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Chloral hydrate Disease Interactions

There are 9 disease interactions with chloral hydrate:

Major

Anxiolytics/sedatives/hypnotics (applies to chloral hydrate) alcohol intox

Major Potential Hazard, High plausibility. Applicable conditions: Acute Alcohol Intoxication

Anxiolytic, sedative, and hypnotic agents should generally not be given to patients with acute alcohol intoxication exhibiting depressed vital signs. The central nervous system depressant effects of these agents may be additive with those of alcohol. Severe respiratory depression and death may occur. Therapy with such agents should be administered cautiously in patients who might be prone to acute alcohol intake.

References

  1. "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca, Plattsburg, NY.
  2. "Product Information. Sonata (zaleplon)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  3. "Product Information. Ambien (zolpidem)." sanofi-aventis, Bridgewater, NJ.
  4. "Product Information. Placidyl (ethchlorvynol)." Abbott Pharmaceutical, Abbott Park, IL.
  5. "Product Information. Equanil (meprobamate)." Wallace Laboratories, Cranbury, NJ.
View all 5 references
Major

Anxiolytics/sedatives/hypnotics (applies to chloral hydrate) depression

Major Potential Hazard, Moderate plausibility.

A variety of abnormal thinking and behavior changes have been reported to occur in association with the use of most anxiolytics, sedatives and hypnotics. Some of these changes include decreased inhibition, aggressiveness, agitation, and hallucinations. These drugs can cause or exacerbate mental depression and cause suicidal behavior and ideation. Therapy with these drugs should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.

References

  1. "Product Information. Ambien (zolpidem)." sanofi-aventis, Bridgewater, NJ.
  2. "Product Information. Sonata (zaleplon)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  3. "Product Information. Equanil (meprobamate)." Wallace Laboratories, Cranbury, NJ.
  4. "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca, Plattsburg, NY.
  5. "Product Information. Placidyl (ethchlorvynol)." Abbott Pharmaceutical, Abbott Park, IL.
View all 5 references
Major

Anxiolytics/sedatives/hypnotics (applies to chloral hydrate) drug dependence

Major Potential Hazard, High plausibility. Applicable conditions: Alcoholism, Drug Abuse/Dependence

Anxiolytic, sedative, and hypnotic agents have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use of excessive dosages, and abrupt cessation and/or a reduction in dosage may precipitate withdrawal symptoms. In patients who have developed tolerance, overdosage can still produce respiratory depression and death. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously and for as brief a period as possible. Addiction-prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance or medical supervision when treated with these agents. In addition, it may be prudent to refrain from dispensing large quantities of medication to such patients. After prolonged use or if dependency is suspected, withdrawal of medication should be undertaken gradually using a dosage-tapering schedule.

References

  1. Gericke CA, Ludolph AC "Chronic abuse of zolpidem." JAMA 272 (1994): 1721-2
  2. Cavallaro R, Regazzetti MG, Covelli G, Smeraldi E "Tolerance and withdrawal with zolpidem." Lancet 342 (1993): 374-5
  3. "Product Information. Ambien (zolpidem)." sanofi-aventis, Bridgewater, NJ.
  4. "Product Information. Placidyl (ethchlorvynol)." Abbott Pharmaceutical, Abbott Park, IL.
  5. "Product Information. Sonata (zaleplon)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  6. "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca, Plattsburg, NY.
  7. "Product Information. Equanil (meprobamate)." Wallace Laboratories, Cranbury, NJ.
View all 7 references
Major

Chloral hydrate (applies to chloral hydrate) renal/liver disease

Major Potential Hazard, High plausibility. Applicable conditions: Renal Dysfunction

The use of chloral hydrate is contraindicated in patients with marked renal and/or hepatic impairment due to the potential for significant drug and metabolite accumulation. Chloral hydrate is metabolized by the liver and erythrocytes to the pharmacologically active compound, trichloroethanol (TCE), which has a plasma half-life of 8 to 12 hours. TCE is then metabolized further by both the liver and kidney to inactive substances that are slowly excreted in the urine. High plasma levels of chloral hydrate and TCE may produce respiratory depression and adverse cardiovascular effects such as peripheral vasodilation, hypotension, arrhythmias, and myocardial depression.

References

  1. Muller G, Spassovski M, Henschler D "Metabolism of trichloroethylene in man: pharmacokinetics of metabolites." Arch Toxicol 32 (1974): 283-95
  2. Garrett ER, Lambert HJ "Pharmacokinetics of trichloroethanol and metabolites and interconversions among variously referenced pharmacokinetic parameters." J Pharm Sci 62 (1973): 550-72
  3. "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca, Plattsburg, NY.
Moderate

Anxiolytics/sedatives/hypnotics (applies to chloral hydrate) glaucoma

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Glaucoma/Intraocular Hypertension, Urinary Retention

Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.

Moderate

Anxiolytics/sedatives/hypnotics (applies to chloral hydrate) liver disease

Moderate Potential Hazard, Moderate plausibility.

In general, anxiolytics, sedatives and hypnotics are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with these drugs should be administered cautiously in patients with liver disease (some are not recommended in severe liver impairment), and the dosage should be adjusted accordingly. Laboratory testing is recommended prior and during treatment.

Moderate

Anxiolytics/sedatives/hypnotics (applies to chloral hydrate) resp depression

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Asphyxia, Pulmonary Impairment, Respiratory Arrest

Oral anxiolytic, sedative, and hypnotic agents may cause respiratory depression and apnea when given in high dosages or following acute overdose. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are recommended.

References

  1. "Product Information. Ambien (zolpidem)." sanofi-aventis, Bridgewater, NJ.
  2. "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca, Plattsburg, NY.
  3. "Product Information. Equanil (meprobamate)." Wallace Laboratories, Cranbury, NJ.
  4. "Product Information. Sonata (zaleplon)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  5. Biban P, Baraldi E, Pettennazzo A, Filippone M, Zacchello F "Adverse effect of chloral hydrate in two young children with obstructive sleep apnea." Pediatrics 92 (1993): 461-3
  6. "Product Information. Placidyl (ethchlorvynol)." Abbott Pharmaceutical, Abbott Park, IL.
  7. Murciano D, Aubier M, Palacios S, Parients R "Comparison of zolpidem (Z), triazolam (T), and flunitrazepam (F) effects on arterial blood gases and control of breathing in patients with severe chronic obstructive pulmonary disease (COPD)." Chest 97 Suppl (1990): s51-2
  8. Lheureux P, Debailleul G, De Witte O, Askenasi R "Zolpidem intoxication mimicking narcotic overdose: response to flumazenil." Hum Exp Toxicol 9 (1990): 105-7
  9. Greenberg SB, Faerber EN "Respiratory insufficiency following chloral hydrate sedation in two children with Leigh disease (subacute necrotizing encephalomyelopathy)." Pediatr Radiol 20 (1990): 287-8
View all 9 references
Moderate

Chloral hydrate (applies to chloral hydrate) cardiac disease

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Heart Disease

Although continued use of chloral hydrate at therapeutic dosages has not been associated with deleterious effects on the heart, large doses may produce peripheral vasodilation, hypotension, arrhythmias, and myocardial depression. High dosages of chloral hydrate should be avoided in patients with severe cardiac disease.

References

  1. Nordenberg A, Delisle G, Izukawa T "Cardiac arrhythmia in a child due to chloral hydrate ingestion." Pediatrics 47 (1971): 134-5
  2. Marshall AJ "Cardiac arrhythmias caused by chloral hydrate." Br Med J 2 (1977): 994
  3. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
Moderate

Chloral hydrate (applies to chloral hydrate) gastrointestinal irritation

Moderate Potential Hazard, High plausibility. Applicable conditions: Peptic Ulcer, Duodenitis/Gastritis, Esophagitis, Esophageal Ulceration

Chloral hydrate may cause esophageal and gastric irritation. Oral use of chloral hydrate should be avoided in patients with esophagitis, gastritis, duodenitis, or peptic ulcer disease.

References

  1. "PDR Generics." Montvale, NJ: Medical Economics (1995):

Chloral hydrate drug interactions

There are 328 drug interactions with chloral hydrate

Chloral hydrate alcohol/food interactions

There is 1 alcohol/food interaction with chloral hydrate

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.