Drug interactions
Chloral hydrate + Remimazolam
Severity: Major
Chloral hydrate and Remimazolam: 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
Remimazolam is an ultra-short-acting benzodiazepine used for procedural sedation, and chloral hydrate adds to its sedative and respiratory depressant effects. The combination may cause deeper than intended sedation, hypoventilation or apnea.
What this interaction means in plain words
Chloral hydrate and Remimazolam 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; Remimazolam belongs to Central Nervous System.
Why it happens
Additive GABAergic CNS and respiratory depression.
What to do
Titrate remimazolam carefully with reduced doses, and continuously monitor oxygenation, ventilation and vital signs through the procedure and recovery. Have airway support and reversal agents 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
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 Remimazolam
Frequently asked questions
Can I take Chloral hydrate with Remimazolam?
MediHelp rates the interaction as major. Chloral hydrate and Remimazolam 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. Remimazolam is an ultra-short-acting benzodiazepine used for procedural sedation, and chloral hydrate adds to its sedative and respiratory depressant effects. The combination may cause deeper than intended sedation, hypoventilation or apnea.
How serious is the interaction between Chloral hydrate and Remimazolam?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate remimazolam carefully with reduced doses, and continuously monitor oxygenation, ventilation and vital signs through the procedure and recovery. Have airway support and reversal agents 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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