Formulary
Clonidine hydrochloride: Indications, Dosing, Side Effects and Interactions
Clonidine hydrochloride clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Clonidine hydrochloride: Indications, Dosing, Side Effects and Interactions
Clonidine hydrochloride clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Hypertension**
- **Adult** (By Mouth): Initially 50-100 micrograms 3 times a day, increase dose every second or third day, usual maximum dose 1.2 mg per day.
**Prevention of recurrent migraine,Prevention of vascular headache,Menopausal symptoms, particularly flushing and vasomotor conditions**
- **Adult** (By Mouth): Initially 50 micrograms twice daily for 2 weeks, then increased if necessary to 75 micrograms twice daily.
**Severe hypertension for clonidine hydrochloride**
- **Child 2-17 years** (By mouth): Initially 0.5-1 microgram/kg 3 times a day, dose can be gradually increased if necessary up to 25 micrograms/kg daily in divided doses; maximum 1.2 mg per day.
- **Child 2-17 years** (By slow intravenous injection): 2-6 micrograms/kg for 1 dose (max. per dose 300 micrograms).
Cautions
Cerebrovascular disease; constipation; heart failure; history of depression; mild to moderate bradyarrhythmia; polyneuropathy; Raynaud's syndrome or other occlusive peripheral vascular disease Cautions, further information Elderly For centrally-acting antihypertensives, Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information): potentially inappropriate unless clear intolerance of, or lack of efficacy with, other classes of antihypertensives (generally less well tolerated by older people).
Contraindications
Severe bradyarrhythmia secondary to second- or third-degree AV block or sick sinus syndrome
Side effects
Common or very common Constipation; depression; dizziness; dry mouth; fatigue; headache; nausea; postural hypotension; salivary gland pain; sedation; sexual dysfunction; sleep disorders; vomiting Uncommon Delusions; hallucination; malaise; paraesthesia; Raynaud's phenomenon; skin reactions Rare or very rare Alopecia; atrioventricular block; dry eye; gynaecomastia; intestinal pseudo-obstruction; nasal dryness Frequency not known Accommodation disorder; arrhythmias; confusion
Interactions
**Other interactions (4):**
- Concurrent administration of antihypertensive agents, vasodilators or diuretics may lead to an increased hypotensive effect.
- Substances with alpha 2 -receptor blocking properties, such as mirtazapine, may abolish the alpha 2 - receptor mediated effects of clonidine in a dose-dependent manner.
- Concomitant use of beta-blockers and/or cardiac glycosides can cause bradycardia or dysrhythmia (AV-block) in isolated cases.
- Orthostatic hypotension may be provoked or aggravated by concomitant administration of tricyclic antidepressants or neuroleptics with alpha-receptor blocking properties.
Pregnancy
May lower fetal heart rate. Avoid oral use unless potential benefit outweighs risk. Avoid using injection.
Breast feeding
Avoid-present in milk.
Renal impairment
Manufacturer advises caution. Dose adjustments Manufacturer advises adjust dose according to response.
Medicinal forms
Solution,Tablet,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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