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Drug interactions

Buprenorphine + Chloral hydrate

Severity: Major

Buprenorphine and Chloral hydrate: major interaction.

Last updated Sources: US FDA label

For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.

Summary

Chloral hydrate is a sedative-hypnotic that adds to opioid sedation and respiratory depression. Combined use can lead to excessive sedation and potentially fatal respiratory depression.

What this interaction means in plain words

Buprenorphine and Chloral hydrate can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.

Buprenorphine belongs to Musculoskeletal; Chloral hydrate belongs to Central Nervous System.

Evidence level: Moderate

Why it happens

Additive CNS depression from opioid agonism and the GABAergic effects of trichloroethanol.

What to do

Avoid if possible; otherwise use the lowest doses and monitor sedation and respiratory rate closely. Consider a non-sedating alternative.

What to ask your pharmacist

  • Does the benefit of taking both outweigh the risk in my case?
  • Do I need any blood test, ECG or other check while on both?
  • What early warning signs should I watch for, and what should I do if they appear?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Buprenorphine with Chloral hydrate?

MediHelp rates the interaction as major. Buprenorphine and Chloral hydrate can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Chloral hydrate is a sedative-hypnotic that adds to opioid sedation and respiratory depression. Combined use can lead to excessive sedation and potentially fatal respiratory depression.

How serious is the interaction between Buprenorphine and Chloral hydrate?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible; otherwise use the lowest doses and monitor sedation and respiratory rate closely. Consider a non-sedating alternative.

What other medicines interact with Buprenorphine?

MediHelp also lists interactions of Buprenorphine with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Olanzapine / samidorphan. The full list is on the Buprenorphine page.

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