Hesperian Health Guides

Medicines for Poisoning

First Aid: Medicines

Activated charcoal

Activated charcoal is a powder used to treat some poisonings such as certain pesticides and herbicides that have been swallowed. Activated charcoal prevents the poison from being absorbed by the body, so give it as soon as possible after being poisoned. Activated charcoal will not harm, so give it if you think the person may have been poisoned, even if you are not sure.

If you do not have activated charcoal, you can use powdered charcoal from burnt wood or even burnt bread or tortilla. Mix 1 tablespoon of powdered charcoal with warm water in a large glass. This is not as good as activated charcoal, but it still works.

Never use charcoal briquettes—they are poison!

Activated charcoal is not helpful for poisoning from:

  • corrosives (such as ammonia, batteries, acids, drain cleaner, caustic soda, lye)
  • hydrocarbons (such as gasoline, kerosene, turpentine, paint thinner, phenol, carbolic acid, camphor, pine oil)
  • cyanide (used in mining work, factory work, animal hide hair removal, rat poison)
  • ethanol
  • iron (iron tablets, multivitamins or prenatal vitamins)
  • lithium (found in medication to treat bipolar mental illness)
  • methanol (found in varnish, paint thinner, fuel additives for cars)
  • mineral acids
  • organic solvents (found in paint thinner, glue solvents, nail polish remover, spot removers)
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Can cause black stools, vomiting, constipation, or diarrhea.

How to use

Give as soon as possible after poisoning (or possible poisoning) with a full glass of water. The dose can be given again in 4 hours.
Under 1 year: give 10 to 25 g.
1 year to 12 years: give 25 to 50 g.
Over 12 years: give 50 g.


Atropine is used to treat poisoning from certain pesticides, insecticides, or nerve gases. Only use atropine if the label on the pesticide container says to use atropine, or if it says the pesticide is a “cholinesterase inhibitor.” The amount of atropine needed depends on how severe the poisoning is. Usually, a poisoning from a carbamate requires less medicine than if the poisoning is from an organophosphate.

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Sleepiness, feeling lightheaded, headaches, changes in thinking, and hard stools.


Keep the person cool after giving atropine.

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Inject into the muscle.
Under 2 years: inject 0.05 mg per kg, every 5 to 10 minutes.
2 to 10 years: inject 1 mg, every 5 to 10 minutes.
Over 10 years: inject 2 mg, every 5 to 10 minutes.

Stop giving injections when the skin becomes flushed and dry, and the pupils get bigger. If the poisoning is severe, double the amounts of atropine listed above.


Deferoxamine helps treat iron poisoning by removing iron from the blood.

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Blurred vision and changes in thinking.


Do not give to someone with kidney disease or if the person cannot urinate. Do not give to children under 3 years old.

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Inject slowly into the muscle. Inject 50 mg per kg every 6 hours. Do not give more than 6 g in a day. If you cannot weigh the person, dose by age:
3 to 5 years: slowly inject 500 mg, every 6 hours, for 1 day (4 times).
5 to 12 years: slowly inject 1000 mg, every 6 hours, for 1 day (4 times).
Over 12 years: slowly inject every 6 hours for 1 day (4 times) as follows: The first 2 times give 2000 mg, then use half the dose, 1000 mg, for the next 2 times.


Give acetylcysteine as soon as possible after taking too much paracetamol or acetaminophen. Too much paracetamol or acetaminophen is over 7,000 mg for an adult, and over 140mg per kg for a child.

Acetylcysteine has a strong smell. Mixing it with juice helps the person tolerate it.

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For paracetamol (acetaminophen) overdose

Give the first dose of acetylcysteine at 140 mg per kg by mouth. Wait 4 hours then give half this amount for the second dose (70 mg per kg by mouth). Continue giving the amount of 70 mg per kg every 4 hours, for 16 more times. This makes a total of 18 doses during a 3-day period (72 hours). If the person vomits within 1 hour of taking the medicine, give the dose again.


Naloxone is used to treat an overdose from opioids such as morphine, heroin, fentanyl, methadone, opium, oxycodone, codeine, and other strong pain medicines. Give naloxone until the person is breathing well on their own. The treatment can wear off, so you may need to give another dose in 20 minutes if the person starts to have difficulty breathing again.

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Nausea, vomiting, and sweating. Extreme discomfort.

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Under 5 years or child weighs less than 20 kg: inject 0.1 mg per kg into the muscle every 2 to 3 minutes as needed, but do not give more than 2 mg in total.
Over 5 years or weighs more than 20 kg: inject ½ to 2 mg in the muscle. If needed, repeat the dose every 2 to 3 minutes, but do not give more than 10 mg in total.

Sodium nitrite

Sodium nitrite is used to treat cyanide poisoning together with sodium thiosulfate. It must be injected into the vein. Only do this if you know how.

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Slowly inject sodium nitrite into the vein over 5 to 20 minutes.
Under 12 years: inject 4 to 10 mg per kg into the vein. Do not give more than 300 mg.
Over 12 years: inject 300 mg into the vein.

Follow with an injection of sodium thiosulfate. See below for doses.

Sodium thiosulfate

Sodium thiosulfate is used to treat cyanide poisoning along with an injection of sodium nitrite. It must be injected into the vein. Only do this if you know how.

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Slowly inject sodium thiosulfate into the vein over 10 minutes.
Under 12 years: inject 400 mg per kg into the vein.
Over 12 years: inject 12.5 g into the vein.

This page was updated:05 Jan 2024