Chloral Hydrate and Warfarin Interaction: Clinical Significance?

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Abstract
Chloral hydrate has been cited among the sedatives and hypnotics capable of altering the anticoagulant response to coumarin drugs. The clinical significance of any interaction between chloral hydrate and oral anticoagulants has not been clarified. The effect of chloral hydrate in patients receiving long-term therapy with warfarin was studied in 17 subjects. Prothrombin times and plasma warfarin levels were measured during treatment with chloral hydrate (or its equivalent as chloral betaine) and compared with similar data obtained during placebo control treatment periods. No significant differences were found in mean prothrombin times, plasma warfarin levels, or daily warfarin doses between chloral hydrate versus placebo treatment periods in each of three separate experiments. It is concluded that the clinical significance of any interaction between warfarin and chloral hydrate is negligible for patients receiving long-term therapy with warfarin under the conditions of this experiment.

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