Clonidine

By Medically reviewed by hellodoktor

Generic Name: Clonidine Brand Name(s): Clonidine.

Uses

What is clonidine used for?

Clonidine is used alone or with other medications to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Clonidine belongs to a class of drugs (central alpha agonists) that act in the brain to lower blood pressure. It works by relaxing blood vessels so blood can flow more easily.

This drug may also be used for attention deficit hyperactivity disorder (ADHD), for hot flashes that occur with menopause, for withdrawal symptoms from narcotic drugs, and to help people quit smoking.

How should I take clonidine?

Take clonidine exactly as it was prescribed for you. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Clonidine is usually taken in the morning and at bedtime. If you take different doses of this medicine at each dosing time, it may be best to take the larger dose at bedtime.

Clonidine may be taken with or without food.

Do not use two forms of clonidine at the same time. This medicine is also available as a transdermal patch worn on the skin.

Do not crush, chew, or break an extended-release tablet. Swallow it whole. Tell your doctor if you have trouble swallowing the tablet.

If you need surgery, tell the surgeon ahead of time that you are using clonidine. You may need to stop using the medicine for a short time.

Do not stop using clonidine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Call your doctor if you are sick with vomiting. Prolonged illness can make it harder for your body to absorb this medicine, which may lead to withdrawal symptoms. This is especially important for a child taking clonidine.

If you are being treated for high blood pressure, keep using this medication even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

How do I store clonidine?

Clonidine is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store clonidine in the bathroom or the freezer. There may be different brands of clonidine that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush clonidine down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using clonidine?

Before using this drug, tell your doctor if:

  • You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • You have allergy with any of active or inactive ingredients of clonidine or other medications.
  • You have any other illnesses, disorders, or medical conditions.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using clonidine during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking clonidine. Clonidine is pregnancy risk category C, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from clonidine?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • Fast or pounding heartbeats
  • A very slow heart rate (fewer than 60 beats per minute)
  • Feeling short of breath, even with mild exertion
  • Swelling, rapid weight gain
  • Confusion, hallucinations
  • Fever, pale skin
  • Urinating less than usual or not at all
  • Numbness or cold feeling in your hands or feet
  • Feeling like you might pass out
  • Severe skin irritation, redness, swelling, burning, or blistering where the patch is worn

Less serious side effects may include:

  • Feeling dizzy, drowsy, tired, or nervous
  • Dry mouth
  • Dry or burning eyes, blurred vision
  • Headache, muscle or joint pain
  • Nausea, vomiting, constipation, loss of appetite
  • Sleep problems (insomnia)
  • Urinating more at night
  • Mild skin rash or itching;
  • Decreased sex drive, impotence
  • Skin rash, discoloration, or mild irritation where the patch is worn

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with clonidine?

Clonidine may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Products that may interact with this drug are:

  • Other heart or blood pressure medications
  • An antidepressant
  • Any other medicine that contains clonidine

Does food or alcohol interact with clonidine?

Clonidine may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with clonidine?

Clonidine may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Health conditions that may interact with this drug are:

  • Bradycardia (slow heartbeat)
  • Coronary insufficiency
  • Dehydration
  • Heart attack
  • Heart block
  • Heart or blood vessel disease
  • Heart rhythm problems
  • Hypotension (low blood pressure)
  • Kidney disease
  • Stomach or intestinal problems
  • Stroke
  • Syncope (fainting)
  • Kidney disease

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using clonidine.

What is the dose of clonidine for an adult?

Usual Adult Dose for Hypertension:

Initial dose (PO): 0.1 mg orally twice a day (morning and bedtime).

Maintenance dose: 0.2 to 0.6 mg/day given in divided doses.

Initial dose (patches): Clonidine TTS-1 (0.1 mg/24 hr) applied once a week.

Maintenance dose: If after 1 to 2 weeks the desired reduction in blood pressure is not achieved, increase the dosage by adding another TTS-1 film or changing to a larger system.

An increase in dosage above 2 clonidine TTS-3 films is usually not associated with additional efficacy.

Extended-release tablets:

  • Initial dose: 0.17 mg orally once daily at bedtime. Further increments of 0.09 mg orally once daily may be made at weekly intervals if necessary until the desired response is achieved.
  • Maintenance dose: 0.17 mg to 0.52 mg orally once daily at bedtime

Extended-release oral suspension:

  • Initial dose: 0.17 mg (2 mL) orally once daily at bedtime. Further increments of 0.09 mg (1 mL) orally once daily may be made at weekly intervals if necessary until the desired response is achieved.
  • Maintenance dose: 0.17 mg to 0.52 mg orally once daily at bedtime

Usual Adult Dose for Pain:

Continuous Epidural Infusion:

Initial dose: 30 mcg/hr.

May be titrated up or down depending on pain relief and occurrence of adverse events.

Maximum dose 40 mcg/hr.

Usual Adult Dose for Pheochromocytoma Diagnosis:

0.3 mg orally once. Clonidine is only recommended after baseline determination of plasma catecholamines. Two baseline samples can be obtained five minutes apart from an existing IV line after the patient has remained supine for 90 minutes (a new needle stick could increase catecholamine concentrations and foul the test).

After the initial dose of clonidine, three additional hourly blood samples may be obtained for plasma catecholamine concentration measurements.

Generally, patients with hypertension and pheochromocytoma do NOT show a decrease in plasma catecholamine levels after this “suppression test”, whereas hypertensive patients without pheochromocytoma do. False negative tests have been reported.

Usual Adult Dose for Hypertensive Emergency:

0.2 mg orally once. Additional doses of 0.1 mg may be given as needed and tolerated every hour to control this patient’s blood pressure. Be cognizant of the risk of stroke or heart attack or other problem associated with aggressive blood pressure reduction, especially in older persons. The maximum recommended total daily dose in any case of emergent hypertension is 0.8 mg.

Some clinicians report a poor antihypertensive effect of clonidine in patients with spinal injuries since this drug acts on the central nervous system to inhibit peripheral sympathetic tone, and the central and peripheral nervous systems are disrupted in these patients.

Usual Adult Dose for Alcohol Withdrawal:

0.1 mg orally twice a day or TTS-1 (0.1 mg) transdermal patch once a week.

Usual Adult Dose for Anxiety:

0.1 mg orally twice a day or TTS-1 (0.1 mg) transdermal patch once a week.

Usual Adult Dose for Benzodiazepine Withdrawal:

0.1 mg orally twice a day or TTS-1 (0.1 mg) transdermal patch once a week.

Usual Adult Dose for Migraine Prophylaxis:

0.1 mg orally twice a day or TTS-1 (0.1 mg) transdermal patch once a week.

Usual Adult Dose for Perimenopausal Symptoms:

0.1 mg orally twice a day or TTS-1 (0.1 mg) transdermal patch once a week.

Usual Adult Dose for Smoking Cessation:

0.1 mg orally twice a day or TTS-1 (0.1 mg) transdermal patch once a week.

Usual Adult Dose for Bipolar Disorder:

0.1 mg orally twice a day or TTS-1 (0.1 mg) transdermal patch once a week.

Usual Adult Dose for Opiate Withdrawal:

0.2 mg orally twice a day or TTS-2 (0.2 mg) transdermal patch once a week.

What is the dose of clonidine for a child?

Usual Pediatric Dose for Attention Deficit Disorder:

May be used alone or as an adjunct to stimulants.

Immediate release (unlabeled indication):

Children less than or equal to 45 kg:

  • Initial dose: 0.05 mg orally at bedtime. Increase sequentially every 3 to 7 days by 0.05 mg increments as 2 times daily, then 3 times daily, then 4 times daily.
  • Maximum dose: 0.2 mg/day orally for patients weighing 27 to 40.5 kg; 0.3 mg/day for patients weighing 40.5 to 45 kg.
  • When discontinuing therapy, taper gradually over 1 to 2 weeks.

Children greater than 45 kg:

  • Initial dose: 0.1 mg orally at bedtime. Increase sequentially every 3 to 7 days by 0.1 mg increments as 2 times daily, then 3 times daily, then 4 times daily.
  • Maximum dose: 0.4 mg/day.
  • When discontinuing therapy, taper gradually over 1 to 2 weeks.

Extended release (Kapva {R}):

Children greater than or equal to 6 years:

  • Initial dose: 0.1 mg orally at bedtime. Increase in 0.1 mg/day increments every 7 days until desired response. Doses should be administered twice daily (either split equally or with the higher split dosage given at bedtime).
  • Maximum dose: 0.4 mg/day orally
  • Note: Maintenance treatment for greater than 5 weeks has not been evaluated.
  • When discontinuing therapy, taper daily dose by less than or equal to 0.1 mg every 3 to 7 days.
  • Transdermal: Children may be switched to the transdermal delivery system after oral therapy is titrated to an optimal and stable dose; a transdermal dose approximately equivalent to the total oral daily dose may be used.
  • The dose of clonidine extended-release tablets, administered either as monotherapy or as adjunctive therapy to a psychostimulant, should be individualized according to the therapeutic needs and response of the patient. Dosing should be initiated with one 0.1 mg tablet at bedtime, and the daily dosage should be adjusted in increments of 0.1 mg/day at weekly intervals until the desired response is achieved. Doses should be taken twice a day, with either an equal or higher split dosage being given at bedtime.

How is clonidine available?

Clonidine is available in the following dosage forms and strengths:

  • Tablet
  • Suspension

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of clonidine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: July 18, 2017 | Last Modified: September 13, 2019

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