Kohle-Compretten (Charcoal, Activated)

Kohle-Compretten is an oral adsorbent used in gastrointestinal decontamination and related emergency situations.

• Acute poisoning: binds ingested toxins to limit absorption.
• Drug overdose: reduces systemic exposure to excess medications.
• Gastrointestinal decontamination: adsorbs gases and substances to alleviate symptoms and prevent complications.

• Activated charcoal consists of a porous carbon matrix with a large surface area that physically adsorbs a wide range of organic molecules, gases and toxins within the gastrointestinal lumen. By binding these substances, it prevents their passage across the intestinal wall, thereby limiting systemic absorption and facilitating elimination via feces.

Activated charcoal is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Constipation: reduced bowel movements may develop.
• Black or tarry stools: discoloration due to charcoal.
• Nausea: feeling of unease in the stomach.
• Vomiting: expulsion of stomach contents.
• Abdominal discomfort: mild cramping or pain.
• Dry mouth: reduced salivation.

Serious or Rare Side Effects

• Aspiration pneumonia: inhalation of charcoal particles into the lungs.
• Bowel obstruction: blockage from accumulated charcoal.
• Severe allergic reaction: rash, swelling, or anaphylaxis.
• Electrolyte imbalance: rare shifts due to gastrointestinal loss.
• Hematemesis: vomiting of blood if mucosal injury occurs.
• Persistent vomiting: may lead to dehydration.

When using Kohle-Compretten, consider the following safety measures.

• Airway assessment: ensure the patient can protect their airway before oral administration.
• Consciousness level: avoid use in patients with reduced consciousness or impaired gag reflex.
• Gastrointestinal integrity: do not administer if perforation, obstruction, or severe ileus is suspected.
• Medication timing: separate administration of other oral drugs by at least 2 hours to prevent adsorption.
• Pediatric dosing: exercise caution and follow prescriber guidance for children.
• Store at ambient temperature: keep below 25°C in the original packaging, protect from moisture.

Activated charcoal can affect the absorption of several concomitant medications.

Major Interactions (Avoid)

• Life‑saving oral drugs: concurrent use may markedly reduce efficacy of emergency medications such as digoxin or warfarin.
• Anticonvulsants: adsorption can lower plasma levels of carbamazepine and phenytoin.
• Antiretrovirals: may diminish absorption of protease inhibitors.

Moderate Interactions (Monitor Closely)

• Antacids: calcium or magnesium salts can bind charcoal, reducing its capacity.
• Iron supplements: adsorption may decrease iron bioavailability.
• Oral contraceptives: potential reduction in hormone absorption.
• Antibiotics: certain broad‑spectrum agents may be partially adsorbed.