CHLORAL HYDRATE:
Drug is used primarily in pediatric patients.
Availability note (2026): oral chloral hydrate products have been discontinued from the U.S. market and are generally obtainable only via compounding — confirm current availability and your facility policy before relying on this agent.
Description:
A pure sedative hypnotic with no analgesic properties. It may produce a state of disinhibition with an agitated response to noxious stimuli. It is used as an adjunct for painful therapeutic procedures. Most effective in children less than 4 years of age. See table for more information.
Dosage and Route of Administration:
Oral: 25-100 mg/kg up to 1g dose (max of 2g in 2 divided doses)
Onset: 15-30 Minutes
Peak effect: 30-60 minutes
Duration: 60 minutes (residual sedation may persist for 10 or more hours in toddlers, but 20 hours or more in neonates)
Adverse reactions
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Desaturation, respiratory depression and airway obstruction, agitation, ataxia, vomiting, cardiac arrhythmias.
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Increased risk of direct and indirect hyperbilirubinemia and kernicterus in newborns.
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Metabolic acidosis with repeat administration particularly in neonates.
- Not recommended for repeat use in neonates.
- Single use will produce prolonged sedation in preterm infants and full-term infants< 1 month of age.
Drug interactions
- Cautious use with other sedatives or opioids – may increase the risk of respiratory complications.
- May alter the rate of metabolism of warfarin or warfarin-related anticoagulants.
Contraindications
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Preterm and term neonates (repeat dosing).
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Should not be used on a chronic basis
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Patients with significant hepatic or renal disease
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Patients with cardiac dysrhythmias
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Patients who have previously exhibited an idiosyncrasy or hypersensitivity to the drug
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Oral dose contraindicated in patients with gastritis
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Patients with Porphyria
Antagonist
- None available
Educational reference for sedation providers, relocated from the previous version of this site — not a substitute for the current package insert, your facility protocols, or clinical judgment. Verify all doses against current references before clinical use.