Can You Take Charcoal With Your Medication?

In our latest question and answer, our pharmacist discusses whether or not charcoal can be taken with medication.

Dec 01, 2017

Sickofbeingdivk asked

I was diagnosed with labyrinthitis on Monday and prescribed prednisone. I took 2 tablets yesterday and was fine. This morning after eating oatmeal breakfast I took 2 tablets. I am supposed to take 2 tablets tomorrow and 1 tablet for 3 days. Today I have been sick to my stomach ALL day with flatulence, burping, cramps, vomiting and chills. Miserable day. Can I take activated charcoal caps to ease tummy issues? I take a Bentyl every night for Cyclical Vomiting Syndrome & Zofran for nausea. I took 2 Zofran over 12 hrs today. Should I take the Bentyl or charcoal for my gastrointestinal symptoms? Help.

Answer

It is not recommended to take charcoal at the same time as any medication, as drug absorption will be negatively impacted. The common recommendation for charcoal products is to separate it by at least 2 hours from other medications.

Charcoal, commonly referred to as 'activated charcoal' is a commonly used intestinal adsorbent, meaning it binds to drugs and toxins in the stomach/intestine, preventing or slowing down the absorption of said materials. This of course would make any medication much less effective.

Activated charcoal is created by treating charcoal with a variety of agents (e.g. steam, zinc chloride) to increase its adsorptive capacity and surface area. It is important to note that activated charcoal is an adsorptive agent, not absorptive. The difference is that adsorptive agents physically bind or adhere materials to the surface, whereas absorptive agents dissolve materials or allows them to permeate the absorptive material.

Since activated charcoal binds materials, it is well known to reduce the effects of whatever it binds to. While this is bad news when taking it along with routine medications, it can be a beneficial antidote when we are exposed to toxins. In fact, activated charcoal is the agent of choice for gastric decontamination.  Charcoal doesn't completely inhibit the absorption of what it binds to. Material that is bound to charcoal can "desorb" unless extremely large quantities of charcoal are used. Still, charcoal will almost certainly affect the absorption of most medications it is taken with.

As mentioned, activated charcoal is not a good option to take around the same time as your other medications but there are typically other alternatives available to help you with the GI issues you are having. Prescription Bentyl (dicyclomine) is certainly an option. It is an effective antispasmodic agent used for the treatment of diarrhea and stomach cramping. Zofran certainly could be another option.

It is important to let your doctor know of the symptoms you are having so you can be appropriately treated. They can also give you a recommendation on what they believe will be the best agent for you to take to relieve your symptoms.

Lastly, prednisone, a corticosteroid, is well known to cause GI issues. It often recommended to take it with food reduce the adverse reactions that may occur. Since you have already tried that, again, be sure to let your doctor know of your problems so they can provide the treatment you need in your particular situation. 

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