Drug interactions
Chloral hydrate + Ketamine
Severity: Major
Chloral hydrate and Ketamine: 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
Both agents are used for procedural sedation, and combining them can produce deeper sedation than intended. Airway compromise, hypoxia and loss of protective reflexes are possible, particularly in children.
What this interaction means in plain words
Chloral hydrate and Ketamine 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 belongs to Central Nervous System; Ketamine belongs to Central Nervous System.
Why it happens
Additive CNS depression from GABAergic chloral hydrate metabolite and NMDA antagonism by ketamine.
What to do
Use only where airway management, pulse oximetry and continuous monitoring are available, and reduce doses accordingly. Observe until fully recovered.
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
Other interactions of Ketamine
Frequently asked questions
Can I take Chloral hydrate with Ketamine?
MediHelp rates the interaction as major. Chloral hydrate and Ketamine 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. Both agents are used for procedural sedation, and combining them can produce deeper sedation than intended. Airway compromise, hypoxia and loss of protective reflexes are possible, particularly in children.
How serious is the interaction between Chloral hydrate and Ketamine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use only where airway management, pulse oximetry and continuous monitoring are available, and reduce doses accordingly. Observe until fully recovered.
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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