Aquachloral Supprettes, Noctec, Novochlorhydrate
Classifications: anxiolytic, sedative-hypnotic; Therapeutic: antianxiety; sedative-hypnotic
Pregnancy Category: C
Controlled Substance: Schedule IV
500 mg capsules; 250 mg/5 mL, 500 mg/5 mL syrup; 324 mg, 500 mg, 648 mg suppositories
Produces "physiologic sleep" by mild cerebral depression with little effect on respirations or BP and little or
Chloral hydrate in low doses is a sedative-hypnotic which does not affect sleep physiology (e.g., REM sleep).
Short-term management of insomnia, general sedation (especially in the young and the older adult), sedation before and after
surgery, to reduce anxiety associated with drug withdrawal, and alone or with paraldehyde to prevent or suppress alcohol
Known hypersensitivity to chloral hydrate or chloral derivatives; severe hepatic, renal, or cardiac disease; rectal dosage
form in patients with proctitis; oral use in patients with esophagitis, gastritis, gastric or duodenal ulcers; pregnancy
History of intermittent porphyria, asthma, history of or proneness to drug dependence, depression, suicidal tendencies.
Route & Dosage
Adult: PO/PR 250 mg t.i.d. p.c.
Child: PO/PR 2550 mg/kg/d divided q68h (max: 500 mg/dose)
Adult: PO/PR 500 mg1 g 1530 min before h.s. or 30 min before surgery
Geriatric: PO/PR 250 mg h.s.
Child: PO/PR 50 mg/kg 1530 min before h.s. or 30 min before surgery (max: 1 g)
Child: PO/PR 2025 mg/kg 3060 min prior to procedure
- Dilute liquid preparations in chilled fluids to minimize unpleasant taste.
- Watch to see that drug is not cheeked and hoarded.
- Moisten suppository with a water-based lubricant, such as K-Y jelly, prior to insertion.
- Solutions are preserved in tightly covered, light-resistant containers.
Adverse Effects (≥1%) Body as a Whole: Angioedema,
eosinophilia, breath odor, leukopenia
, ketonuria, renal
damage, sudden death. CV:
Arrhythmias, cardiac arrest. GI: Nausea, vomiting, diarrhea,
Dizziness, motor incoordination, headache. Skin:
Purpura, urticaria, erythematous
, erythema multiforme
, fixed drug eruptions. Special Senses: Conjunctivitis
Diagnostic Test Interference
False-positive results for urine glucose with Benedict's solutions, and possibly with Clinitest but not with glucose oxidase methods (e.g., Clinistix, Diastix, TesTape). Possible interference with fluorometric test for urine catecholamines (if chloral hydrate is administered within 48 h of test) and urinary 17-OHCS determinations (by modification of Reddy, Jenkins, Thorn procedure).
InteractionsDrug: Alcohol, barbiturates
other cns depressants
depression; tachycardia may also occur with alcohol;
increases anticoagulant effect of oral anticoagulants
; furosemide IV
can produce flushing, diaphoresis, BP changes.
Readily from oral or rectal administration
3060 min. Peak:
13 h. Duration:
48 h. Distribution:
Well distributed to all tissues; 7080% protein bound; crosses placenta. Metabolism:
In liver to the active metabolite
Primarily by kidneys; small amount excreted in feces via bile. Half-Life:
Assessment & Drug Effects
- Chloral hydrate is not intended for relief of pain. When used in the presence of pain, it may cause excitement and delirium.
- Do not discontinue abruptly following prolonged use. Sudden withdrawal from dependent patients may produce delirium, mania,
- Monitor for S&S of allergic skin reactions, which may occur within several hours or as long as 10 d after drug administration.
- Evaluate patient's response to chloral hydrate and continued need for the drug.
Patient & Family Education
- Do not ambulate without assistance until response to drug is known.
- Avoid concomitant use of alcoholic beverages.
- Avoid driving and other potentially hazardous activities while under the influence of chloral hydrate.