Celcoal

Celcoal Uses, Dosage, Side Effects, Food Interaction and all others data.

Activated charcoal, also known as activated carbon, is a medication used to treat poisonings that occurred by mouth. To be effective it must be used within a short time of the poisoning occurring, typically an hour. It does not work for poisonings by cyanide, corrosive agents, iron, lithium, alcohols, or malathion. It may be taken by mouth or given by a nasogastric tube. Other uses include inside hemoperfusion machines.

Active charcoal binds the poison and prevents its absorption by the gastrointestinal tract. In cases of suspected poisoning, medical personnel administer activated carbon on the scene or at a hospital's emergency department. In rare situations, it may also be used in a hemoperfusion system to remove toxins from the blood stream of poisoned patients. Activated carbon has become the treatment of choice for many poisonings, and other decontamination methods such as ipecac-induced emesis or stomach pumping are now used rarely. It interrupts the enterohepatic and enteroenteric circulation of some drugs/toxins and their metabolites.

Activated charcoal is used as a gastric decontamination agent in emergency clinical settings in case of poison or medication overdose. Studies show that early administration of one dose of activated charcoal can adsorb poison in the stomach and reduce absorption while it also works long after ingestion, by interruption of enterohepatic and enterovascular cycling of poison.

Papain, also known as papaya proteinase I, is a cysteine protease (EC 3.4.22.2) enzyme that is found in species of papaya, Carica papaya and Vasconcellea cundinamarcensis. The enzyme is found to be localized in the skin of papaya, and is collected from slashed unripe papayas as a crude latex. Papain is used in food, pharmaceutical, textile, and cosmetic industries. While it has been used for the treatment of inflammation and pain via topical administration, papain has also shown to have anthelmintic and tooth-whitening properties. Present in over-the-counter mixture products consisting of different digestive enzymes, its active site contains a catalytic diad that plays a role in breaking peptide bonds. Papain is also used as an ingredient in various enzymatic debriding preparations.

Papain is a digestive enzyme and often acts as a skin allergen.

Trade Name Celcoal
Generic Activated Charcoal + Alpha Amylase + Papain
Type Tablet
Therapeutic Class
Manufacturer Anthem Biopharma Pvt Ltd
Available Country India
Last Updated: September 19, 2023 at 7:00 am
Celcoal
Celcoal

Uses

Diarrhoea & poisoning due to foods, heavy meals & drugs. Flatulence due to diet & other factors.

Papain is a proteolytic enzyme derived from papaya used for its anti-inflammatory properties.

No FDA-approved therapeutic indications.

Celcoal is also used to associated treatment for these conditions: Abdominal Cramping, Aerophagy, Bloating, Constipation, Delayed Transit Time, Flatulence, Belching, MeteorismInflammation

How Celcoal works

Active charcoal acts by binding to the pharmaceutical drugs or poisons such as organophosphates and decreasing the systemic absorption of toxic agents. Molecules with large volume of distribution, thus likely having higher lipid solubility, tends to bind have better absorptive binding to activated charcoal. Following the administration of activated charcoal, cathartics are indicated to evacuate the charcoal-poison bonded complex from the gastrointestinal tract. Activated charcoal may also have an effect on systemic drug levels by lowering the serum levels of already absorbed drugs or toxins. Many absorbed drugs that undergo significant hepatic metabolism and conjugation are eliminated via bile into the small intestines. When they reach the small intestines, drug conjugates can undergo hydrolysis and return to the enterohepatic circulation. Activated charcoal interferes with this process and binds to the conjugated drug before hydrolysis or the free deconjugated drug before reabsorption.

When topically applied, papain induces an allergen-like inflammatory response via recruiting neutrophils, mast cells, and CD3-positive cells and by induction of a TH2-biased antibody response . In vitro, treatment of papain resulted in the breakdown of tight junctions of primary human keratinocytes that maintain the epithelial barrier integrity. These tight junction proteins include zonula occludens-1, claudin-4, and occludin . It is proposed that papain induces allergic responses via activation of TLR4, leading to an increase in neutrophils, CD3+ cells, mast cells, and CCL8-positive cells .

Dosage

Celcoal dosage

Diarrhoea:

  • Adult: 2-4 tab tds-qds.
  • Children: ½ adult dose.

Poisoning:

  • Adult: 2-4 tab/kg body weight
  • children: 3-4 tab/kg body weight

Flatulence:

  • Adult: Disintegrate 1-2 tab. Repeat every 2 hr.

Side Effects

As most undesirable effects are based on post-marketing spontaneous reporting, precise frequency estimation is not possible. No adverse reactions to Ultracarbon are known to occur if taken in the recommended dosage to treat the diarrhoea. After very high doses as those taken in intoxications, constipation and intestinal obstruction (mechanical ileus) may occur in individual cases; this can be prevented by administering saline laxatives (eg, sodium sulfate). As medicinal charcoal is excreted in unchanged form, the stools turn black (discoloured faeces) after intake of Ultracarbon tablets.

Toxicity

Adverse effects from the treatment include aspiration into the lungs and possibly pneumonitis, black stools, vomiting, and constipation or diarrhea. The oral LD50 value in rats is 15400mg/kg.

Acute oral LD50 of 200 mcu papain is 4000 mg/kg in rat and 12500 mg/kg in mouse . It acts as an irritant in case of inhalation or contact with eyes.

Precaution

Several poisons and drugs require different or additional measures. Medicinal charcoal is not effective in intoxications with organic and inorganic salts as well as solvents eg, for instance, lithium, thallium, cyanide, iron salts, methanol, ethanol and ethylene glycol. Different measures are in these cases indicated to eliminate the poison (eg, gastric lavage).

In many intoxications, a specific antidote must be administered additionally to medicinal charcoal (eg, acetylcysteine in paracetamol poisoning).

To avoid aspiration in unconscious patients, a physician should administer the suspension of Ultracarbon tablets in water by gastric tube.

In patients undergoing multiple dose, activated charcoal therapy after intoxication, gastrointestinal sounds should be monitored frequently to assess peristaltic action.

Ultracarbon should not be used in cases of poisoning with pesticides.

Interaction

Ultracarbon should not be administered together with other drugs because their efficacy can be reduced.

Volume of Distribution

No pharmacokinetic data available.

Elimination Route

No evidence of systemic absorption of activated charcoal

No pharmacokinetic data available.

Half Life

No pharmacokinetic data available.

Clearance

No pharmacokinetic data available.

Elimination Route

Fecal excretion.

No pharmacokinetic data available.

Contraindication

Febrile diarrhoea. Medicinal charcoal should not be taken in the case of intoxication with corrosive substances (strong acids and alkalis) as this would complicate diagnostic measures eg, oesophagoscopy and gastroscopy.

Acute Overdose

Activated charcoal is well tolerated and due to its lack of toxicity, overdose requiring treatment is unlikely. Should symptoms of overdose like constipation and intestinal obstruction (mechanical ileus) occur, a saline laxative may be administered to enhance the elimination of Ultracarbon tablets.

Storage Condition

Do not store above 30°C.

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*** Taking medicines without doctor's advice can cause long-term problems.
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