Drug interactions
Chloral hydrate + Fentanyl transdermal
Severity: Major
Chloral hydrate and Fentanyl transdermal: 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 with transdermal fentanyl can cause profound sedation, hypotension, respiratory depression, coma and death. Fentanyl continues to be released from the skin depot even after patch removal, prolonging the risk.
What this interaction means in plain words
Chloral hydrate and Fentanyl transdermal 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 from opioid and sedative-hypnotic effects.
What to do
Avoid if possible; otherwise limit doses and duration and reduce fentanyl or chloral hydrate dose. Monitor respiration and sedation closely.
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
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 Fentanyl transdermal?
MediHelp rates the interaction as major. Chloral hydrate and Fentanyl transdermal 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 with transdermal fentanyl can cause profound sedation, hypotension, respiratory depression, coma and death. Fentanyl continues to be released from the skin depot even after patch removal, prolonging the risk.
How serious is the interaction between Chloral hydrate and Fentanyl transdermal?
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 limit doses and duration and reduce fentanyl or chloral hydrate dose. Monitor respiration and sedation closely.
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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