Chloroform

(BAN, rINN)
Chloroform Chemical formula

💊 Chemical information

Chloroformium Anesthesicum; Chloroformum; Chloroformum pro Narcosi; Cloroformo. Trichloromethane.
Chemical formula: CHCl3 = 119.4.
CAS — 67-66-3.
ATC — N01AB02.
ATC Vet — QN01AB02.

Pharmacopoeias.

In Br., Chin., and Viet.

BP 2008

(Chloroform). A colourless volatile liquid with a characteristic odour. Not more than 5.0% v/v distils below 60° and the remainder distils at 60° to 62°. It contains 1.0 to 2.0% v/v of ethyl alcohol; amylene 50 micrograms/mL is permitted as an alternative to ethyl alcohol. Slightly soluble in water; miscible with dehydrated alcohol, with ether, with fixed and volatile oils, and with most other organic solvents. Store in containers with glass stoppers or other suitable closures. Protect from light. The label should state whether it contains ethyl alcohol or amylene.

Stability.

The addition of a small percentage of alcohol greatly retards the gradual oxidation that occurs when chloroform is exposed to air and light, and which results in its becoming contaminated with the very poisonous carbonyl chloride (phosgene) and with chlorine; the alcohol also serves to decompose any carbonyl chloride that may have been formed. From a study 1 of chloroform losses from chloroform water and from 6 typical BPC mixtures under various conditions of storage the following shelf-lives were recommended: chloroform solutions and non-sedimented mixtures could be stored in wellclosed well-filled containers for 2 months at ambient temperatures; when stored in partially-filled containers and periodically opened the shelf-life should not exceed 2 weeks; sedimented mixtures could be stored for 2 months in well-closed well-filled containers, but because loss of chloroform could be expected in containers periodically opened such mixtures should be prepared as required or packed in their final containers; for chloroformcontaining mixtures in the home a shelf-life of 2 weeks was suggested. 1. Lynch M, et al. Chloroform as a preservative in aqueous systems: losses under "in-use" conditions and antimicrobial effectiveness. Pharm J 1977; 219: 507–10.

Storage.

It has been recommended 1 that if the period of use would exceed 6 weeks, PVC bottles should not be used for storing or dispensing: Chloroform and Morphine Tincture, or aqueous mixtures containing more than 5% thereof; mixtures or dispersions in which chloroform is present in excess of its aqueous solubility; aqueous mixtures containing chloroform and high concentrations of electrolytes; or of mixtures containing chloroform water. 1. Anonymous. Plastics medicine bottles of rigid PVC. Pharm J 1973; 210: 100.

💊 Adverse Effects and Precautions

Chloroform depresses respiration and produces hypotension. Cardiac output is reduced and arrhythmias may develop. Poisoning can lead to respiratory depression and cardiac arrest. Delayed hepatotoxic and nephrotoxic reactions have occurred 6 to 24 hours after a dose; symptoms may include abdominal pain, vomiting, and, at a later stage, jaundice. Liquid chloroform is irritant to the skin and mucous membranes and may cause burns if spilt on them. Suitable precautions should be taken to avoid skin contact with chloroform as it can penetrate skin and produce systemic toxicity. Chloroform is not flammable. Care should be taken not to vaporise chloroform in the presence of a flame because of the production of toxic gases. In the UK medicinal products are limited to a chloroform content of not more than 0.5% (w/w or v/v as appropriate) of chloroform. Exceptions include supply by a doctor or dentist, or in accordance with his prescription, to a particular patient, and supply for anaesthetic purposes. In the USA the FDA has banned the use of chloroform in medicines and cosmetics, because of reported carcinogenicity in animals. It has also been withdrawn from systemic use in other countries. The sale within or import into England and Wales and Scotland of food containing any added chloroform is prohibited. See also Adverse Effects and Precautions for General Anaesthetics.

Breast feeding.

No adverse effects have been seen in breastfed infants whose mothers were receiving chloroform, and the American Academy of Pediatrics1 considers that it is therefore usually compatible with breast feeding.
1. American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 2001; 108: 776–89. Correction. ibid.; 1029. Also available at: http://aappolicy.aappublications.org/cgi/content/full/ pediatrics%3b108/3/776 (accessed 25/05/04)

Porphyria.

Chloroform has been associated with acute attacks of porphyria and is considered unsafe in porphyric patients.

💊 Uses and Administration

Chloroform is a volatile halogenated anaesthetic that was used by inhalation, but safer drugs are now preferred in general anaesthesia. Chloroform is used as a carminative and as a flavouring agent and preservative. For these purposes it is usually employed as Chloroform Spirit (BP 2008) or Double-strength Chloroform Water (BP 2008) but doubts have been cast on the safety of the long-term use of chloroform in mixtures. Externally, chloroform has a rubefacient action. Chloroform is also used as a solvent.

Anaesthesia.

An historical review of the use of chloroform in clinical anaesthesia.1
1. Payne JP. Chloroform in clinical anaesthesia. Br J Anaesth 1981; 53: 11S–15S.

💊 Preparations

BP 2008: Chloroform and Morphine Tincture; Chloroform Spirit; Doublestrength Chloroform Water. Proprietary PreparationsMulti-ingredient: Belg.: Dentophar; Rus.: Eludril (Элюдрил); Espol (Эспол); S.Afr.: Diphenhydramine Expectorant Syrup; Mrs Johnsons American Soothing Syrup; SB Toothache Drops; Tandpyndruppels; Vicks Acta Plus; Venez.: Fiometil†; Gamasol†; Iodex†; Rubefric†.
Published October 13, 2018.