Efficacy of activated charcoal versus gastric lavage half an hour after ingestion of moclobemide, temazepam, and verapamil.
OBJECTIVE
To compare the efficacy of activated charcoal and gastric lavage in preventing the absorption of moclobemide, temazepam, and verapamil 30 min after drug ingestion.


METHODS
In this randomized cross-over study with three phases, nine healthy volunteers received a single oral dose of 150 mg moclobemide, 10 mg temazepam, and 80 mg verapamil after an overnight fast. Thirty minutes later, they were assigned to one of the following treatments: 25 g activated charcoal as a suspension in 200 ml water, gastric lavage (10x200 ml), or 200 ml water (control). Plasma concentrations of moclobemide, temazepam, and verapamil were determined up to 24 h.


RESULTS
Activated charcoal reduced the area under the plasma concentration time curve from 0 h to 24 h (AUC0-24 h) of moclobemide and temazepam by 55% (P<0.05) and by 45% (P<0.05), respectively. The AUC0-24 h of verapamil was not significantly reduced by charcoal. Gastric lavage decreased the AUC0-24 h of moclobemide by 44% (P<0.05), but had no significant effect on that of temazepam or verapamil. The peak plasma concentration (Cmax) of moclobemide, temazepam, and verapamil was reduced by 40%, 29% (P<0.05), and 16%, respectively, by activated charcoal. Gastric lavage did not significantly decrease the Cmax of any of these drugs.


CONCLUSIONS
The absorption of moclobemide, temazepam, and verapamil can be moderately reduced by activated charcoal given 30 min after drug ingestion, while gastric lavage seems to be less effective.
Lapatto-Reiniluoto
O
O
Department of Clinical Pharmacology, University of Helsinki, Finland. outi.lapatto-reiniluoto@nam.fi
Kivistö
K T
KT
Neuvonen
P J
PJ
D000284:Administration, Oral; D000328:Adult; D014151:Anti-Anxiety Agents / Q000097:blood / Q000493:pharmacokinetics*; D000928:Antidepressive Agents / Q000097:blood / Q000493:pharmacokinetics*; D019540:Area Under Curve; D002606:Charcoal / Q000494:pharmacology*; D002851:Chromatography, High Pressure Liquid; D018592:Cross-Over Studies; D005260:Female; D005751:Gastric Lavage; D006801:Humans; D007408:Intestinal Absorption / Q000187:drug effects; D008297:Male; D020912:Moclobemide / Q000097:blood / Q000493:pharmacokinetics*; D013693:Temazepam / Q000097:blood / Q000493:pharmacokinetics*; D014665:Vasodilator Agents / Q000097:blood / Q000493:pharmacokinetics*; D014700:Verapamil / Q000097:blood / Q000493:pharmacokinetics*
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D014665:Vasodilator Agents; D002606:Charcoal; D013693:Temazepam; D014700:Verapamil; D020912:Moclobemide