1 The effects of emesis, gastric lavage and oral activated charcoal on
theophylline absorption were compared in healthy volunteers. 2 One of
four regimes (ipecacuanha-induced emesis, gastric lavage, oral activa
ted charcoal and no treatment) was randomly chosen one hour after a si
mulated overdose with sustained-release theophylline on four separate
occasions in twelve healthy volunteers. 3 Syrup of ipecacuanha produce
d emesis in all twelve volunteers but only seven vomited any tablets.
Gastric lavage yielded tablets in only one volunteer. 4 The mean syste
mic availabilities (areas under the concentration-time curves relative
to control) of theophylline for ipecacuanha-induced emesis, gastric l
avage and charcoal, were 107.1%, 101.1% and 16.9%, respectively. 5 Ora
l activated charcoal was thus highly effective, while gastric lavage a
nd emesis were ineffective in preventing theophylline absorption. Acti
vated charcoal is potentially the most effective first-line treatment
for acute overdosage with sustained-release theophylline tablets.