A patient weighing 60 kg ingests a toxic substance. What is the recommended dose range of activated charcoal?

• A. 0.5-1 g/kg
• B. 1-2 g/kg
• C. 3-4 g/kg
• D. 5-6 g/kg

Answer: (B)

Dosing activated charcoal is based on body weight because the amount needed to adsorb toxins scales with how much a person weighs. Activated charcoal works by binding many ingested toxins in the GI tract, preventing their absorption into the bloodstream. The commonly recommended range is 1 to 2 grams per kilogram of body weight. For a patient who weighs 60 kg, that translates to about 60 to 120 grams in a single dose. In practice, charcoal is given as a slurry with water to make it easier to swallow, and you’d ensure the airway is protected if the patient cannot swallow safely. Avoid giving charcoal if the ingestion involves caustics or hydrocarbons, or if the patient cannot protect their airway, since aspiration risk increases.