Drug interactions
Buprenorphine long-acting + Chloral hydrate
Severity: Major
Buprenorphine long-acting and Chloral hydrate: major interaction.
Last updated Sources: UK SmPC
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 the central nervous system and respiratory depression caused by buprenorphine. The combination can cause profound sedation, respiratory depression, coma and death, and the long-acting depot formulation cannot be quickly withdrawn if problems arise.
What this interaction means in plain words
Buprenorphine long-acting 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.
Why it happens
Additive pharmacodynamic CNS and respiratory depression from opioid receptor agonism combined with sedative-hypnotic GABAergic activity.
What to do
Avoid the combination where possible, or use the lowest effective doses for the shortest duration. Monitor closely for sedation and respiratory depression, and counsel the patient and caregivers on warning signs.
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?
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References
- Chloral Hydrate 143mg/5ml Oral Solution - SmPC sections 4.3/4.5 (class statement: narcotic analgesics; "Concomitant use with antipsychotics, hypnotics, anxiolytics/sedatives, antidepressant agents, centrally acting muscle relaxants, narcotic analgesics, anti-epile") — electronic medicines compendium (UK SmPC)
Other interactions of Chloral hydrate
- Calcium / magnesium / potassium / sodium oxybates + Chloral hydrate Contraindicated
- Chloral hydrate + Sodium oxybate Contraindicated
- Alfentanil + Chloral hydrate Major
- Alprazolam + Chloral hydrate Major
- Amobarbital + Chloral hydrate Major
- Belladonna and opium + Chloral hydrate Major
Frequently asked questions
Can I take Buprenorphine long-acting with Chloral hydrate?
MediHelp rates the interaction as major. Buprenorphine long-acting 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 the central nervous system and respiratory depression caused by buprenorphine. The combination can cause profound sedation, respiratory depression, coma and death, and the long-acting depot formulation cannot be quickly withdrawn if problems arise.
How serious is the interaction between Buprenorphine long-acting 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 the combination where possible, or use the lowest effective doses for the shortest duration. Monitor closely for sedation and respiratory depression, and counsel the patient and caregivers on warning signs.
What other medicines interact with Chloral hydrate?
MediHelp also lists interactions of Chloral hydrate with, for example, Calcium / magnesium / potassium / sodium oxybates, Sodium oxybate, Alfentanil. The full list is on the Chloral hydrate page.
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