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Pharmacy and Medications

Charcoal Question



Hi, I would like to know if you have heard of AST-120 which is a a novel oral charcoal compound. In Japan it is marketed under the name of Kremezin.

I have Crohn`s Disease and have had a non-healing anal fistula for three years so far. Nothign has worked to try to close it including Remicade, Surgisis Plug, and drainign Setons.

I understand in Japan that a study was done showing positive results for Crohn`s patients with non-healing anal fistuals closing within 8 weeks when taking AST-120 (Kremezin).

I have not been able to find anywhere to purchase it. So I was wondering if it is available in the states and whether you need a prescription.

Thank you for your help.


I have not heard of AST-120. It is described as a spherical adsorptive carbon preparation which appears to have similar effects to charcoal, but with some important differences. The study to which you are referring was conducted in Japan and involved 57 patients.* The 37% of the 27 patients receiving AST-120 experienced improvement versus 10% of the 30 patients receiving placebo. The authors concluded that there were no life-threatening side effects. Unfortunately, it is not available in the United States.

*Fukuda, Y., et al. “Oral spherical adsorptive carbon for the treatment of intractable anal fistulas in Crohn's disease: a multicenter, randomized, double-blind, placebo-controlled trial.” American Journal of Gastroenterology, v. 103 issue 7, 2008, p. 1721-9.

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Response by:

Michael  Ganio, PharmD Michael Ganio, PharmD
Clinical Applications Pharmacist
Wexner Medical Center
The Ohio State University