Drug Interactions between Healthstream Activated Charcoal and NAC

A number of studies have been conducted to determine whether activated charcoal absorbs N-acetylcysteine (NAC) and, if so, whether the interaction is clinically significant. No specific therapeutic blood level has been determined for NAC, so studies that show decreases in the area under the plasma concentration-time curve (AUC) may not be relevant. One study has indicated that a 6-gram charcoal dose would absorb 96.2% of an NAC dose. Other studies have found little difference in the AUC, C(max), or T(max) when NAC is administered alone or without charcoal. In vitro studies have suggested that NAC may reduce the adsorptive capacity of charcoal. The clinical significance of this finding is unclear. Much of the timing depends on the overdose situation. When the overdose has occurred within the last hour, it may be reasonable to give charcoal, then wait to administer NAC until the laboratory has determined blood acetaminophen levels.