Furosemide Injection and Chloral Hydrate: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Chloral Hydrate
No brand names on recordFurosemide Injection
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
An increased risk of flushing, sweating attacks, restlessness, nausea and an increased blood pressure and tachycardia
Interaction Deep Dive
Concomitant use of furosemide with chloral hydrate is not recommended21. There have been isolated cases of cardiac toxicity (ie, flushing, sweating attacks, restlessness, nausea, increase in blood pressure, and tachycardia) when IV furosemide was administered within 24 hours of chloral hydrate administration 213. This interaction may be more predominant in the presence of hypoalbuminemia 5. In patients who require IV furosemide therapy, an alternate hypnotic drug may be preferable 3.
Why it happens (mechanism)
Unknown
Literature reports
3 reports — tap to read
a) Concomitant chloral hydrate and furosemide (IV) therapy has been reported to result in toxic effects consisting of diaphoresis, skin flushing, uneasiness and blood pressure variations 45. This interaction occurred in an 8-year-old patient who experienced similar adverse effects, except changes in blood pressure. The adverse effects abated in 15 to 20 minutes without intervention 6. This interaction may be more predominant in the presence of hypoalbuminemia. The mechanism is unclear at the present time; however, it may involve competition for protein binding sites 5.
b) Patients (n=5262) who received either chloral hydrate or flurazepam and furosemide over a period of 6 years were studied. The study group consisted of 43 patients who received both chloral hydrate and furosemide (chloral hydrate being administered within the previous 24 hours). The remainder of the patients were placed in control groups. Of the 43 patients in the study group, 1 patient exhibited symptoms of a drug interaction (tachycardia, increased blood pressure, diaphoresis, weakness, and nausea) immediately following IV administration of furosemide (80 mg). Chloral hydrate (500 mg orally) had been given 8 hours earlier. Two patients were evaluated as having a possible drug interaction ("being on fire", mild respiratory distress, and generalized discomfort). No patient in any of the control groups exhibited manifestations of this reaction. Until further investigations are available, the combination of IV furosemide and chloral hydrate should be administered with caution or avoided 4.
c) A case was reported where a 68-year-old female 12 hours status post MI who had received 80 mg of furosemide and 500 mg of chloral hydrate within a 12 hour period. The patient developed flushes, tachycardia (140 beats/min), severe diaphoresis, and a blood pressure of 169 mmHg following a second dose of furosemide. Chloral hydrate was discontinued although furosemide therapy was administered over the next 3 days without any further sequela. However, rechallenge of the patient with a 500 mg dose of chloral hydrate with IV furosemide 40 mg 8 hours later resulted in an immediate reaction similar to the previous. The data suggests that these drugs should not be administered concomitantly 5.
Common questions
Can I take Furosemide Injection and Chloral Hydrate together?
An increased risk of flushing, sweating attacks, restlessness, nausea and an increased blood pressure and tachycardia Always confirm with your pharmacist or prescriber before making any change.
How serious is the Furosemide Injection and Chloral Hydrate interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Furosemide Injection or Chloral Hydrate need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (6)
- Product Information: LASIX® ONYU subcutaneous injection, furosemide subcutaneous injection. SQ Innovation, Inc (per manufacturer), Burlington, MA, 2025. DailyMed
- Product Information: FUROSCIX(R) subcutaneous injection, furosemide subcutaneous injection. scPharmaceuticals Inc (per FDA), Burlington, MA, 2025. DailyMed
- Product Information: SOMNOTE(R) oral capsules, chloral hydrate oral capsules. Breckenridge Pharmaceuticals,Inc, Boca Raton, FL, 2004. DailyMed
- Pevonka MP, Yost RL, Marks RG, et al: Interaction of chloral hydrate and furosemide. Drug Intell Clin Pharm 1977; 11:332-335. DOI
- Malach M & Berman N: Furosemide and chloral hydrate: adverse drug reaction. JAMA 1975; 232:638-639. DOI
- Dean RP, Rudinsky BF, & Kelleher MD: Interaction of chloral hydrate and intravenous furosemide in a child. Clin Pharm 1991; 10:385-387.
Keep reading about Chloral Hydrate
Keep reading about Furosemide Injection
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