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May 12, 1975

Furosemide and Chloral HydrateAdverse Drug Interaction

Author Affiliations

From the departments of medicine (Dr. Malach) and pharmacy (Mr. Berman), The Brooklyn Hospital, Brooklyn-Cumberland Medical Center, Brooklyn, NY.

JAMA. 1975;232(6):638-639. doi:10.1001/jama.1975.03250060034019

THIS article deals with an adverse effect from the combination of intravenously administered furosemide (40 to 120 mg) preceded by oral nocturnal sedation with chloral hydrate in the same 24-hour period. These observations took place under the closely monitored control of the coronary care unit of The Brooklyn Hospital, in patients with a diagnosis of acute myocardial infarction of coronary insufficiency and congestive heart failure.

The reaction consisted of diaphoresis, hot flashes, variable blood pressure including hypertension, and uneasiness in six patients. The substitution of flurazepam hydrochloride (Dalmane) as a nocturnal sedative in the same patients and its routine use subsequently in all patients in the coronary care unit has not resulted in any such reaction. The specificity of the reaction was clear and was noted on two separate occasions in the same patient (see next section). Repeated intravenous doses of furosemide without chloral hydrate in the preceding 24 hours