A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Noctec Side Effects, and Drug Interactions - Chloral Hydrate
Noctec Side Effects, and Drug Interactions - Chloral Hydrate
SIDE EFFECTS
Central Nervous System
Occasionally a patient
becomes somnambulistic and he may be disoriented and incoherent
and show paranoid
behavior. Rarely, excitement, tolerance, addiction, delirium,
drowsiness, staggering
gait, ataxia,
lightheadedness, vertigo, dizziness,
nightmares, malaise,
mental confusion
and hallucinations have been reported.
Hematelogical
Leukopenia and eosinophilia
have occasionally occurred.
Dermatological
Allergic skin rashes including
hives, erythema,
eczematoid dermatitis, urticaria, and scarlatiniform
exanthems have occasionally been reported.
Gastrointestinal
Some patients experience
gastric irritation
and occasionally nausea and vomiting,
flatulence, diarrhea,
and unpleasant taste occur.
Miscellaneous
Rarely, headache,
hangover, idiosyncratic syndrome,
and ketonuria have
been reported.
DRUG ABUSE AND DEPENDENCE
Controlled Substance
Drug Enforcement Administration Schedule IV.
Abuse
Chloral hydrate may
be habit- forming. Patients known to be addiction- prone and patients
who actively solicit hypnotics in increasing doses are potential
addicts. Many patients take
higher doses of hypnotics than they admit, and slurring of speech,
incoordination,
tremulousness, and nystagmus should arouse suspicion. Drowsiness,
lethargy, and hangover
are frequently observed from excessive drug
intake.
Dependence
Prolonged use of larger than usual therapeutic
doses may result in psychic and physical
dependence. Tolerance and psychologic dependence
may develop by the second week of continued administration.
Chloral hydrate addicts
may take huge doses of
the drug (i.e., up to 12
g nightly has been reported). This abuse
is similar to alcohol
addiction and sudden withdrawal
may result in central
nervous excitation,
with tremor, anxiety, hallucination,
or even delirium which
may be fatal. In patients
suffering from chronic
chloral hydrate
intoxication, gastritis
is common and skin eruptions
may develop. Parenchymatous renal
injury may also occur.
Withdrawal should be undertaken in a hospital
and supportive treatment similar to that used during barbiturate
withdrawal is recommended.
DRUG INTERACTIONS
Chloral hydrate may
cause hypoprothrombinemic
effects in patients taking oral anticoagulants (See WARNINGS).
Administration of chloral
hydrate followed by
intravenous furosemide
may result in sweating, hot
flashes, and variable
blood pressure
including hypertension due to a hypermetabolic state
caused by displacement
of thyroid hormone from its bound
state.
Caution is recommended in combining chloral
hydrate with other CNS
depressants such as alcohol
barbiturates and
tranquilizers. Administration of chloral hydrate should be delayed
in patients who have ingested significant
amounts of alcohol in
the preceding 12 to 24 hours. CNS
depressants are additive in effect
and the dosage should
be reduced when such combinations
are given concurrently.
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