Drug interactions
Chloral hydrate + Diamorphine
Severity: Major
Chloral hydrate and Diamorphine: 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
Diamorphine (heroin) is a potent opioid, and chloral hydrate increases the risk of profound sedation and respiratory depression. Fatal respiratory arrest is possible, especially at higher doses.
What this interaction means in plain words
Chloral hydrate and Diamorphine 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 CNS and respiratory depression.
What to do
Avoid concurrent use where possible, or use the lowest doses with close monitoring of respiration and sedation. Keep naloxone and airway equipment available.
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 Chloral hydrate with Diamorphine?
MediHelp rates the interaction as major. Chloral hydrate and Diamorphine 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. Diamorphine (heroin) is a potent opioid, and chloral hydrate increases the risk of profound sedation and respiratory depression. Fatal respiratory arrest is possible, especially at higher doses.
How serious is the interaction between Chloral hydrate and Diamorphine?
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 concurrent use where possible, or use the lowest doses with close monitoring of respiration and sedation. Keep naloxone and airway equipment available.
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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