Treatment of acetaminophen ingestion with a superactivated charcoal–cola mixture

Study Objective: We evaluate the adsorptive capacity of a superactivated charcoal–cola mixture to acetaminophen compared with superactivated charcoal alone. Methods: This was a triple-arm, prospective, unblinded study of 8 healthy adult human volunteers who ingested 80 mg/kg of acetaminophen. In the control arm of the study, participants ingested acetaminophen alone. In the next arm, acetaminophen was followed by 1 g/kg of superactivated charcoal mixed with water. In the final arm, acetaminophen was followed by 1 g/kg of superactivated charcoal mixed with caffeine-free diet cola. Serum acetaminophen concentrations over 6 hours for each arm were analyzed for area under the time-concentration curve (AUC), peak concentrations, and time to peak concentrations. Results: AUCs were 298.5±82.5 mg-h/L (control), 77.1±85.2 mg-h/L (superactivated charcoal), and 81.3 ± 71.8 mg-h/L (superactivated charcoal–cola). Comparison of AUCs by analysis of variance revealed mean square of 128,315.1 between treatments, and residual mean square of 6,405.0, yielding an F ratio of 20.03 (P<.0001). Student-Newman-Keuls pairwise multiple comparison procedure revealed a statistically significant difference in AUC for control versus superactivated charcoal (P<.05) and for control versus superactivated charcoal–cola (P<.05), but not for superactivated charcoal versus superactivated charcoal–cola (P>.05). Time-concentration curves for the 3 study arms were illustrated graphically. Conclusion: Combining superactivated charcoal with cola does not limit the adsorptive capacity of superactivated charcoal. [Rangan C, Nordt SP, Hamilton R, Ingels M, Clark RF. Treatment of acetaminophen ingestion with a superactivated charcoal–cola mixture. Ann Emerg Med. January 2001;37:55-58.]