Method	Indications	Contraindications	Dosing
Activated charcoal8,10	Use within one hour of ingestion of a potentially toxic amount of medication	Decreased level of consciousness Ingestion of medication with a low affinity for binding with activated charcoal (e.g., iron, lithium) Increased risk of gastrointestinal bleeding or perforation	Children up to one year of age: 10 to 25 g or 0.5 to 1.0 g per kg Children one to 12 years of age: 25 to 50 g or 0.3 to 1.0 g per kg Adolescents and adults: 25 to 100 g
Gastric lavage9,12	For extraordinary situations involving a potentially toxic amount of medication	Unprotected airway Ingestion of substances with high potential for aspiration (e.g., hydrocarbons) Ingestion of strong acid or alkali Increased risk of gastrointestinal bleeding or perforation	Lavage via large-bore orogastric tube with 200 to 300 mL of warm saline or water for adults, 10 mL per kg of warm saline for children Continue until fluid is free of pills or pill fragments
Cathartics10	No definite indications for use Consider for ingestion of potentially toxic amounts of sustained-release, enteric-coated drugs, or medications that are poorly absorbed by activated charcoal	Bowel obstruction or perforation Absent bowel sounds Recent bowel surgery Volume depletion Electrolyte imbalance	Use only single dose (caution should be used in children younger than one year and in older persons) Adults: 1 to 2 mL per kg sorbitol 70% solution; or 250 mL magnesium citrate 10% solution Children: 4.3 mL per kg sorbitol 35% solution; or 4 mL per kg magnesium citrate 10% solution
Whole bowel irrigation11	Consider for ingestion of potentially toxic amounts of sustained-release, enteric-coated drugs, or medications that are poorly absorbed by activated charcoal Used in persons who ingest large quantities of illicit drugs for the purpose of smuggling (body packers)	Unprotected airway Ileus or bowel obstruction or perforation Intractable vomiting Hemodynamic instability	Infuse via nasogastric tube (or have patient drink) polyethylene glycol electrolyte solution until rectal effluent is clear Children nine months to six years of age: 500 mL per hour Children six to 12 years of age: 1,000 mL per hour Adolescents and adults: 1,500 to 2,000 mL per hour
Ipecac syrup13–16	No role in health care setting Routine home use is not recommended and it should be removed from all homes