What is the recommended dose and route for activated charcoal?

• A. 1 g/kg PO or by NG tube
• B. 0.5 g/kg IV
• C. 10 g/kg IM
• D. 5 g/kg subcutaneous

Answer: (A)

Activated charcoal works by adsorbing ingested toxins in the GI tract, so it must be given where it can interact with the poison. The recommended regimen is 1 g/kg of body weight, administered by mouth or via a nasogastric tube, typically within the first hour after ingestion. This route and dose maximize the surface area exposed to the toxin and prevent absorption. Parenteral routes such as intravenous, intramuscular, or subcutaneous administration are not used because charcoal acts locally in the GI tract and does not provide systemic adsorption. Remember that charcoal isn’t suitable for all substances (for example, caustics or hydrocarbons) and airway protection should be considered in patients at risk of aspiration.