Adverse Reactions and Side EffectsChloral hydrate, eszopiclone ● ● Use Cautiously in:● pressed or suicidal patients • Patients with history of drug abuse or dependence • Patients with hepatic, renal, or respiratory dys-function • Patients susceptible to acute intermittent porphyria (● InteractionsRamelteon ● ● ● ● ● ● ● ● ● of:The effects chloral hydrateDrowsinessLethargyAmnesiaConcomitantly with flNauseaPhysical and/or psychological dependenceDry mouthUnpleasant tasteRashSevere hepatic function impairmentParadoxical excitementDizzinessHeadacheAre increased by:) • Elderly or debilitated patients • De- uvoxamineAre decreased by:Sedative-Hypnotics Concurrent use may result in: ●^517
2 2506_Ch30_511-521.indd Sec2:517 506 Ch 30 511 - 521 .indd SRamelteonEszopicloneChloral ehydratec 2 : 517 Drugs that inhibit the Alcohol Alcohol, azole antipsychoticsritonavir, nelfi naviritraconazole, ketoconazole, CYP3A4 enzyme system, includingnefazodone, hypnotics, includingfl uoxetineantihistamines, clarithromycin, antidepressants, opioids, sedative/antifungals, CNS depressants and other^ Rifampin;Lorazepam; or immediately mealthat induce the ramelteon with or CYP3A4 enzyme or heavy mealhigh-fat or heavy afterimmediately after a system, such aseszopiclone with rifampin; a high-fat taking taking drugs^ Increased effects of Additive CNS depression hypertension, weakness, hot fl ashes, tachycardia, symptoms of sweating, oral anticoagulants; CNS depressants, decreased effects withand nausea with opioids, sedative/antidepressants, hypnotics, antipsychotics; furosemide; cludingeffects of of lorazepam alcohol antihistamines, phenytoindecreased and otherContinuedIV in-^1 10/1/10 9:40:40 AM 0 / 1 / 10 9 : 40 : 40 AM