Enhanced elimination

Because tricyclic antidepressants have a large volume of distribution and enterohepatic recirculation accounts for only 15 per cent of their elimination, repeated doses of charcoal are unlikely to have a significant effect. A further dose of charcoal (50 g in adults) after 2 to 4 h should be considered only in large overdoses or with sustained release preparations. Diuresis, hemodialysis, and hemoperfusion are ineffective and are not recommended for elimination of tricyclic antidepressants.

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