Charcoal, activated repeated doses

Ipecac should be taken with at least eight or more ounces of water or juice (do not use milk or carbonated beverages). If vomiting does not occur within 20 minutes, then the dose should be repeated. If vomiting cannot be induced, then administer activated charcoal. The absorption of ipecac is minimal. Protein-binding is unknown and the half life is short. Duration of action is only 20-25 minutes. Do not attempt to induce vomiting if the patient is not fuUy awake and alert. 

Repeat-dose activated charcoal interrupts enterohepatic recirculation and is very effective, reducing the half-life from 77 to 13.5 hours in one report. Continue charcoal for at least 48-72 hours. Do not use charcoal/sor-bitol suspension (see p 57). 

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