Chloral hydrate drug interactions

Geriatric Considerations - Summary Because chloral hydrate has a low therapeutic window, rapid development of tolerance, and drug interactions, it is not recommended for use in older adults. 

Barbiturates and barbiturate-like drugs, such as chloral hydrate, although effective hypnotics, are considered far less safe than BZDs in terms of tolerance, interaction with alcohol, and lethality in overdose. Therefore, their use is not generally recommended. 

Boston Collaborative Drug Surveillance Program, Boston Universtiy Medical Center. Interaction between chloral hydrate and warfarin. N Engl J Med 1972 286(2) 53-5. 

Breckenridge A, Orme ML, Thorgeirsson S, Davies DS, Brooks RV. Drug interactions with warfarin studies with dichloralphenazone, chloral hydrate and phenazone (anti-pyrine). Clin Sci 1971 40(4) 351-64. 

Other adverse effects Barbiturates and carbamates (but not benzodiazepines, buspirone, zolpidem, or zaleplon) induce the formation of the liver microsomal enzymes that metabolize dmgs. This enzyme induction may lead to multiple drug interactions. Barbiturates may also precipitate acute intermittent porphyria in susceptible patients. Chloral hydrate may displace coumarins from plasma protein binding sites and increase anticoagulant effects. 

Wong LK, Biemann K. A study of drug interaction by gas chromatography-mass spectrometry—synergism of chloral hydrate and ethanol. Biochem Pharmacol (1978) 27, 1019-22. 

Breckenrir e A, Orme ML E, Thorgeirsson S, Davies D, Erodes RV. Drug interactions with war iin studies with dichloralphena nie, chloral hydrate and phenazene (anti rine). CUn Sci (1971) 40,351-64. 

Malaoh M, Berman N. Furosemide and chloral hydrate. Adverse drug interaction. JAMA (1975)232,638-9. 

Pevoi a MP, Yost RL, Marks RG, Howell WS, Stewart RB. Interaction of chloral hydrate and furosemide. A controlled retrospective study. Drug Melt ClinPharm (1977) 11,332-5. 

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