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      For You News & Perspective Drugs & Diseases CME & Education Academy Video Decision Point
      Drugs & Diseases

      chloral hydrate (Rx)

      Brand and Other Names:Somnote
      • Print

      Dosing & Uses

      AdultPediatric

      Dosage Forms & Strengths

      capsule: Schedule IV

      • 500mg

      syrup: Schedule IV

      • 500mg/5mL

      Insomnia

      Indicated for use as hypnotic for simple insomnia; rarely used for this indication

      500 mg to 1 g PO 15-30 minutes before bedtime; for short-term use only (ie, up to 2 weeks); not to exceed 2 g/24hr

      Sedative/Anxiety

      250 mg PO PC q8hr; not to exceed 2 g/day

      Renal Impairment

      Contraindicated in moderate-severe renal impairment

      Hepatic Impairment

      Contraindicated in moderate-severe hepatic impairment

      Administration

      Upon discontinuation withdraw gradually over 2 weeks if patient maintained on high doses for prolong periods of time; abrupt discontinuation may result in delirium

      Dosage Forms & Strengths

      capsule: Schedule IV

      • 500mg

      syrup: Schedule IV

      • 500mg/5mL

      Sedation for Procedures (Off-label)

      50-75 mg/kg PO 30-60 min before procedure; may repeat in 30 min if necessary  

      Not to exceed 120 mg/kg or 1 g/dose in infants or 2 g/dose in children

      Sedation/Anxiety (Off-label)

      May be used prior to procedure or EEG evaluation

      25-50 mg/kg/day PO divided q6-8hr; not to exceed 500 mg/dose  

      Next:

      Interactions

      Interaction Checker

      and chloral hydrate

      No Results

         activity indicator 
        No Interactions Found
        Interactions Found

        Contraindicated

          Serious - Use Alternative

            Significant - Monitor Closely

              Minor

                All Interactions Sort By:
                 activity indicator 

                Contraindicated (2)

                • calcium/magnesium/potassium/sodium oxybates

                  chloral hydrate, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Coadministration with alcohol or sedative hypnotics are contraindicated because of additive CNS depression.

                • sodium oxybate

                  chloral hydrate, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Coadministration with alcohol or sedative hypnotics are contraindicated because of additive CNS depression.

                Serious - Use Alternative (12)

                • benzhydrocodone/acetaminophen

                  benzhydrocodone/acetaminophen, chloral hydrate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

                • fentanyl

                  fentanyl, chloral hydrate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

                • fentanyl intranasal

                  fentanyl intranasal, chloral hydrate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

                • fentanyl transdermal

                  fentanyl transdermal, chloral hydrate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

                • fentanyl transmucosal

                  fentanyl transmucosal, chloral hydrate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

                • hydrocodone

                  hydrocodone, chloral hydrate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

                • lemborexant

                  lemborexant, chloral hydrate. Either increases effects of the other by sedation. Avoid or Use Alternate Drug. Use of lemborexant with other drugs to treat insomnia is not recommended.

                • mefloquine

                  mefloquine increases toxicity of chloral hydrate by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.

                • metoclopramide intranasal

                  chloral hydrate, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

                • selinexor

                  selinexor, chloral hydrate. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

                • sufentanil SL

                  sufentanil SL, chloral hydrate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

                • valerian

                  valerian and chloral hydrate both increase sedation. Avoid or Use Alternate Drug.

                Monitor Closely (190)

                • albuterol

                  chloral hydrate increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • alfentanil

                  chloral hydrate and alfentanil both increase sedation. Use Caution/Monitor.

                • alprazolam

                  alprazolam and chloral hydrate both increase sedation. Use Caution/Monitor.

                • amitriptyline

                  chloral hydrate and amitriptyline both increase sedation. Use Caution/Monitor.

                • amobarbital

                  amobarbital and chloral hydrate both increase sedation. Use Caution/Monitor.

                • amoxapine

                  chloral hydrate and amoxapine both increase sedation. Use Caution/Monitor.

                • apomorphine

                  chloral hydrate and apomorphine both increase sedation. Use Caution/Monitor.

                • arformoterol

                  chloral hydrate increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • aripiprazole

                  chloral hydrate and aripiprazole both increase sedation. Use Caution/Monitor.

                • armodafinil

                  chloral hydrate increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • azelastine

                  azelastine and chloral hydrate both increase sedation. Use Caution/Monitor.

                • baclofen

                  chloral hydrate and baclofen both increase sedation. Use Caution/Monitor.

                • belladonna and opium

                  chloral hydrate and belladonna and opium both increase sedation. Use Caution/Monitor.

                • benperidol

                  chloral hydrate and benperidol both increase sedation. Use Caution/Monitor.

                • benzphetamine

                  chloral hydrate increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • brexanolone

                  brexanolone, chloral hydrate. Either increases toxicity of the other by sedation. Use Caution/Monitor.

                • brompheniramine

                  brompheniramine and chloral hydrate both increase sedation. Use Caution/Monitor.

                • buprenorphine

                  chloral hydrate and buprenorphine both increase sedation. Use Caution/Monitor.

                • buprenorphine buccal

                  chloral hydrate and buprenorphine buccal both increase sedation. Use Caution/Monitor.

                • buprenorphine, long-acting injection

                  chloral hydrate increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.

                • butabarbital

                  butabarbital and chloral hydrate both increase sedation. Use Caution/Monitor.

                • butalbital

                  butalbital and chloral hydrate both increase sedation. Use Caution/Monitor.

                • butorphanol

                  chloral hydrate and butorphanol both increase sedation. Use Caution/Monitor.

                • caffeine

                  chloral hydrate increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • carbinoxamine

                  carbinoxamine and chloral hydrate both increase sedation. Use Caution/Monitor.

                • carisoprodol

                  chloral hydrate and carisoprodol both increase sedation. Use Caution/Monitor.

                • cenobamate

                  cenobamate, chloral hydrate. Either increases effects of the other by sedation. Use Caution/Monitor.

                • chlordiazepoxide

                  chlordiazepoxide and chloral hydrate both increase sedation. Use Caution/Monitor.

                • chlorpheniramine

                  chlorpheniramine and chloral hydrate both increase sedation. Use Caution/Monitor.

                • chlorpromazine

                  chloral hydrate and chlorpromazine both increase sedation. Use Caution/Monitor.

                • chlorzoxazone

                  chloral hydrate and chlorzoxazone both increase sedation. Use Caution/Monitor.

                • cinnarizine

                  cinnarizine and chloral hydrate both increase sedation. Use Caution/Monitor.

                • clemastine

                  clemastine and chloral hydrate both increase sedation. Use Caution/Monitor.

                • clobazam

                  chloral hydrate, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).

                • clomipramine

                  chloral hydrate and clomipramine both increase sedation. Use Caution/Monitor.

                • clonazepam

                  clonazepam and chloral hydrate both increase sedation. Use Caution/Monitor.

                • clorazepate

                  clorazepate and chloral hydrate both increase sedation. Use Caution/Monitor.

                • clozapine

                  chloral hydrate and clozapine both increase sedation. Use Caution/Monitor.

                • codeine

                  chloral hydrate and codeine both increase sedation. Use Caution/Monitor.

                • cyclizine

                  cyclizine and chloral hydrate both increase sedation. Use Caution/Monitor.

                • cyclobenzaprine

                  chloral hydrate and cyclobenzaprine both increase sedation. Use Caution/Monitor.

                • cyproheptadine

                  cyproheptadine and chloral hydrate both increase sedation. Use Caution/Monitor.

                • dantrolene

                  chloral hydrate and dantrolene both increase sedation. Use Caution/Monitor.

                • daridorexant

                  chloral hydrate and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

                • desipramine

                  chloral hydrate and desipramine both increase sedation. Use Caution/Monitor.

                • deutetrabenazine

                  chloral hydrate and deutetrabenazine both increase sedation. Use Caution/Monitor.

                • dexchlorpheniramine

                  dexchlorpheniramine and chloral hydrate both increase sedation. Use Caution/Monitor.

                • dexfenfluramine

                  chloral hydrate increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • dexmedetomidine

                  chloral hydrate and dexmedetomidine both increase sedation. Use Caution/Monitor.

                • dexmethylphenidate

                  chloral hydrate increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • dextroamphetamine

                  chloral hydrate increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • dextromoramide

                  chloral hydrate and dextromoramide both increase sedation. Use Caution/Monitor.

                • diamorphine

                  chloral hydrate and diamorphine both increase sedation. Use Caution/Monitor.

                • diazepam

                  diazepam and chloral hydrate both increase sedation. Use Caution/Monitor.

                • diazepam intranasal

                  diazepam intranasal, chloral hydrate. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.

                • diethylpropion

                  chloral hydrate increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • difelikefalin

                  difelikefalin and chloral hydrate both increase sedation. Use Caution/Monitor.

                • difenoxin hcl

                  chloral hydrate and difenoxin hcl both increase sedation. Use Caution/Monitor.

                • dimenhydrinate

                  dimenhydrinate and chloral hydrate both increase sedation. Use Caution/Monitor.

                • diphenhydramine

                  diphenhydramine and chloral hydrate both increase sedation. Use Caution/Monitor.

                • diphenoxylate hcl

                  chloral hydrate and diphenoxylate hcl both increase sedation. Use Caution/Monitor.

                • dipipanone

                  chloral hydrate and dipipanone both increase sedation. Use Caution/Monitor.

                • dobutamine

                  chloral hydrate increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • dopamine

                  chloral hydrate increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • dopexamine

                  chloral hydrate increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • dosulepin

                  chloral hydrate and dosulepin both increase sedation. Use Caution/Monitor.

                • doxepin

                  chloral hydrate and doxepin both increase sedation. Use Caution/Monitor.

                • doxylamine

                  chloral hydrate and doxylamine both increase sedation. Use Caution/Monitor.

                • droperidol

                  chloral hydrate and droperidol both increase sedation. Use Caution/Monitor.

                • ephedrine

                  chloral hydrate increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • epinephrine

                  chloral hydrate increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • epinephrine racemic

                  chloral hydrate increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • estazolam

                  estazolam and chloral hydrate both increase sedation. Use Caution/Monitor.

                • ethanol

                  chloral hydrate and ethanol both increase sedation. Use Caution/Monitor.

                • etomidate

                  etomidate and chloral hydrate both increase sedation. Use Caution/Monitor.

                • fenfluramine

                  chloral hydrate increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • flibanserin

                  chloral hydrate and flibanserin both increase sedation. Modify Therapy/Monitor Closely. Risk for sedation increased if flibanserin is coadministration with other CNS depressants.

                • fluphenazine

                  chloral hydrate and fluphenazine both increase sedation. Use Caution/Monitor.

                • flurazepam

                  flurazepam and chloral hydrate both increase sedation. Use Caution/Monitor.

                • formoterol

                  chloral hydrate increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • gabapentin

                  gabapentin, chloral hydrate. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

                • gabapentin enacarbil

                  gabapentin enacarbil, chloral hydrate. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

                • ganaxolone

                  chloral hydrate and ganaxolone both increase sedation. Use Caution/Monitor.

                • gotu kola

                  gotu kola increases effects of chloral hydrate by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.

                • haloperidol

                  chloral hydrate and haloperidol both increase sedation. Use Caution/Monitor.

                • hawthorn

                  hawthorn increases effects of chloral hydrate by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.

                • hops

                  hops increases effects of chloral hydrate by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.

                • hydromorphone

                  chloral hydrate and hydromorphone both increase sedation. Use Caution/Monitor.

                • hydroxyzine

                  hydroxyzine and chloral hydrate both increase sedation. Use Caution/Monitor.

                • iloperidone

                  chloral hydrate and iloperidone both increase sedation. Use Caution/Monitor.

                • imipramine

                  chloral hydrate and imipramine both increase sedation. Use Caution/Monitor.

                • isoproterenol

                  chloral hydrate increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • kava

                  kava increases effects of chloral hydrate by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.

                • ketamine

                  ketamine and chloral hydrate both increase sedation. Use Caution/Monitor.

                • ketotifen, ophthalmic

                  chloral hydrate and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

                • lasmiditan

                  lasmiditan, chloral hydrate. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

                • levalbuterol

                  chloral hydrate increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • levorphanol

                  chloral hydrate and levorphanol both increase sedation. Use Caution/Monitor.

                • lisdexamfetamine

                  chloral hydrate increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • lofepramine

                  chloral hydrate and lofepramine both increase sedation. Use Caution/Monitor.

                • lofexidine

                  chloral hydrate and lofexidine both increase sedation. Use Caution/Monitor.

                • loprazolam

                  loprazolam and chloral hydrate both increase sedation. Use Caution/Monitor.

                • lorazepam

                  lorazepam and chloral hydrate both increase sedation. Use Caution/Monitor.

                • lormetazepam

                  lormetazepam and chloral hydrate both increase sedation. Use Caution/Monitor.

                • loxapine

                  chloral hydrate and loxapine both increase sedation. Use Caution/Monitor.

                • loxapine inhaled

                  chloral hydrate and loxapine inhaled both increase sedation. Use Caution/Monitor.

                • lurasidone

                  lurasidone, chloral hydrate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.

                • maprotiline

                  chloral hydrate and maprotiline both increase sedation. Use Caution/Monitor.

                • marijuana

                  chloral hydrate and marijuana both increase sedation. Use Caution/Monitor.

                • melatonin

                  chloral hydrate and melatonin both increase sedation. Use Caution/Monitor.

                • meperidine

                  chloral hydrate and meperidine both increase sedation. Use Caution/Monitor.

                • meprobamate

                  chloral hydrate and meprobamate both increase sedation. Use Caution/Monitor.

                • metaproterenol

                  chloral hydrate increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • metaxalone

                  chloral hydrate and metaxalone both increase sedation. Use Caution/Monitor.

                • methadone

                  chloral hydrate and methadone both increase sedation. Use Caution/Monitor.

                • methamphetamine

                  chloral hydrate increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • methocarbamol

                  chloral hydrate and methocarbamol both increase sedation. Use Caution/Monitor.

                • methylenedioxymethamphetamine

                  chloral hydrate increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • midazolam

                  midazolam and chloral hydrate both increase sedation. Use Caution/Monitor.

                • midazolam intranasal

                  midazolam intranasal, chloral hydrate. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

                • midodrine

                  chloral hydrate increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • mirtazapine

                  chloral hydrate and mirtazapine both increase sedation. Use Caution/Monitor.

                • modafinil

                  chloral hydrate increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • morphine

                  chloral hydrate and morphine both increase sedation. Use Caution/Monitor.

                • motherwort

                  chloral hydrate and motherwort both increase sedation. Use Caution/Monitor.

                • moxonidine

                  chloral hydrate and moxonidine both increase sedation. Use Caution/Monitor.

                • nabilone

                  chloral hydrate and nabilone both increase sedation. Use Caution/Monitor.

                • nalbuphine

                  chloral hydrate and nalbuphine both increase sedation. Use Caution/Monitor.

                • norepinephrine

                  chloral hydrate increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • nortriptyline

                  chloral hydrate and nortriptyline both increase sedation. Use Caution/Monitor.

                • olanzapine

                  chloral hydrate and olanzapine both increase sedation. Use Caution/Monitor.

                • oliceridine

                  oliceridine, chloral hydrate. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

                • opium tincture

                  chloral hydrate and opium tincture both increase sedation. Use Caution/Monitor.

                • orphenadrine

                  chloral hydrate and orphenadrine both increase sedation. Use Caution/Monitor.

                • oxazepam

                  oxazepam and chloral hydrate both increase sedation. Use Caution/Monitor.

                • oxycodone

                  chloral hydrate and oxycodone both increase sedation. Use Caution/Monitor.

                • oxymorphone

                  chloral hydrate and oxymorphone both increase sedation. Use Caution/Monitor.

                • paliperidone

                  chloral hydrate and paliperidone both increase sedation. Use Caution/Monitor.

                • papaveretum

                  chloral hydrate and papaveretum both increase sedation. Use Caution/Monitor.

                • papaverine

                  chloral hydrate and papaverine both increase sedation. Use Caution/Monitor.

                • passion flower

                  passion flower increases effects of chloral hydrate by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.

                • pentazocine

                  chloral hydrate and pentazocine both increase sedation. Use Caution/Monitor.

                • pentobarbital

                  pentobarbital and chloral hydrate both increase sedation. Use Caution/Monitor.

                • perphenazine

                  chloral hydrate and perphenazine both increase sedation. Use Caution/Monitor.

                • phendimetrazine

                  chloral hydrate increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • phenobarbital

                  phenobarbital and chloral hydrate both increase sedation. Use Caution/Monitor.

                • phentermine

                  chloral hydrate increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • phenylephrine

                  chloral hydrate increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • phenylephrine PO

                  chloral hydrate increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

                • pholcodine

                  chloral hydrate and pholcodine both increase sedation. Use Caution/Monitor.

                • pimozide

                  chloral hydrate and pimozide both increase sedation. Use Caution/Monitor.

                • pirbuterol

                  chloral hydrate increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • pregabalin

                  pregabalin, chloral hydrate. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

                • primidone

                  primidone and chloral hydrate both increase sedation. Use Caution/Monitor.

                • prochlorperazine

                  chloral hydrate and prochlorperazine both increase sedation. Use Caution/Monitor.

                • promethazine

                  promethazine and chloral hydrate both increase sedation. Use Caution/Monitor.

                • propofol

                  propofol and chloral hydrate both increase sedation. Use Caution/Monitor.

                • propylhexedrine

                  chloral hydrate increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • protriptyline

                  chloral hydrate and protriptyline both increase sedation. Use Caution/Monitor.

                • quazepam

                  quazepam and chloral hydrate both increase sedation. Use Caution/Monitor.

                • quetiapine

                  chloral hydrate and quetiapine both increase sedation. Use Caution/Monitor.

                • ramelteon

                  chloral hydrate and ramelteon both increase sedation. Use Caution/Monitor.

                • remimazolam

                  remimazolam, chloral hydrate. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.

                • risperidone

                  chloral hydrate and risperidone both increase sedation. Use Caution/Monitor.

                • salmeterol

                  chloral hydrate increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • scullcap

                  chloral hydrate and scullcap both increase sedation. Use Caution/Monitor.

                • secobarbital

                  secobarbital and chloral hydrate both increase sedation. Use Caution/Monitor.

                • sevoflurane

                  sevoflurane and chloral hydrate both increase sedation. Use Caution/Monitor.

                • shepherd's purse

                  chloral hydrate and shepherd's purse both increase sedation. Use Caution/Monitor.

                • sufentanil

                  chloral hydrate and sufentanil both increase sedation. Use Caution/Monitor.

                • tapentadol

                  chloral hydrate and tapentadol both increase sedation. Use Caution/Monitor.

                • temazepam

                  temazepam and chloral hydrate both increase sedation. Use Caution/Monitor.

                • terbutaline

                  chloral hydrate increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • thioridazine

                  chloral hydrate and thioridazine both increase sedation. Use Caution/Monitor.

                • thiothixene

                  chloral hydrate and thiothixene both increase sedation. Use Caution/Monitor.

                • topiramate

                  chloral hydrate and topiramate both increase sedation. Modify Therapy/Monitor Closely.

                • tramadol

                  chloral hydrate and tramadol both increase sedation. Use Caution/Monitor.

                • trazodone

                  chloral hydrate and trazodone both increase sedation. Use Caution/Monitor.

                • triazolam

                  triazolam and chloral hydrate both increase sedation. Use Caution/Monitor.

                • triclofos

                  chloral hydrate and triclofos both increase sedation. Use Caution/Monitor.

                • trifluoperazine

                  chloral hydrate and trifluoperazine both increase sedation. Use Caution/Monitor.

                • trimipramine

                  chloral hydrate and trimipramine both increase sedation. Use Caution/Monitor.

                • triprolidine

                  triprolidine and chloral hydrate both increase sedation. Use Caution/Monitor.

                • valerian

                  valerian increases effects of chloral hydrate by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.

                • warfarin

                  chloral hydrate increases effects of warfarin by unspecified interaction mechanism. Use Caution/Monitor.

                • xylometazoline

                  chloral hydrate increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • yohimbine

                  chloral hydrate increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • ziconotide

                  chloral hydrate and ziconotide both increase sedation. Use Caution/Monitor.

                • ziprasidone

                  chloral hydrate and ziprasidone both increase sedation. Use Caution/Monitor.

                • zotepine

                  chloral hydrate and zotepine both increase sedation. Use Caution/Monitor.

                Minor (6)

                • ashwagandha

                  ashwagandha increases effects of chloral hydrate by pharmacodynamic synergism. Minor/Significance Unknown. May enhance CNS depression.

                • brimonidine

                  brimonidine increases effects of chloral hydrate by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

                • eucalyptus

                  chloral hydrate and eucalyptus both increase sedation. Minor/Significance Unknown.

                • nettle

                  nettle increases effects of chloral hydrate by pharmacodynamic synergism. Minor/Significance Unknown. (High dose nettle; theoretical interaction) May enhance CNS depression.

                • sage

                  chloral hydrate and sage both increase sedation. Minor/Significance Unknown.

                • Siberian ginseng

                  Siberian ginseng increases effects of chloral hydrate by pharmacodynamic synergism. Minor/Significance Unknown. May enhance CNS depression.

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                Warnings

                Contraindications

                Hypersensitivity/idiosyncrasy to chloral derivatives

                Marked renal, hepatic impairment; severe cardiac disease; gastritis & ulcers

                Cautions

                Potential toxic dose <6 years old: 50 mg/kg

                Use with caution in porphyria

                Use caution in long term care patients, elderly, and neonates

                Use not recommended for >2 weeks

                Abrupt discontinuation may cause withdrawal symptoms

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                Pregnancy & Lactation

                Pregnancy Category: C

                Lactation: small amount secreted into breast milk

                Pregnancy Categories

                A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                NA: Information not available.

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                Pharmacology

                Mechanism of Action

                Unknown; produces central nervous system depression

                Absorption

                Onset: 30-60 min

                Duration: 4-8 hr

                Peak plasma levels: 7-10 mcg/mL

                Metabolism

                Metabolized by alcohol dehydrogenase, glucuronidation

                Metabolites: trichloroethanol

                Elimination

                Half-life: 8-11 hr (active metabolite)

                Excretion: Mostly in urine; some feces

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                Images

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                Patient Handout

                A Patient Handout is not currently available for this monograph.
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                Formulary

                FormularyPatient Discounts

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                • Compare formulary status to other drugs in the same class.
                • Access your plan list on any device – mobile or desktop.

                The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                View explanations for tiers and restrictions
                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                NC NOT COVERED – Drugs that are not covered by the plan.
                Code Definition
                PA Prior Authorization
                Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                QL Quantity Limits
                Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                ST Step Therapy
                Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
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                Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.
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