Trade Names:Chloral Hydrate- Syrup 500 mg per 5 mL
Trade Names:Somnote- Capsules 500 mgChloral Hydrate-Odan (Canada)
Exact mechanism is unknown; can produce mild CNS depression.
35% to 41% protein bound (trichloroethanol). Excreted in breast milk.
Metabolized to trichloroethanol (active), which is then converted in liver and kidney to trichloroacetic acid (inactive).
The half-life is 7 to 10 h (trichloroethanol). Metabolites are excreted in urine and bile.
Management of short-term insomnia; sedation; prevention or suppression of alcohol withdrawal symptoms; reduce anxiety associated with withdrawal of drugs such as narcotics or barbiturates; preoperatively or prior to electroencephalographic evaluation to allay anxiety and produce sedation and/or sleep.
Hypersensitivity to chloral derivatives; severe renal or hepatic function impairment.
PO Capsules/Syrup: 500 mg to 1 g every 6 h if needed (max, 2 g daily).InsomniaAdults
PO Capsules/Syrup: 500 mg to 1 g 15 to 30 min before bedtime.Children
PO Syrup: 50 mg/kg/day (max, 1 g per dose) for sleep.PremedicationChildren
PO Syrup: 20 to 25 mg/kg.SedationAdults
PO Capsules/Syrup: 250 mg 3 times daily after meals.Children
PO Syrup: 8 mg/kg or 250 mg/m 2 3 times daily (max, 500 mg 3 times daily).
Administer syrup or capsules with full glass of water or fruit juice to help prevent GI upset problems. Chilling of syrup may lessen its unpleasant taste.
Store at 59° to 86°F. Do not freeze.Syrup
Store at 68° to 77°F. Protect from light and freezing.
Additive CNS depression may occur. Rarely, disulfiram-like reactions may occur with alcohol ingestion.Furosemide (IV)
Administration within 24 h of chloral hydrate may lead to diaphoresis, hot flashes, tachycardia, and hypertension.Oral anticoagulants (eg, warfarin)
Anticoagulant effects may be increased transiently.Phenytoin
May reduce effects of phenytoin.
May cause false-positive urine glucose test results with Benedict solution or cupric sulfide tablets (eg, Clinitest ), but not with enzyme-based tests (eg, Clinistix , Tes-tape ); altered urinary 17-ketosteroid values when using the Reddy, Jenkins, and Thorn procedure; false-positive phentolamine test results; results of fluorometric tests for urine catecholamines may be altered (do not administer chloral hydrate 48 h before this test).
Ataxia; dizziness; residual sedation (“hangover effect”); somnambulistic reaction including disorientation and incoherence.
Angioedema; bullous lesions; eczema; erythema multiforme; purpura; scarlatiniform or erythematous rash; urticaria.
Diarrhea; gastric irritation; nausea; vomiting.
Category C .
Excreted in breast milk.
Safety and efficacy of capsules not established.
Anaphylaxis and angioedema may occur as early as the first dose.
Use with caution in patients who are depressed, have suicidal tendencies, or have a history of drug abuse.
Attacks may be precipitated in susceptible patients.
May be habit forming. Use with caution in patients with history of drug or alcohol addiction. Withdraw drug slowly.
Avoid use in patients with esophagitis, gastritis, or gastric or duodenal ulcers.
Gastritis, skin eruptions, or parenchymatous renal damage may develop following prolonged administration. In addition, prolonged use may produce drug tolerance and physical and/or psychological dependence.
Irritates skin and mucous membranes.
Behaviors may include sleep-driving as well as making phone calls and preparing and eating food while asleep.
Areflexia, cardiac arrhythmias, coma, death from respiratory failure or hypertension, esophageal stricture, gastric necrosis and perforation, GI hemorrhage, hepatic and renal function impairment with resulting transient jaundice and/or albuminuria, hypotension, hypothermia, miosis, muscle flaccidity, respiratory depression, vomiting.
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