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Norit® Carbomix 50g granules

Norit® Carbomix is used for emergency treatment of oral poisoning and drug overdose. Its active ingredient—activated charcoal is officially indicated for detoxification in which it adsorbs the poison in the gastrointestinal tract and blocks its absorption into the systemic circulation.
When time is the essence...
UNIVERSAL ANTIDOTE
  • Effective against almost all oral poisonings and drug overdose
  • The only activated charcoal-containing medicinal product in the world meeting the USP- and EUP-specifications for absorption-efficacy tests.

SAFE & EFFECTIVE
  • Safe for human consumption.
  • Reduce hospitalization duration.
FAST & EASY
  • Just add 350ml water and shake vigorously
  • Ready to use in 2 minutes.
WORLDWIDE RECOGNITION
  •  Used exclusively by key opinion leaders (KOLs) and world leading hospitals (e.g. Finland’s Helsinki University Hospital, major European & US hospitals.)
  • Preferred by Malaysian toxicologist in leading government hospitals.

RIGHT PORES SIZE FOR MAXIMUM ADSORPTION

The enormous surface area created in Norit® Activated Charcoal is the result of the proprietary technology which enables the ability to control and create the correct pore size needed for maximal adsorption for drugs, toxins, bacteria, viruses, toxic metabolic agents and other unwanted physiological substances.

Normal Charcoal
Activated Carbon
LIST OF ADSORBED TOXINS
Agent WELL Adsorbed by Activated Charcoal
  • Acetylsalicylic Acid
  • Aflatoxin
  • Amphetamines
  • Antidepressants
  • Antiepileptics
  • Antihistamines
  • Aspirin/
  • Other Salicylates
  • Atropine
  • Barbiturates
  • Benzodiazapines
  • Beta -blockers
  • Biphenyls
  • Carbamazepine
  • Chloroquines
  • & Primaquine
  • Cimetidine
  • Dapsone
  • DDT
  • Dextropropoxyphene
  • & other opioids
  • Digitalis
  • DIQUAT &
  • other Herbicides
  • Glycosides Disopyramide
  • Ergot Alkaloids
  • Furosemide
  • Glibenclamide & Glipizide Glutethimide
  • Indomethacin &
  • other NSAIDs
  • Kerosene, Benzene
  • Dichloroethane
  • Malathion & other Pesticides
  • Meprobamate
  • Nefopam
  • Methotrexate
  • Mexiletine
  • NSAIDs
  • (e.g. Tolfenamin Acid)
  • *Paracetamol
  • PARAQUAT
  • Polychlorinated Phenothiazines
  • Phenylbutazone
  • Phenylpropanolamine
  • Piroxicam
  • Phenol Syrup of
  • IPECAC constituents
  • Quinidine & Quinine
  • Strychnine
  • Tetracyclines
  • Theophylline
  • Torbutamide
  • Chlorpropamide
  • Carbutamide
  • Tolazamide
Agent POORLY Adsorbed by Activated Charcoal
  • Cyanide
  • Ethanol
  • Ethylene Glycol
  • Iron
  • Isopropanol
  • Lithium
  • Methanol
  • Strong Mineral Acids & Alkali
* In cases of severe paracetamol poisoning, concurrent intravenous antidote (N-acetylcysteine) administration and oral Norit® Carbomix is recommended.
How Much to GIVE ?

Body Weight (kg) x 8 

=

Suspension in ml to GIVE

Dosage & Administration

Presentation

Norit® Carbomix contains 50g of granulated form of activated charcoal in a plastic bottle. 

Administration
Easy administration by
1) mouth or
2) naso-gastric tube (for hospital setting use)

Reconstitution/Preparation of Suspension

  1. Shake the bottle to loosen the granules. Add 350mL water and top up to the RED line.
  2. Shake thoroughly 1-2 minutes to form a homogenous and palatable reconstituted suspension
  3. Discard 3 days after reconstitution.
  4. Store at 2′ to 8′ reconstitution /  

Dosage

  1. Adults & Children: 1g/kg of body weight *Usual adult dosage: 50-100g (1-2 bottles)
  2. Infant: 0.5g/kg of body weight *Usual infant dosage: 12.5-25g (100-200mL)


** Calculation Formula : 8ml of reconstituted suspension =1g of activated charcoal

Example 1

If a child is 23 kg , then the amount given in mL is : 23 × 8mL = 184mL

Example 2

If an adult weighs 74kg, then the amount given in ml is : 74 × 8mL = 592 mL

(i.e. One full bottle of suspension + another 192 mL of the reconstituted suspension)

NORIT CARBOMIX, granulate for suspension is a fine, black granules, relatively uniform in size, without taste or odour.


COMPOSITION:
Each 5g Activated Charcoal as active ingredient, has an excipients of Citric Acid 0.15g, Acaciae gummi 0.5g and Glycerol 0.5g.


PHARMACODYNAMIC PROPERTIES:
Activated charcoal is a specifically carbonized material of a botanical origin with a large internal surface, which can adsorb harmful and undesirable substances in the gastrointestinal tract.
In case of intoxications the activated charcoal can be used to adsorb the active ingredients from the gastrointestinal tract.
The absorption of a partly absorded active ingredient to activated charcoal will cause a concentration gradient between circulating plasma and bowel contents. Therefore passively adsorbed substances can diffuse in the opposite direction again to the intestines. Thus a repeated administration of activated charcoal can be effective, even after absorption of an active ingredient.


PHARMACOKINETIC PROPERTIES:
Since activated charcoal is not absorbed from the gastro intestinal tract, there is no distribution phase nor any metabolism. The complex between activated carbon and the adsorbed compounds will be completely passed out in the stool.


INDICATIONS:
For acute oral poisoning of toxins and overdose of medication.


DOSAGE & METHOD OF
ADMINISTRATION:
Adult and children from 12 years of age:
50-100g Activated Charcoal to be administered as soon as possible. In case of serious poisoning the treatment should, during a number of days, be followed by a repeated dose of 20g every 4-6 hours (20g Activated Charcoal equals approximately 160ml of the suspension). In unconscious patients a doctor, or nurse under medical supervision, should administer the suspension through a stomach tube. Norit Carbomix can also be administered after vomiting or gastric lavage.

Children up to 12 years of age:
Recommended dosage: about 1g activated charcoal per kg body weight. In case of acute poisoning in children younger than 12 years half a dosage (25g) should be administered; in children younger than 4 years a first dosage of 12.5g bottle should be given which should be repeated a number of times in consultation with a doctor.
In order to prevent the poison from being absorbed in the body and to remove the poison already absorbed, Norit Carbomix should be administered quickly. A delay administration, however, maybe beneficial too.
In case of serious poisoning a repeated administration of activated charcoal is recommended.


PREPARATION OF THE SUSPENSION: Granulate should be shaken loose well. Add 350ml water to the content of the bottle up to the RED MARK. Shake vigorously during 1 minute. Carefully open the bottle and use the suspension immediately. In the case of repeated administration shake the bottle again before use. Suspension should be consumed within 3 days from date of reconstitution.


CONTRAINDICATIONS:
Norit Carbomix should not be administered if the poisoning is certain to have been caused by irritating substances (such as strong acids or bases). It can interfere with oesophagosco-py and gastroscopy.


WARNING & PRECAUTIONS:
Norit Carbomix suspension should be administered immediately and a doctor should be sent for immediately.
The use of activated charcoal will cause the feces to be black.
Activated charcoal will not adsorb well organ-ic and inorganic salts and solvents, e.g. salts of iron, lithium, thallium, cyanide, methanol, ethanol, ethylene glycol, and petroleum containing solvents. With these substances, other methods of poison elimination (e.g. gastic la-vage) should be used.
The main poisons concerned are listed below, together with treatment antidote for these substances:

Cyanide: (Specific antidote, Sodium nitrite/4-dimethyl & Aminophenol)

Iron compounds Lithium: (Deferoxamine,  Calcium polystyrene & Sulphate)

Methanol Ethylene glycol: (Ethanol, Elthanol)

For many intoxications both Norit Carbo mix and a specific antidote should be adminitered (for example, for paracetamol poisoning: N-acetylcysteine). In those cases in which an oral therapy or an oral specific antidote maybe crucially important for the patient, the use of activated charcoal is advised against.
Activated charcoal may cause dehydration. Appropriate fluid and electrolyte therapy should be given to protect against dehydration. Oral rehydration therapy which is the use of appropriate fluids including oral rehydration salts remains the most effective treatment for dehydration due to diarrhea. The intake of as much of these fluids as possible is therfore imperative.
Activated charcoal may interfere with the absorption of other drugs, including antibiotics when administered concurrently.
It is not recommended for treatment of diarrhea in children under 6 years of age without medical supervision.


Poison Information Centre (USM Penang) Call-line: 1-800-88-8099 /                                   +6012-430 9499


PREGNANCY & LACTATION:
This medicine can, as far as is known, be used as prescribed during pregnancy and breastfeeding without any danger for foetus or the child.


SIDE EFFECTS:
The use of this medicine does not have any adverse effects on the driving ability and the ability to handle machinery.
Activated charcoal is relatively non-toxic when given by mouth but gastrointestinal disturbances such as vomiting and constipation have been reported. It may colour the feces black.


DRUG INTERACTIONS:
The use of activated charcoal will generally reduce the effect of orally applied medicines. It can reduce the efficacy of oral contraceptive steroids and an additional method of contraception should be used when activated charcoal has been used. Therefore, simultaneous oral therapy should be avoided by taking activated charcoal at least 2 hours after medications taken orally.

OVERDOSE:
Activated Charcoal is not absorbed from the gastrointestinal tract and will not produce toxicological risks for patient. Obstipation may occur. This symptom can be treated with lactulose products (such as lactulose syrup) or another laxative.
Small bowel obstruction may be caused by high doses of medical charcoal. This is prevented by the administration of laxatives (e.g. sodium sulphate)


STORAGE:
Store in the original package, in order to protect from moisture. The reconstituted product (suspension) should be stored at 2-8ºC.


Keep out of reach of children
Jauhkan daripada kanak-kanak


Manufactured by:
Cabot Norit Nederland B.V.
Mr. Ovingkanaal O.Z. 3,
7891 EV Klazienaveen, The Netherlands. A division of: Cabot Norit Nederland B.V., Astronaut 34, 3824 MJ Amersfoort,
The Netherlands.


Imported & Marketed by:
Ubisson Sdn. Bhd. (585048-H)
No.35, 1st& 3rd Floor, Pusat Pedada,
Jalan Pedada, 96000 Sibu, Sarawak, Malaysia.
Tel: +6084-333 858 Fax: +6084-311 688 Email: enquiry@ubisson.com


MAL REG. NO: 07061573XZ
HUKKM: P01BE03000P3001XX
Revised Date (version) May 2019

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