In preparing this Position Statement, all relevant scientific literatu
re was identified and reviewed critically by acknowledged experts usin
g agreed criteria. Well-conducted clinical and experimental studies we
re given precedence over anecdotal case reports and abstracts were not
usually considered. A draft Position Statement was then produced and
subjected to detailed peer review by an international group of clinica
l toxicologists chosen by the American Academy of Clinical Toxicology
and the European Association of Poisons Centres and Clinical Toxicolog
ists. The Position Statement went through multiple drafts before being
approved by the Boards of the two societies and being endorsed by oth
er societies. The Position Statement includes a summary statement for
ease of use and is supported by detailed documentation which describes
the scientific evidence on which the Statement is based. The administ
ration of a cathartic alone has no role in the management of the poiso
ned patient and is not recommended as a method of gut decontamination.
Experimental data are conflicting regarding the use of cathartics in
combination with activated charcoal. No clinical studies have been pub
lished to investigate the ability of a cathartic, with or without acti
vated charcoal, to reduce the bioavailability of drugs or to improve t
he outcome of poisoned patients. Based on available data, the routine
use of a cathartic in combination with activated charcoal is not endor
sed. If a cathartic is used, it should be limited to a single dose in
order to minimize adverse effects.