Off Label Use of Chloral Hydrate to sedate neonates and children in critical care

Dear Colleagues,

I am very pleased to announce the publication of this latest position statement produced by the Neonatal and Paediatric Pharmacist Group (NPPG) in conjunction with the Paediatric Critical Care Society (PCCS).

This position statement has been prepared following the recent MRHA Drug Safety Update in October 2021 describing new restrictions to the use of Chloral Hydrate and Chloral Betaine.
This statement helps provide information and clarity around the off-label use of chloral hydrate in management of neonates and children where chloral hydrate is used to provide sedation in critical care. It provides information on the indications for use of chloral hydrate in critical care as well as advice on how chloral hydrate should be used and when doses should be weaned.

We do hope that this position statement provides useful information and advice to guide your practice.

Nigel Gooding
Neonatal and Paediatric Pharmacist Group Chair