Efficacy of Ipecac and Activated Charcoal/Cathartic

Abstract

• Twelve adult volunteers were given 24 81-mg aspirin tablets and were randomly assigned into the following treatment groups: (1) control aspirin, (2) 30 mL of ipecac repeated if vomiting not induced, (3) 60 g of activated charcoal per 15 g of magnesium sulfate (MgSO₄), and (4) ipecac repeated if needed, followed by activated charcoal/MgSO4 given 1½ hours after the last vomiting episode. All treatments began 60 minutes following aspirin ingestion. Urine was collected for 48 hours for percent total salicylate excretion. Mean SD recovery of salicylate from urine was as follows: aspirin, 96.3% ±7.5%; ipecac 70.3%±11.8%, activated charcoal/MgSO₄, 56.4%±12%; and ipecac and activated charcoal/MgSO₄, 72.4%± 14.1%. Ten subjects completed the study. In group 4, eight of ten subjects vomited the activated charcoal/MgSO₄ immediately, making statistical analysis impossible. Analysis revealed that activated charcoal/MgSO₄ significantly lowered the absorption of aspirin compared with the control and ipecac-treated groups. Furthermore, ipecac significantly lowered aspirin absorption compared with the control group. We conclude that activated charcoal/MgSO₄ used alone is superior to the other treatment modalities at inhibiting the absorption of multiple aspirin tablets. (Arch Intern Med 1984;144:48-52)