The Effect of Activated Charcoal on Drug Exposure in Healthy Volunteers: A Meta‐Analysis

The objective of the study was to estimate the effect of activated charcoal (AC) administered during the first 6 h after drug intake and the effect of drug properties on drug exposure. Sixty‐four controlled studies were integrated in a meta‐analysis. AC administered 0–5 min after administration of a drug reduced median drug exposure by 88.4% (25–75 percentile: 65.0–96.8) ( P < 0.00001). The effect of AC continued to be statistically significant when administered up to 4 h after drug intake (median reduction in drug exposure 27.4% (range 21.3–31.5%, P = 0.0006). The reduction in drug exposure was correlated with the AC/drug ratio ( ρ = 0.69, P < 0.0001), the volume of distribution ( V d ) ( ρ = 0.46, P = 0.0001), and time to peak concentration ( ρ = 0.40, P = 0.02). We found that AC is most effective when given immediately after drug ingestion but has statistically significant effects even when given as long as 4 h after drug intake. AC appears to be most effective when given in a large dose. Clinical Pharmacology & Therapeutics (2009); 85 , 5, 501–505 doi: 10.1038/clpt.2008.278