Product Information
Registration Status: ActiveCARBON COMPOUND TABLET is approved to be sold in Singapore with effective from 1991-10-21. It is marketed by BLENDFORTE TRADING COMPANY, with the registration number of SIN06634P.
This product contains Belladonna Dry Extract 6mg,Charcoal 100mg, and Magnesium Hydroxide 100mg in the form of TABLET. It is approved for ORAL use.
This product is manufactured by COX LABORATORIES (THAILAND) LTD PART in THAILAND.
It is a Pharmacy Only Medicine that can be obtained from a pharmacist at a retail pharmacy.
Source of information: Drugbank (External Link). Last updated on: 3rd July 18. *Trade Name used in the content below may not be the same as the HSA-registered product.
Description
Activated charcoal, or activated carbon, is an amorphous form of carbon prepared from incomplete combustion of carbonaceous organic matter. It is activated by an oxidizing gas flow at high temperature passed over its surface to make a fine network of pores, producing a material with large surface area and high affinity for various substances. It is used as a gastric decontaminant and emergency medication to treat poisonings following excessive oral ingestion of certain medications or poisons by absorbing most drugs and toxins. However its effects is rendered poor on some compounds including strong acids or bases, methanol and substances with limited absorptive capacity (including iron, lithium, arsenic). It works by binding to the poison in the gastric contents in a reversible fashion thus may be adminstered together with a cathartic to reduce the small intestine transit time. The clinical applications of activated charcoal occured in the early 1800's. While this management for acute poisoning is considered fairly invasive, it is on the World Health Organization's List of Essential Medicines that includes the most important medications needed in a basic health system.
Indication
Used as a antidote to treat poisonings following excessive oral ingestion of certain medications or poisons.
Mechanism of Action
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.
Pharmacokinetics
- Absorption
- No evidence of systemic absorption of activated charcoal
- Distribution
- Metabolism
- Elimination
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.
Active Ingredient/Synonyms
Activated carbon | Carbo activates | Carbo activatus | Carbo vegetabilis | Carbon | Carbon, Activated | Carbon, decolorizing | Charcoal activated | Charcoal-activated | Charcoal, Activated | Charcoal,activated | Medicinal carbon | Medicinal charcoal | Activated charcoal |
Source of information: Drugbank (External Link). Last updated on: 3rd July 18. *Trade Name used in the content below may not be the same as the HSA-registered product.
Description
Magnesium hydroxide is an inorganic compound with the chemical formula Mg(OH)2. It is naturally found as the mineral brucite. Magnesium hydroxide can be used an antacid or a laxative in either an oral liquid suspension or chewable tablet form. Additionally, magnesium hydroxide has smoke supressing and flame retardant properties and is thus used commercially as a fire retardant. It can also be used topically as an antiperspirant underarm deodorant or for relief of canker sores (aphthous ulcers).
Indication
Magnesium hydroxide can be used as an antacid or a laxative depending on the administered dose. As an antacid, it is used for the temporary relief of heartburn, upset stomach, sour stomach or acid indigestion. As a laxative, it is used for the relief of occasional constipation by promoting bowel movements for 30 minutes and up to 6 hours.
Mechanism of Action
The suspension of magnesium hydroxide is ingested and enters the stomach. According to the amount ingested, the magnesium hydroxide will either act as an antacid or a laxative. Through the ingestion of 0.5-1.5 grams (in adults) the magnesium hydroxide will act by simple acid neutralization in the stomach. The hydroxide ions from the magnesium hydroxide suspension will combine with the acidic H+ ions of the hydrochloric acid made by the stomachs parietal cells. This neutralization reaction will result in the formation of magnesium chloride and water. Through the ingestion of 2-5 grams (in adults) the magnesium hydroxide acts as a laxative in the colon. The majority of the suspension is not absorbed in the intestinal tract and will create an osmotic effect to draw water into the gut from surrounding tissues. With this increase of water in the intestines, the feces will soften and the intraluminal volume of the feces will increase. These effects still stimulate intestinal motility and induce the urge to defecate. Magnesium hydroxide will also release cholecystokinin (CKK) in the intestines which will accumulate water and electrolytes in the lumen and furthermore increase intestinal motility.
Pharmacokinetics
- Absorption
- About 15%-50% of magnesium hydroxide is absorbed very slowly through the small intestine.
- Distribution
- The peak action and distribution of magnesium hydroxide are variable.
- Metabolism
- Unless a patient is deficient in magnesium, very little is absorbed by the intestine. Overall, about 15%-50% of the magnesium hydroxide suspension is absorbed systemically. However, it does not undergo any metabolism as it is rapidly excreted in the urine.
- Elimination
Clearance
Magnesium hydroxide is mainly excreted in the urine by the kidneys. Since the kidneys play a major role in its clearance, individuals with renal failure are at risk of hypermagnesemia with long term consumption as the appropriate amounts of magnesium may not be excreted.
Toxicity
LD50=8500 mg/kg (rat, oral) Common side effects include drowsiness or flushing (warmth, redness or tingly feeling). Daily use of magnesium hydroxide can result in fluid and electrolyte disturbances. Excessive use of the laxative effects of magnesium hydroxide may result in abdominal cramping, nausea and/or diarrhea. In overdose, symptoms of gastrointestinal irritation and/or watery diarrhea may occur. Magnesium hydroxide poisoning can result in hypermagnesemia which includes symptoms of: nausea, vomiting, flushing, thirst, hypotension, drowsiness, confusion, loss of tendon reflexes, muscle weakness, respiratory depression, cardiac arrhythmias, coma and cardiac arrest. Not to be used in individuals with any form of kidney disease or renal failure, a magnesium restricted diet or with any sudden changes in bowel movement lasting over two weeks. Also not to be used in those individuals with abdominal pain, nausea, vomiting, symptoms of appendicitis or myocardial damage, heart block, fecal impaction, rectal fissures, intestinal obstruction or perforation or renal disease. Not to be used in women who are about to deliver as magnesium crosses the placenta and is excreted in small amounts in breast milk. Using magnesium hydroxide with aluminum hydroxide can decrease the absorption rate of these drugs. Magnesium hydroxide can react with digoxin, dicoumerol and cimetidine. Use of ibuprofen with magnesium hydroxide can increase the absorption of the ibuprofen. Use of magnesium hydroxide with penicallamine, bisphosphates, ketoconazole, quinolones or tetracycline can decrease the absorption of these drugs. Enteric-coated tablets can be prematurely released when taken with magnesium hydroxide. It is important to routinely monitor levels of serum magnesium and potassium in patients using magnesium hydroxide. Serum magnesium levels are necessary to determine how much magnesium is being absorbed and how much is being excreted by the kidneys. Excessive diarrhea can occur from use of magnesium hydroxide and thus it is important to also monitor serum potassium levels to ensure hypokalemia does not occur.
Active Ingredient/Synonyms
Magnesium dihydroxide | Milk of magnesia | Magnesium hydroxide |
Source of information: Drugbank (External Link). Last updated on: 3rd July 18. *Trade Name used in the content below may not be the same as the HSA-registered product.