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Chloral Hydrate

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Indications

Insomnia

In adults, Chloral Hydrate oral solution is used for the short-term treatment of severe insomnia, for a maximum of 2 weeks. It is meant for insomnia that is interfering with normal daily life, where other therapies (behavioural and pharmacologic) have failed. It should be used as an adjunct to non-pharmacological therapies. For children and adolescents aged 2 years and above, Chloral Hydrate oral solution is indicated for short-term treatment (maximum 2 weeks) of severe insomnia. This applies to those with suspected or definite neurodevelopmental disorder, when the insomnia is interfering with normal daily life and other therapies (behavioural and pharmacologic) have failed. Treatment should be given as an adjunct to behavioural therapy and sleep hygiene management. Using Chloral Hydrate Oral Solution in children and adolescents is not generally recommended, and if it is used, it should be under the supervision of a medical specialist.

⚠️ Always consult a registered physician before taking any medicine.

Pharmacology

Chloral hydrate has been used for many years as a sedative and hypnotic, in both human and veterinary medicine. Its pharmacological effect comes from its metabolite, trichloroethanol. Several mechanisms have been proposed for how it depresses the central nervous system. These include potentiating the function of GABAA receptors, inhibiting excitatory amino acid-activated currents mediated by N-methyl-D-aspartate, and allosteric modulation of the 5-hydroxytryptamine 3 receptor-mediated depolarization of the vagus nerve.

Pregnancy & Breastfeeding

Pregnancy: There isn't much information on how chloral hydrate might harm a human pregnancy. It is known to cross the human placenta at term, but it was used in relatively few pregnancies and no detectable increase in abnormal outcomes was seen. Some data suggest that giving sedative doses of chloral hydrate to neonates for a long time makes hyperbilirubinemia more likely.

Breast Feeding: Low levels of chloral hydrate have been found in breast milk. Breastfeeding infants may be sedated by the chloral hydrate in the milk. Still, the highest concentration measured in milk (about 15 µg/ml) was considerably lower than what would be found in blood at a clinically active dose (100 µg/ml).

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.

Adults: Treatment with chloral hydrate should be as short as possible, and it must not go beyond 2 weeks. Repeat courses are not recommended. They can only be given after a medical specialist has re-assessed the patient, because the risk of abuse and dependence grows the longer the treatment lasts. After prolonged treatment, the dose should be tapered slowly before stopping. Chloral Hydrate Oral Solution is not generally recommended for children and adolescents. If it is used, a medical specialist should supervise it. Chloral Hydrate 143 mg/5 ml Oral Solution is taken as a single daily dose, 15 to 30 minutes before bedtime, with water or milk. Adults: The usual dose is 430-860 mg (15-30 ml of the 143 mg/5 ml strength). Higher doses should not exceed a maximum of 2 g chloral hydrate (70 ml of the 143 mg/5 ml strength) per dose. Elderly: The dose is the same as for adults. For the frail elderly, or for those with hepatic impairment, a reduction in dose may be appropriate (see section 4.4). Children 12 years and over: The usual dose is 430-860 mg (15-30 ml of the 143 mg/5 ml strength). Higher doses should not exceed a maximum of 2 g chloral hydrate (70 ml of the 143 mg/5 ml strength) per dose. Children (between 2 and 11 years): 30-50 mg/kg (1-1.75 ml/kg of the 143 mg/5 ml strength) of bodyweight. The dose should not exceed 1 g chloral hydrate (35 ml of the 143 mg/5 ml strength) per dose. Children under 2 years: Chloral hydrate should not be used, because its safety and efficacy in children under 2 years has not been established.