Superiority of activated charcoal alone compared with ipecac and activated charcoal in the treatment of acute toxic ingestions

Timothy E Albertson, Robert W. Derlet, Garrett E. Foulke, MC Minguillon, SR Tharratt

Research output: Contribution to journalArticle

97 Scopus citations


A prospective, randomized clinical trial compared the clinical effectiveness of syrup of ipecac and activated charcoal to that of activated charcoal alone in the treatment of acute toxic ingestions. Two hundred adult patients with mild to moderate oral overdoses were entered into the trial. Patients receiving only activated charcoal were discharged from the emergency department in significantly (P ≤ .05) less time than those receiving both syrup of ipecac and activated charcoal (6.0 ± 0.3 vs 6.8 ± 0.2 hours, respectively). The percentage of patients requiring nonpsychiatric hospitalizations was not significantly different between the two groups (11.2% vs 14.0%, respectively). For the hospitalized patients, the length of time spent in the ICU and in the hospital was not statistically different between the two groups. A complication rate of 5.4% was found with the ipecac and activated charcoal treatment compared with a 0.9% complication rate in the activated charcoal group (P ≤ .05). Three episodes of aspiration pneumonitis occurred after administration of ipecac and activated charcoal, while no episodes of aspiration were noted after treatment with only activated charcoal. Together, these data are consistent with the recommendation that ED treatment with activated charcoal alone be the gastrointestinal decontamination procedure of choice for the routine mildly-to-moderately orally poisoned adult patient.

Original languageEnglish (US)
Pages (from-to)56-59
Number of pages4
JournalAnnals of Emergency Medicine
Issue number1
StatePublished - 1989



  • activated charcoal
  • ipecac
  • toxic ingestion

ASJC Scopus subject areas

  • Emergency Medicine

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