Decontamination

The use of activated charcoal for gastrointestinal decontamination depends on the specific herbicide ingested. Activated charcoal can be life saving after paraquat and bromoxynil poisonings.

Give activated charcoal immediately for paraquat and bromoxynil poisonings and seek further advice from a clinical toxicologist. Activated charcoal is also recommended early after glyphosate poisoning.

Activated charcoal is not routinely recommended for other herbicide poisonings because the risk of vomiting and aspiration of surfactants (coformulated with the herbicide) may outweigh the likely benefits of treatment. Consider gastrointestinal decontamination with activated charcoal if the patient presents within 1 hour after ingestion, is alert and cooperative and able to protect their airway, and is not vomiting—consult with a clinical toxicologist. If the patient is intubated, activated charcoal can be given any time after ingestion via a nasogastric or orogastric tube—confirm correct placement of the nasogastric or orogastric tube beforehand.