When Not to Use Activated Charcoal

• Activated charcoal will not be given to people with an obstruction of the intestines or if the person swallowed a corrosive agent, such as a strong acid or alkali.
  
  
• Strong acids may "burn" through the lining of the GI tract. Doctors will need to look at the lining with an endoscope - a special instrument designed to look inside the stomach. Activated charcoal is not to be used with this type of poison because it is difficult to see the lining of the GI tract with the scope after charcoal is given.
  
  
• Activated charcoal can cause intestinal problems such as constipation, or it can create clumps of foreign material. This situation can be prevented by giving a laxative such as sorbitol to the patient, however, repeated doses with sorbitol may cause excessive diarrhea, dehydration, and chemical imbalance.
  
  
• If the patient is fructose intolerant, family members should notify the treating doctor, and sorbitol will not be given with the activated charcoal. Sorbitol is a sugar substitute that acts as a laxative to move the charcoal through the system. Babies younger than one year of age year should not be given sorbitol because it may cause excessive fluid losses.
  
  
• If an antidote to a specific type of drug poisoning is given, then the doctor may not give activated charcoal because the drug given as treatment will also be adsorbed. A classic example is an acetaminophen (Tylenol overdose), in which there is a clearly established antidote with acetylcysteine (Mucomyst).