Clonidine Brand Names
Catapres | Catapres-TTS | Duraclon | JENLOGA | Kapvay | NEXICLON XR
What is Clonidine
Clonidine is a centrally acting alpha2 agonist used transdermally for the treatment of hypertension, orally for the treatment of hypertension and attention-deficit hyperactivity disorder (ADHD), and parenterally as an epidural agent for refractory cancer pain.
It is similar to guanabenz in mechanism of action, although clonidine is less expensive.
Synthesized in the early 1960s for use as a nasal decongestant, clonidine was serendipitously found to produce hypotension, bradycardia, and sedation at remarkably low doses.
Clonidine has been used successfully for a variety of other conditions ‘off-label’, including opiate withdrawal, nicotine withdrawal, vascular headaches, diabetic diarrhea, glaucoma, ulcerative colitis, and for hot flashes.
Clonidine is used ‘off-label’ for Tourette’s syndrome, particularly when comorbid ADHD is present.
The American Academy of Neurology practice guideline states that clonidine is probably more likely than placebo to reduce tic severity in patients with Tourette’s syndrome or chronic tic disorders. For those with comorbid ADHD, clonidine may provide benefits for both conditions.
Clonidine is not considered a first-line agent for ADHD due to the potential for toxic cardiac effects and the availability of safer and more effective agents (i.e., methylphenidate, amphetamines).
When clonidine is used for the treatment of ADHD, the American Heart Association recommends careful cardiovascular screening and monitoring of patients; weigh the benefits of treatment against the risks (e.g., sedation, hypotension).
Single doses of clonidine have been used in the diagnosis of pheochromocytoma. Clonidine is effective in the treatment of severe pain in cancer patients refractory to opiate agonists.
Epidural clonidine seems to be more effective in patients with neuropathic pain rather than visceral pain.
The use of epidural clonidine has resulted in decreases in opiate requirements when used in combination with epidural opiate agonists and increases the duration of response to anesthetic agents used in peripheral nerve blocks.
Indications
- alcohol withdrawal
- andropause
- attention-deficit hyperactivity disorder (ADHD)
- autistic disorder
- benzodiazepine withdrawal
- cyclosporine nephrotoxicity prophylaxis
- diabetic neuropathy
- diarrhea
- growth hormone deficiency diagnosis
- hot flashes
- hypertension
- hypertensive emergency
- hypertensive urgency
- menopause
- neonatal abstinence syndrome
- neuropathic pain
- opiate agonist withdrawal
- peripheral nerve block
- pheochromocytoma diagnosis
- scleroderma renal crisis
- severe pain
- tobacco cessation
- Tourette’s syndrome
Side Effects
- abdominal pain
- agitation
- alopecia
- angioedema
- anorexia
- anxiety
- arrhythmia exacerbation
- arthralgia
- asthenia
- AV block
- blurred vision
- bradycardia
- chest pain (unspecified)
- confusion
- constipation
- contact dermatitis
- delirium
- depression
- diaphoresis
- dizziness
- drowsiness
- dysgeusia
- dyspnea
- edema
- elevated hepatic enzymes
- emotional lability
- erythema
- fatigue
- fever
- fluid retention
- GI obstruction
- gynecomastia
- hallucinations
- headache
- heart failure
- hepatitis
- hyperesthesia
- hypotension
- hypoventilation
- ileus
- impotence (erectile dysfunction)
- infection
- insomnia
- irritability
- lethargy
- libido decrease
- maculopapular rash
- malaise
- meningitis
- muscle cramps
- musculoskeletal pain
- nasal congestion
- nasal dryness
- nausea
- nightmares
- nocturia
- orthostatic hypotension
- pallor
- palpitations
- paresthesias
- parotitis
- peripheral vasoconstriction
- pruritus
- QT prolongation
- rash
- restlessness
- sinus tachycardia
- skin hyperpigmentation
- skin ulcer
- stroke
- syncope
- throat irritation
- thrombocytopenia
- tremor
- urinary incontinence
- urinary retention
- urticaria
- vesicular rash
- vomiting
- weight gain
- withdrawal
- xerophthalmia
- xerostomia
Monitoring Parameters
- blood pressure
Contraindications
- abrupt discontinuation
- anticoagulant therapy
- AV block
- bradycardia
- breast-feeding
- cardiac disease
- cerebrovascular disease
- children
- coagulopathy
- defibrillation (cardioversion)
- dehydration
- depression
- diabetes mellitus
- driving or operating machinery
- females
- geriatric
- heart failure
- hypotension
- infants
- infection
- intrathecal administration
- labor
- magnetic resonance imaging (MRI)
- myocardial infarction
- obstetric delivery
- orthostatic hypotension
- pheochromocytoma
- polyarteritis nodosa
- pregnancy
- Raynaud’s phenomenon
- renal disease
- renal failure
- renal impairment
- scleroderma
- sick sinus syndrome
- skin abrasion
- surgery
- syncope
- systemic lupus erythematosus (SLE)
- thromboangiitis obliterans (Buerger’s disease)
- vomiting
Interactions
- Acarbose
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Dichloralphenazone; Isometheptene
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Pseudoephedrine
- Acetazolamide
- Acrivastine; Pseudoephedrine
- Albiglutide
- Aldesleukin, IL-2
- Alemtuzumab
- Alogliptin; Metformin
- Alpha-glucosidase Inhibitors
- Alprazolam
- Alprostadil
- Amifostine
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amlodipine; Celecoxib
- Amoxapine
- Amphetamine
- Amphetamine; Dextroamphetamine
- Amphetamine; Dextroamphetamine Salts
- Amyl Nitrite
- Apomorphine
- Apraclonidine
- Aripiprazole
- Articaine; Epinephrine
- Asenapine
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Baclofen
- Benzodiazepines
- Benzonatate
- Benzphetamine
- Beta-blockers
- Bortezomib
- Bosentan
- Brexpiprazole
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Cabergoline
- Canagliflozin
- Canagliflozin; Metformin
- Cannabidiol
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbidopa; Levodopa
- Carbidopa; Levodopa; Entacapone
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Carbonic anhydrase inhibitors
- Cardiac glycosides
- Cariprazine
- Celecoxib
- Cenobamate
- Ceritinib
- Cetirizine
- Cetirizine; Pseudoephedrine
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chlophedianol; Guaifenesin; Phenylephrine
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chloroprocaine
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpromazine
- Clomipramine
- Clonazepam
- Clorazepate
- Clozapine
- Co-Enzyme Q10, Ubiquinone
- Cocaine
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Crizotinib
- Cyclobenzaprine
- Cyclosporine
- Dapagliflozin
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Desipramine
- Desloratadine; Pseudoephedrine
- Deutetrabenazine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexmethylphenidate
- Dextroamphetamine
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Diazepam
- Diazoxide
- Diclofenac
- Diclofenac; Misoprostol
- Diethylpropion
- Diflunisal
- Digitoxin
- Digoxin
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diltiazem
- Dipeptidyl Peptidase-4 Inhibitors
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Dobutamine
- Dopamine
- Doxepin
- Dulaglutide
- Duloxetine
- Empagliflozin
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Enflurane
- Ephedrine
- Epinephrine
- Epoprostenol
- Ertugliflozin
- Ertugliflozin; Metformin
- Ertugliflozin; Sitagliptin
- Esketamine
- Esomeprazole; Naproxen
- Estazolam
- Estradiol
- Estradiol Cypionate; Medroxyprogesterone
- Ethanol
- Etodolac
- Etomidate
- Exenatide
- Famotidine; Ibuprofen
- Fenoprofen
- Fexofenadine; Pseudoephedrine
- Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
- Fluoxetine; Olanzapine
- Fluphenazine
- Flurazepam
- Flurbiprofen
- Fospropofol
- Gabapentin
- General anesthetics
- Glipizide; Metformin
- Glyburide; Metformin
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guaifenesin; Phenylephrine
- Guaifenesin; Pseudoephedrine
- Haloperidol
- Halothane
- Hydralazine; Isosorbide Dinitrate, ISDN
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Iloperidone
- Iloprost
- Imipramine
- Incretin Mimetics
- Indomethacin
- Insulin Degludec; Liraglutide
- Insulin Glargine; Lixisenatide
- Insulins
- Intravenous Lipid Emulsions
- Isoflurane
- Isoproterenol
- Isosorbide Dinitrate, ISDN
- Isosorbide Mononitrate
- Ketamine
- Ketoprofen
- Ketorolac
- Lansoprazole; Naproxen
- Lasmiditan
- Levocetirizine
- Levodopa
- Levomilnacipran
- Linagliptin; Metformin
- Liraglutide
- Lisdexamfetamine
- Lixisenatide
- Lofexidine
- Loratadine; Pseudoephedrine
- Lorazepam
- Lovastatin; Niacin
- Lumateperone
- Lurasidone
- Macimorelin
- Maprotiline
- Meclofenamate Sodium
- Mefenamic Acid
- Meglitinides
- Meloxicam
- Meperidine; Promethazine
- Mesoridazine
- Mestranol; Norethindrone
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methamphetamine
- Methazolamide
- Methylphenidate
- Midazolam
- Midodrine
- Miglitol
- Milnacipran
- Milrinone
- Mirtazapine
- Monoamine oxidase inhibitors
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nateglinide
- Nesiritide, BNP
- Niacin, Niacinamide
- Niacin; Simvastatin
- Nitrates
- Nitroglycerin
- Nitroprusside
- Nonsteroidal antiinflammatory drugs
- Norepinephrine
- Nortriptyline
- Olanzapine
- Opiate Agonists
- Oxaprozin
- Oxazepam
- Oxymetazoline
- Paliperidone
- Pentoxifylline
- Perphenazine
- Perphenazine; Amitriptyline
- Phendimetrazine
- Phenothiazines
- Phentermine
- Phentermine; Topiramate
- Phenylephrine
- Phenylephrine; Promethazine
- Pimozide
- Piroxicam
- Pramlintide
- Prazosin
- Pregabalin
- Prilocaine; Epinephrine
- Procainamide
- Procaine
- Prochlorperazine
- Promethazine
- Propofol
- Protriptyline
- Pseudoephedrine
- Quazepam
- Quetiapine
- Quinidine
- Rasagiline
- Repaglinide
- Risperidone
- Ritodrine
- Rofecoxib
- Semaglutide
- Sevoflurane
- SGLT2 Inhibitors
- Silodosin
- Sulfonylureas
- Sulindac
- Temazepam
- Tetrabenazine
- Tetracaine
- Thiazolidinediones
- Thiethylperazine
- Thioridazine
- Thiothixene
- Tizanidine
- Tolmetin
- Trandolapril; Verapamil
- Trazodone
- Triazolam
- Tricyclic antidepressants
- Trifluoperazine
- Trimipramine
- Valdecoxib
- Verapamil
- Yohimbine
- Ziprasidone
