chloral hydrate

Pronunciation

Generic Name: chloral hydrate (KLOR al HY drayt)
Brand Name: Somnote

What is chloral hydrate?

Chloral hydrate is a hypnotic and a sedative medication that slows the activity of your central nervous system. Chloral hydrate has both fast-acting and long-lasting sedative effects.

Chloral hydrate is for short-term use as a sedative or sleep medicine. It is sometimes given before a surgery to help you relax.

Chloral hydrate may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about chloral hydrate?

Before taking chloral hydrate, tell your doctor if you are using a blood thinner such as warfarin (Coumadin). If you are using a blood thinner, you may not be able to take chloral hydrate, or you may need dosage adjustments or special tests during treatment.

Chloral hydrate should be given only for a short time, such as 2 to 7 days in a row.

Call your doctor at once if you have any of these serious side effects: uneven heartbeats, shallow breathing, feeling light-headed, fainting, weakness, lack of coordination, or a red, blistering, peeling skin rash.

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Avoid drinking alcohol, which can increase some of the side effects of chloral hydrate.

Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to sleepiness caused by chloral hydrate.

Chloral hydrate can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

This medication may be habit-forming. You may have severe or life-threatening withdrawal symptoms when you stop using chloral hydrate after using it for 2 weeks or longer. Do not stop using this medication suddenly without first talking to your doctor. You may need to gradually reduce the dose.

What should I discuss with my health care provider before taking chloral hydrate?

Do not use this medication if you have severe kidney or liver disease.

Before taking chloral hydrate, tell your doctor if you have:

  • heart disease or heart rhythm problems;

  • ulcer, colitis, or other stomach disorders;

  • adenoids, sleep apnea, or other breathing disorders;

  • porphyria;

  • depression or mental illness;

  • thoughts of suicide; or

  • a history of drug abuse or dependence.

If you have any of these conditions, you may not be able to use chloral hydrate, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Chloral hydrate can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

This medication may be habit-forming. You may have severe or life-threatening withdrawal symptoms when you stop using chloral hydrate after using it for 2 weeks or longer. Do not stop using this medication suddenly without first talking to your doctor. You may need to gradually reduce the dose.

Older adults may be more sensitive to the sedative effects of chloral hydrate.

How should I take chloral hydrate?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Chloral hydrate should be given only for a short time, such as 2 to 7 days in a row.

Take each dose with a full glass of water.

Measure the liquid form of chloral hydrate with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. Dilute the liquid medicine with water, fruit juice, milk, or ginger ale to make it easier on your stomach.

If you take chloral hydrate as a sleep aid, take it just before bedtime.

If you take this medication as a sedative, take it after meals as directed by your doctor.

Do not crush, chew, or open a chloral hydrate capsule. Swallow the pill whole.

This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using chloral hydrate.

Do not stop using chloral hydrate without first talking to your doctor. You may need to use less and less before you stop the medication completely.

Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a chloral hydrate overdose may include extreme drowsiness, nausea, coughing up blood or vomit that looks like coffee grounds, shallow breathing, fainting, uneven heartbeats, cold feeling, muscle weakness, or jaundice (yellowing of the skin or eyes).

What should I avoid while taking chloral hydrate?

Avoid drinking alcohol, which can increase some of the side effects of chloral hydrate.

Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to sleepiness caused by chloral hydrate.

Chloral hydrate can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Chloral hydrate side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • uneven heartbeats;

  • feeling light-headed, fainting;

  • shallow breathing;

  • weakness, lack of coordination; or

  • a red, blistering, peeling skin rash.

Other less serious side effects are more likely to occur, such as:

  • drowsiness, deep sleep;

  • headache, or hangover feeling;

  • nausea, vomiting, indigestion, gas, stomach pain;

  • redness or drooping of your eyelids;

  • excitement or confusion;

  • mild itching or skin rash; or

  • unpleasant taste in your mouth;

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Chloral hydrate Dosing Information

Usual Adult Dose for Insomnia:

500 mg to 1 g 15 to 30 minutes before bedtime.

Usual Adult Dose for Sedation:

250 mg 3 times daily after meals, or

500 mg to 1 g 30 minutes before surgery

Usual Pediatric Dose for Insomnia:

Oral, Rectal:
Hypnotic: 50 mg/kg/dose at bedtime
Maximum dose: 1 g/dose
Total maximum: 1 g/day for infants and 2 g/day for children

Usual Pediatric Dose for Sedation:

Neonatal: Oral, Rectal:
For sedation prior to a procedure: 25 mg/kg. Repeat doses should be used with great caution as drug and metabolites accumulate with repeated use; toxicity has been reported after 3 days in a preterm neonate and after 7 days in a term neonate receiving chloral hydrate 40 to 50 mg/kg every 6 hours.

Infants and Children:
Oral, Rectal:
Sedation, anxiety: 25 to 50 mg/kg/day divided every 6 to 8 hours
Maximum dose: 500 mg/dose
Prior to EEG: 25 to 50 mg/kg/dose 30 to 60 minutes prior to EEG; may repeat in 30 minutes to a total maximum of 100 mg/kg or 1 g total for infants and 2 g total for children.
Sedation, nonpainful procedure: 50 to 75 mg/kg/dose 30 to 60 minutes prior to procedure; may repeat 30 minutes after initial dose if needed.
Maximum dose: 120 mg/kg or 1 g total for infants and 2 g total for children

What other drugs will affect chloral hydrate?

Before taking chloral hydrate, tell your doctor if you are using a blood thinner such as warfarin (Coumadin). If you are using a blood thinner, you may not be able to take chloral hydrate, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect chloral hydrate. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist has more information about chloral hydrate written for health professionals that you may read.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.04. Revision Date: 2010-12-15, 5:01:39 PM.

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