.nih.gov

[Use of activated charcoal in acute poisonings: clinical safety and factors associated with adverse reactions in 575 cases]. [2010]

7. United States pubmed.ncbi.nlm.nih.gov

Misadventures with activated charcoal and recommendations for safe use. [2017]

8. New Zealand pubmed.ncbi.nlm.nih.gov

Effect of activated charcoal on apixaban pharmacokinetics in healthy subjects. [2021]

9. England pubmed.ncbi.nlm.nih.gov

Systematic review on the use of activated charcoal for gastrointestinal decontamination following acute oral overdose. [2022]

10. Spain pubmed.ncbi.nlm.nih.gov

[Adverse events caused by activated charcoal in an emergency services survey]. [2018]

11. United States pubmed.ncbi.nlm.nih.gov

Activated charcoal laryngitis in an intubated patient. [2019]

12. United States pubmed.ncbi.nlm.nih.gov

Activated charcoal updated. [2019]

13. Thailand pubmed.ncbi.nlm.nih.gov

Effect of activated charcoal in reducing paracetamol absorption at a supra-therapeutic dose. [2013]