NutriStack
Activated Charcoal and Polyethylene Glycol, timing-sensitive.
High-volume polyethylene glycol electrolyte lavage used for whole bowel irrigation can interfere with activated charcoal's toxin-binding role if the two are mixed or coadministered improperly. An in vitro study found PEG lavage solution caused desorption of theophylline from activated charcoal, and toxicology position guidance discusses sequencing charcoal and whole bowel irrigation separately. This concern applies to poisoning management or lavage-level PEG use, not ordinary once-daily constipation dosing.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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At a glance
- Substances
- Activated Charcoal and Polyethylene Glycol
- Pair type
- Timing Sensitive
- Evidence (highest tier)
- Moderate
- Source citations
- 3 sources
- Stack Score effect
- −5 to your Stack Score (per scored timing-sensitive row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Timing Sensitive · Moderate evidence
Timing Sensitive
What is happening. High-volume polyethylene glycol electrolyte lavage used for whole bowel irrigation can interfere with activated charcoal's toxin-binding role if the two are mixed or coadministered improperly. An in vitro study found PEG lavage solution caused desorption of theophylline from activated charcoal, and toxicology position guidance discusses sequencing charcoal and whole bowel irrigation separately. This concern applies to poisoning management or lavage-level PEG use, not ordinary once-daily constipation dosing.
Mechanism. Activated charcoal adsorbs many drugs and toxins in the gut lumen. PEG electrolyte lavage rapidly moves intestinal contents and, when present with charcoal, can reduce retained adsorption by dilution, transit acceleration, or desorption from the charcoal surface.
Recommendation. Do not self-combine activated charcoal with high-dose PEG bowel prep or whole-bowel-irrigation regimens. For suspected poisoning, call poison control or emergency services; charcoal timing, PEG lavage, airway safety, and the substance ingested need clinician direction. Avoid taking activated charcoal close to routine oral medicines because it can reduce their absorption.
Sources (3)
- Tenenbein M. Position statement: whole bowel irrigation. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. Journal of toxicology. Clinical toxicology. 1997;35(7):753-62. PMID 9482429
- Hoffman RS, Chiang WK, Howland MA et al.. Theophylline desorption from activated charcoal caused by whole bowel irrigation solution. Journal of toxicology. Clinical toxicology. 1991;29(2):191-201. PMID 2051506
- Hoegberg LCG, Shepherd G, Wood DM et al.. Systematic review on the use of activated charcoal for gastrointestinal decontamination following acute oral overdose. Clinical toxicology (Philadelphia, Pa.). 2021 Dec;59(12):1196-1227. PMID 34424785
Stack Score
How this pair moves the number.
Effect on the composite score
If both Activated Charcoal and Polyethylene Glycol are in the same stack, this pair applies −5 to your Stack Score (per scored timing-sensitive row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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