Effects of size and frequency of oral doses of charcoal on theophylline clearance

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Abstract
Six fasting, healthy men received i.v. infusions of aminophylline (6 mg/kg) over 1 h, followed by either no activated charcoal as a control, 5 g activated charcoal every 2 h for 6 doses, 10 g every 2 h for 6 doses, 10 g every h for 12 doses, 20 g every 2 h for 6 doses or 40 g every 4 h for 3 doses. Five g every 2 h decreased serum theophylline t1/2 [half-life] from the control of 9.1 .+-. 0.7 to 5.6. .+-. 0.4. (SE) h and decreased the AUS [area under the concentration-time curve] from the control of 123 .+-. 11 to 79 .+-. 6 mg/h per/l. The regimen of 20 g every 2 h further decreased theophylline t1/2 to 4.3 .+-. 0.4 h and decreased AUC to 62 .+-. 6 mg/hr per l. When a 120-g dose of activated charcoal was given as a regimen of 40 g every 4 h or as a regimen of 10 g every h, there were small differences in serum theophylline t1/2 (5.4 .+-. 0.3 and 4.3 .+-. 0.2 h) and in AUC (73 .+-. 5 and 60 .+-. 4 mg/h per/l). Repeated small doses of oral activated charcoal enhanced the total body clearance of theophylline, and larger doses induced a relatively small further increase. Ther was little difference between the effects of the same total dose every 4 h vs. every h. The use of activated charcoal in certain patients wtih theophylline overdose may increase the rate of recovery from toxicity and obviate the need for invasive and expensive procedures such as hemoperfusion.

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